S.

Specific Time Content Teaching Learning activities

No Objectives (Min.)
. Teaching AV aids Evaluation
Method

1 Teacher will ½ min Self-introduction- My name is meena khokhar, student of M.SC. (N) 1 st year. Lecture Verbally
be able to
establish
rapport with
group

2 Recall the 1min Do you have any idea about what is contraception? Lecture Verbally
previous
knowledge

3 Appraise 2min Introduction to topic: Lecture verbally

the topic method
India was the first country to launch National Family Planning Programme in 1952 and
adopt National population policy. The program was renamed as National Family Welfare
Programme in 1979. Since its launch a lot of efforts were made to reduce birth rates and
stabilize the population. In India, the family planning services are mainly concentrated on
preventing births rather than improving other factors. Secondly, birth prevention services
are dominated by sterilization operations, particularly tubectomy. Contraception is one
of the proximate determinants of fertility and the most important predictor of fertility
transition. The choice of the contraceptive method, however, is influenced by a host of
interdependent demographic, cultural, economic, and social factors which means that a
multidimensional approach needs to be adopted for analysing the contraceptive use
pattern.

4 To tell the 3 min Need of contraceptives: Lecture PPT What is the

students cum need of
 World’s population expected to reach 9 billion by 2050.
about the discussion contraceptive
 India accounts for 17% of world’s population. Wikipedia, The Free
 need of Encyclopedia s?
contraceptiv  Annually, 529,000 maternal deaths & 50 million morbidity.
es  In India, contraceptive prevalence is 48.3%
 21% of all pregnancies resulting live births are unplanned.
 If unmet need for contraceptionwas met, we can avoid
 52 million unwanted pregnancies
 25-50% of maternal deaths
5 To discuss 2 mins Contraceptives measures would be: Lecture PPT What are the
about the cum effect of
 Slow the pace of population growth
effects of discussion contraceptive
 Decrease abortion related complications and deaths
contraceptiv s?
 Cut down maternal care costs
es  Promote better maternal health
 Improve the health of children through provision of better nutrition and other care
……..beneficial to the society at large!!!
Population reference bureau, Washington, USA, Nov 2004
6 To discuss 2 mins  DEFINITION :- Lecture PPT What do you
about cum mean by
Contraception refers to the methods that are used to prevent pregnancy.
definition discussion contraceptive
and aim of  AIMS OF CONTRACEPTION:- s?
contraceptiv
-Family Planning
es
-Prevents STD’S – AIDS.
-Medical Grounds – To control stress of pregnancy, labor & lactation.
7 To discuss 3 mins Characteristics of ideal contraceptives: Lecture PPT What are the
about ideal  Highly effective. cum characteristic
contraceptiv  No side effects. discussion s of
 Independent of intercourse.
es contraceptive
 Rapidly reversible.
 Cheap. s?
 Widespread availability.
 Acceptable to all cultures and religions.
 For administration healthcare personnel not required.
 Easily distributed.
8 To discuss 2 mins Methods of contraception: Lecture PPT Name
about the cum different
 Natural methods
different discussion methods of
 Hormonal contraception
methods of  Oral contraceptio
contracepti  Non-oral n?
on.  IUCD
 Barrier methods
 Sterilization
 Emergency contraception
9 To discuss 2 mins  LAM is the use of breastfeeding as a contraceptive method . Lecture PPT What is full
about LAM  Breastfeeding reduce the probability of ovulation ,therefore reduce the chance of cum form of LAM?
pregnancy. discussion
 98% effective till 6 months , if baby is on exclusive breastfeeding.
10 To discuss 10 min  Calender method / safe period method / natural method. Lecture PPT Name
about  Depend on time of ovulation. cum different
different  Dangerous period – ovulation occurs on 14 day & ovum viable for 48-72 hrs & discussion methods
sperm remain alive for 24-48 hrs. so pregnancy occurs if coitus occur in this period.
method of used by
 Safe period – rest of cycle i.e. 5-6 days after mensturation & 5-6 days before next
contracepti females.
cycle.
on used by  Advantage – most natural
females  Disadvantage – most unreliable when cycle are irregular & ovulation time is
variable.
Mechanical .
Diaphargm. –
 Flexible rim made up of spring.
 Cup shaped synthetic rubber or plastic.
 Inserted into vagina over the cervix.
Cervical caps.
 Smaller than Diaphargm,
 Applied on cervix itself.
Advantages.
 Inexpensive.
 Do not require medical consultation.
Disadvantages.
 Demonstration by trained person needed for proper use.
 Failure most common – due to displacement of device.
 Cervicitis ( inflammation of cervix) & local irritation.
Female condoms
 Tube of thin rubber or polyurethane plastics, which is pre lubricated
 Closed at one end and has two flexible rings.
 How does it works: stop sperm entry vagina remove after intercourse.
Advantages
 Can be used with oil based lubricants
 Protect from STDs
 May be put before sex
 Protect against cx cancer
 Disadvantages –

