OBJECTIVES Health Benefits to Children:

(WHO) "the use of a range of • Ensures better chance of

methods of a fertility regulation to survival at birth.
help individuals or couples attain • Promote better childhood
certain objectives: nutrition.
• avoid unwanted birth. • Promote physical growth
• bring about wanted birth. and development.
• Produce a change in the no. • Prevent birth defects.
of children born. Regulate
the intervals between Health Benefits to Father
pregnancies. Control time at • Allows father to keep a
which birth occur." constant balance between
their physical, mental, social
well-being.
Elements of family planning
3 important elements in family Benefits to Whole Family
planning: • Benefits to Whole Family
• Proper spacing Health - help the family
• Proper timing enjoy the better kind of life.
• No. of pregnancies • Increase father sense of
respect because he is able
Benefits to provide the type of
Health Benefits to Mother education and home
• Reduce the health risk environment.
• Below 20y, And above 35 y.
At risk of developing TYPES OF FAMILY PLANNING
complications during • Natural family planning
pregnancy. • Barrier family planning
• physical strain of child • Permanent/surgical family
bearing. • Planning
• reduce number of maternal
death.
• reduce the risk of ovarian
cysts.
INTRODUCTION OF NATURAL before until 3 or 4 days after
FAMILY PLANNING ovulation). Woman keeps a
• No introduction of chemical diary of 6 menstrual cycles.
of foreign material into the
body. • This method may be used by
• Practice may be due to women whose menstrual
religious belief, "natural" way cycles are always between
is best for them. 26 and 32 days in length.
• Effectiveness varies greatly, • To calculate:
depends on couples ability o • 18 from shortest cycle
refrain from having documented -11 from
intercourse on fertile days. longest cycle = represents
• Failure Rates: about 25% her last fertile day.
Poses no risk to fetus • Example: If she has 6
menstrual cycles ranging
NATURAL FAMILY PLANNING from 25 to 29 days, fertile
• Rhythm (Calendar) method period would be from 7 th
• Basal Body Temperature day (25- 18) to the 18 th day
(BBT) (29-11). To avoid pregnancy,
• Ovulation or Cervical Mucus avoid coitus/use
Method contraceptive during those
• Symptothermal method days.
• Coitus Interruptus Disadvantages
• Lactation amennorhea Lifespan of
sperm+Reliability=Failure of
RHYTHM (Calendar) METHOD method
• The rhythm method, also
called the fertility awareness Base Body Temperature (BBT)
method, is a form of • Identifying fertile and infertile
pregnancy prevention where period of a woman's cycle by
couples calculate a woman's daily taking and recording of
fertile time using a calendar. the rise in body temperature
• Abstaining from coitus on during and after ovulation.
the days of menstrual cycle • Just before ovulation, a
when a woman is most likely woman's BBT falls about
to conceive (3 or 4 days 0.5°F At time of ovulation,
her BBT rises a full degree
 (influence of progesterone). daily. > Watch for midcycle
This higher level is abdominal pain Couple must
maintained the rest of abstain from intercourse until
menstrual cycle. 3 days after rise in temp. or
4 th day after peak of mucus
DISADVANTAGES change.
It is not a particularly reliable • More effective than BBT or
method of birth control, especially CM method alone Ideal
for women with irregular cycles. Failure rate: 2%
Remember that cervical mucus
does not let you know when you
will soon be ovulating, but sperm COTROS INTERRUPTUS
can live up to seven days inside • One of oldest known
the vagina. Any sperm deposited methods of contraception
ahead of time can still impregnate Couple proceeds with coitus
the woman. until the moment of
• Right before ovulation, the ejaculation which Offers little
mucus from the cervix protection.
changes from being cloudy
and scanty to being clear LACIATION AMENNORRHEA
and slippery. • The lactation amenorrhea
• The consistency of ovulation method (LAM) is a natural
mucus is like that of an egg birth control technique based
white and it can be stretched on the fact that lactation
between the fingers. It is the (breast milk production)
peak of her fertility. causes amenorrhea (lack of
• After the ovulation, the menstruation).
mucus tends to dry up again.
These are also safe days. DISADVANTAGES
• Ideal Failure rate: 3% • "an use this method only for
the first six months after birth
or until the first menstrual
Symptothermal Method period.
• Combines the cervical • LAM does not provide
mucus and BBT methods protection against
Watches temp. daily and SEXUALLY TRANSMITTED
analyzes cervical mucus INFECTIONS.