Failure rate- 95% reliable

Vaginal rings:
NuvaRing is a flexible plastic (ethylene-vinyl acetate copolymer) ring that releases a low
dose of a progestin and an estrogen over 3 weeks.
Advantages –
 95-99% effective
 Long lasting.
 No need of health personnel
Dis-Advantages –
 Leads to sterility.
 Alterations in menstrual bleeding pattern
 No medical side effect
 Not interfere with sexual pleasure
 Prevent STIs
 spermicidal not accepted by some women.
 Infection may occur if cap not removed for long time.
 Not prevent HIV
After care and follow up:
 Remove 6-8 hrs.
  Not kept beyond 24 hrs
 Can be reused 50 times upto 6 months
 Failure rate-
<2%
11 To discuss 12mins Chemical methods: Lecture PPT Name some
about  Locally applied chemicals – anti-spermicidal. cum chemical
chemical  Foams, jellies. discussion methods
 Drugs –
methods method used by
 Steroidal –
used by females.
 Oral contraceptives and depot preparation.
females  Non-steroidal
Advantages:
 Cheap
 Easy available
 Protect against STD
 Add lubrication
 Disadvantages-10-30% failure
not like by people .
Steroidal
ORAL CONTRACEPTIVE PILLS (OCP)
 Recommended in women of younger age group ( up to 35 yrs )
 Mechanism of action.
 Synthetic preparation of estrogen & Progesterone.
 When taken orally, hormone level rises
 Negative feedback effect act on Anterior pituitary
 Inhibit Gonadotrophins (FSH & LH)
 Inhibit Ovulation.
Types.
 Combined pill.
 Minipill pill.
 Postcoital (Morning After) pill.
 Combined pill.
 Contains both
 Oestrogen (ethyl estradiol/mestranol) 20-50 Mg.
 Progesterone(norethisterone, norgestrel) 0.5-2mg.
 Availability
 MALA-N (21 Tab) & MALA-D (28 Tab-7 ferrous fumarate)
 Combined pill.
 Dosage –
 Everyday orally at night for 21 days. ( from 5th day to 25th day of cycle)
 7 day break for MALA-N
 During this bleeding occurs, which is not menstrual bleeding but is withdrawal
bleeding.
 Mechanism of action.
 Prevents Ovulation.
 Prevents Implantation.
 Makes cervical secretions thick & viscid & prevent entry of sperm in female
genital tract.
 Mini-pills
 Only progesterone.
 Dose – daily through whole of menstrual cycle.
 Action – ovulation not inhibited but prevents fertility.
 Makes cervical mucosa thick & decrease motility of fallopian tube.
.POSTCOITAL
 Within 72 hrs of unprotected intercourse.
 Dose – 2 combined pills immediately followed by 2 pill after12 hrs.
 Indication – only in emergency– rape, contraceptive failure, or unprotected sex.
Advantages– 100 % effectivity
Dis-Advantages. –
 Hypertension.
 Thromboembolism.
 Metabolic effects – diabetes & obesity.
 Carcinogenic effect – breast & cervix.
Contra-indications.
 Women having carcinoma of breast & uterus.
 Liver diseases
 Hyperlipidemia.
 Age group above 35 yrs.
Oral pills
Side effects
 A –abdomen pain
 C- chest pain
 H- headache
 E- eye problem
 S- severe leg pain
CHECKLIST FOR PRESCRIBING COCs
 Last menstrual period, rule out pregnancy
 Less than 6 months postpartum & lactating?
 Age, Cigarette smoking, h/o migraine
 Known case of diabetes or hypertension
 History of stroke, MI or thrombosis
 h/o jaundice/ liver disease
 h/o breast/ genital tract malignancies
h/o drug intake: Antitubercular, antiepileptic.
Depot preparation.
Injectable
 Oily solutions given intramuscularly.
Progestrin –
 Medroxyprogesterone acetate (DMPA) – IM every 3-6 months, 150-400mg.
 Norethindrone enanthate (NET-EN) – IM every 3 months , 200 mg.
Combined –
 Both estrogen & progesterone
 IM , monthly .
Sub-dermal implants
Types –
 Norplant – 6 flexible silastic (silicon) tubes
 35 mg progesterone.
 Norplant 2 – 2 rods of levonorgesterol
 Location – beneath skin of arm or forearm.
 Contraception – 3-6 yrs.
Advantages
 Highly effective, relatively cheap
  Protection starts with in 24 hrs
 No after care needed. Effective in long run , no protection for 5 years
 No sex interferences
 Prevent anemia
 No adverse effect on breast feed baby
Disadvantages
 Inserted and removed by trained personal
 Irregular bleeding, prolonged menstrual bleeding
 Headache
 Chance of ovarian cyst
 Injection
 Many women cannot take oral contraceptive regularly,
 Progestrone only contraceptive injection
DMPA or Depo- provera
NET- ET
Combined contraceptive injections: once a month
cyclofem, mesigna
action
 Inhibit release of egg
 Thickening of mucus
 Endometrium less suitable
Failure rate- 1%
12 To discuss 5 min Intrauterine contraceptive device Lecture PPT What is full
about  Device inserted into uterine cavity & left over varying periods of times for the cum form of
intrauterine purpose of contraception discussion IUDs?
 Made of copper wire & nylon thread which protrudes through through vagina, cervix
contraceptiv
 These are hormone releasing IUCD
e devices?  Intrauterine contraceptive device (IUCD)
 Ideal candidate.
 Has born one child.
 Normal menstrual cycle.
 No pelvic inflammation.
 Ready to check the device.
 Mechanism of action.
 Prevents implantation & growth of ovum.
 By aseptic inflammation & causing endometrium not suitable for implantation.
 Sperm phagocytization – by neutrophils & macrophages.
 Cu affects enzymes, motility
 Makes cervical mucus thick prevent entry of sperm.
 Intrauterine contraceptive device (IUCD)
Types.
 Non-medicated.
 1ST generation IUCD.
 Lippes Loop- serpentine or S shaped.
 Made up of Plastic.
 Medicated.
 2nd generation Cu made
 2 types.
 Cu T
 Cu T 200
 Newer like NOVA-7, NOVA-T
 3rd generation.
 Hormone releasing containing progesterone reservoir release continuously for 1
yr.
Cu – T.
 Most commonly used .
 Made up of Cu.
 ‘T’ shaped attached with a nylon thread.(tail)
 Frequently used
 Copper T 200 – available in government hospital,
 Life span -3 years
 Recently used for 5 years
 Multi load Copper- 250 : 3 yrs device
 Multi load Copper- 375 : 5 yrs device
 Cu –T 380 A 6 Yrs.
Method of insertion.
 Ideal time – during mensturation or within 48 hours ( As cervical cavity diameter is
more)
  Otherwise 6 week after delivery.
Advantages.
 Safe
 Effective
 Reversible
 Easily pulled out when not required.
 Long term contraception without adverse effect.
Disadvantages.
 May cause heavy bleeding.
 May come out accidently.
 Risk of ectopic pregnancy.
Contraindications.
 Suspected pregnancy.
 Pelvic inflammation.
 Heavy bleeding during mensturation.
 Suffering from carcinoma cervix.
13 To discuss 7 mins Terminal methods. Lecture PPT What do you
about  Permanent method cum mean by
permanent  Surgical methods. discussion tubectomy?
Tubectomy.
methods
 Fallopian tubes identified , cut , cut ends ligated & buried.
Laparoscopic occlusion.
 Tubes occluded using silicon rubber bands, rings or clips
 Method – quicker, simple, no hospitalization.
14 To discuss 2 min MEDICAL TERMINATION OF PREGNANCY. Lecture PPT When was
about MTP  Medical termination of pregnancy or MTP or abortion is allowed under MTP act cum MTP act was
1971. discussion started?
Indications.
 Medicals – continuation of pregnancy is hazardous to the mother.
 Eugenic – substantial risk to the child if born.
 Humanitarian ground.– when pregnancy is result of rape.
 Failure of contraceptive methods
Methods –
 Dilatation & curettage (D & C).
  Cervix dilated with dilator & implanted ovum removed by curettage of the
endometrium.
 Vacuum aspiration. (up to 12 weeks)
 Same cervix is dilated & contents are aspirated by vacuum / suction.
 Administration of prostaglandins.
 Prostaglandins are administered intravaginally
 Causes uterine contractions – expulsion of product of conception.
15 To explain 10 min CONTRACEPTIVE METHODS IN MALES Lecture PPT What are
about Methods cum natural
contraceptiv  Spacing methods. discussion methods
 Natural.
es methods used by
 Barrier.
in male  Chemical. males?
 Terminal methods.
 Spacing Methods
 Natural Method ( Coitus Interruptus)
 Oldest method of voluntary fertility.
 Male withdraws penis before ejaculation into vagina.
 Failure rate – high
Wrong Timing of Withdrawal
 Barrier method–
 Condom
 Most widely used.
 Made up of fine latex sheath.
Instructions –
 Should be worn on erect penis before intercourse.
 Air must be expelled
 Held carefully when withdrawing from vagina.
 A new condom should be used for each sexual act.
Barrier method
 Mechanism of action,
 Prevents deposition of semen into vagina.
 Advantages –
 Easily available , safe, inexpensive
 Use does not require medical supervision.
 Provide protection against STD.
 Dis-advantage
 May slip off or tear off.
 Interfere with sexual sensation.
 Chemical method.
 Antispermatogenic Drugs – inhibit spermatogenesis.
1. Male pill (Gossypol)
2. Hormonal preparation -- Testosterone
-- Testosterone with Danazol -- Cyproterone acetate
 Male pill ( Gossypol)
 Composition – Gossypol, phenolic derivatives of cottonseed oil.
 Dose – orally. 200mg/D.– 2 months followed by 60mg/wk.
 Mechanism of action – exact action not known.
 Causes azoospermia.
 Advantages – neither hormone nor antihormonal activity
 No change in libido & potency.
 Disadvantages – permanent azospermic after 6 months
Hormonal preparation
 Testosterone
 400 mg orally causes azospermia.
 Testosterone with Danazol.
 Cyproterone acetate.
 Related to progesterone.
 Potent anti-androgenic agent.
 Causes oligozoospermia & loss of libido.
 Calcium channel blockers.
 Block Ca channel on cell membrane of sperm.
 Prevents Ca influx – membrane becomes rigid & loaded with cholesterol.
 Rigid membrane prevents its binding to Zona Pellucida.
 So patient on Ca channel blockers (Nifedipine) for hypertension becomes sterile.
Terminal methods. Lecture
 Vasectomy :- cum
 Vasectomy
  One cm vas deference removed after clamping. discussion
 Both ends ligated & sutured.
 Mechanism of action – entry of sperm into semen prevented.
 Sperm production & hormones not affected.
 Post-operative instructions – use contraceptive measures (condom) as he is not
sterile ,after 30 ejaculations semen is free from sperm.
Advantages.—
 Simple, fast, less expensive & no hospitalization.
Disadvantages.
 Failure rate -0.15%
 Spontaneous recalalization.
 Autoimmune response.
No scalpel vas occlusion.
 Newer technique.
 Safe, convenient & acceptable
Principle – Elastomer injected get hardened insitu within 20 min & occlude it.
Methods
 Elastomer plugs.
 MEDICAL GRADE POLYURETHANE (MPU)
 MEDICAL GRADE SILICON RUBBER(MSR)
16 To 1 min Definition, aims, different contraceptives used by males and females and their pros and Verbally
summarize cons, MTP act.
the topic

LESSON PLAN
STUDENT TEACHER NAME :

: FAMILY PLANNING’s METHOD

LANGUAGE : ENGLISH

DURATION : 45 MINS

PLACE

DATE OF PRESENTATION : 20-3-2019

NAME OF SUPERVISOR :

GENERAL OBJECTIVE:

To enhance the knowledge of students regarding different methods of contraceptives.

Specific objective:
1- To I ntroduce the topic
2- To discuss about the ideal contraceptives.
3- To discuss about the contraceptive methods used by female with their pros and cons.
4- To discuss about the contraceptive methods used by male with their pros and cons.
5- To discuss about MTP act.