BARRIER METHODS • It is 17 cm in length with one
• Condoms (male and female) flexible polyurethane ring at
• Spermicidal each end.
• Sponge ADVANTAGES:
• Diaphragm ✓ Prevents STDs including
• Cervical cap HIV/AIDS
How it works: ✓Not damaged by oils and other
Breastfeeding interferes with the chemicals
release of the hormones needed
to trigger ovulation. ADVANTAGES:
• Simple spacing method
ADVANTAGES: • No side effects
• Breastfeeding on demand • Easily available, safe &
improves health for mother inexpensive Protects against
and baby. STDs
• Nothing to buy or use. DISADVANTAGES
• Chances of slip off and tear
Male condoms off
• These are made up of • Allergic reaction to latex
polyurethane or latex. • Failure rate: 16%
• Silicon used now a days to • High motivation
produce semi dry pre- • Only women who can use
lubricated forms. diaphragms can use female
• In India one particularly condom
brand is widely marketed as • Slippage occurs
'Nirodh. • Expensive
• Spermicidal - coated with • Failure rate 21% with typical
nonoxynol on inner and use and 5% with correct and
outer surfaces. consistent use.
Female condoms:
• It is a pouch made up of Diaphragm
polyurethane which lines the • Most common and easiest to
vagina and also external fit and use.
genitalia.
• Thin, nearly hemispherical
dome made of rubber or
latex material, with circular,
 covered metal spring at Ovarian cysts
periphery (flat type and coil Headache/migraine
type) Acne
• External diameter of rim is depressed/altered mood.
size of diaphragm – 45 mm
diameter rising in steps of 5 ADVANTAGES OF IUD
mm to 105mm (most • Safe
common 60,65,70,75,80) effective, Reversible
The device is introduced up to 3 • Long action, Inexpensive
hrs. before intercourse and is to DISADVANTAGES
be kept for at least 6 hrs after • Heavy bleeding and pain Pelvic
intercourse. inflammatory diseases
• Ectopic pregnancy
ADVANTAGES: • May come out accidently if not
• cheap properly inserted.
• No gross medical side
effects CONTRAINDICATION
• Control of pregnancy in History of PID
hands of woman Abnormal shaped uterus
> Ectopic pregnancy
• Reasonably safe when
Menorrhagia
properly used
• Prevent spread of STDs
though less effective than ARTIFICIAL
condom FAMILY PLANNING METHOD
Combined Oral Contraceptive
INTRAUTERINE DEVICES • Take a pill every day
Intrauterine Device The IUD is a • Can be very effective
small, T-shaped, • Very safe
plastic device that is inserted and • Helps reduce menstrual bleeding
left inside the uterus to prevent and cramps
pregnancy. • Some women have side-effects
at first-not harmful
SIDE EFFECTS • No protection against STIs
Amenorrhea
Intermenstrual bleeding and You may be able to start today
spotting •You can start any day of the
Abdominal/pelvic pain
menstrual cycle if we can be sure Possible side-effects
you aren't pregnant If you choose this method, you
may have some side-effects. They
How to take the pill are not usually signs of illness.
Take one pill each day, by mouth •But many women do not have
• any
If you use the 28-pill pack: •Often go away after a few months
Once you have finished all the pills Most common:
in •Nausea (upset stomach)
the pack, start new pack on the •Spotting
next day or bleeding between periods
If you use the 21-pill pack: •Mild headaches
•Tender breasts
•Dizziness
If you miss pills •Slight weight gain or loss
• ALWAYS take a pill as soon as
you remember, and continue
taking pills, one each day Crakontraceptives
Combined oral contraceptive pills
But if you miss 3 or more pills or Commonly used progestin are
start a pack 3 or more days late: either levonorgestrol or
norethisterone and estrogens are
•You must also use condoms or ethiyl estradiol or menstranol
avoid sex for the next 7 days
•AND if you miss 3 or Types:
more pills in week 3: Monophasic:
•Also skip the reminder fixed doses of both estrogen and
pills (or the pill-free progesterone
week) and go straight to the next throughout 21 day cycle.
pack
Biphasic:
If you miss a reminder pill (28-day constant amount of estrogen
packs only): Throw away the throughout cycle BUT increased
missed pill(s) and continue taking amount of progestin during the last
pills, one each day 11 days.
Triphasic: •Weight gain Headache
Varies level of estrogen and •Breast tenderness
progesterone. Closely mimic •vaginal infection
natural cycle, reducing • Mild HPN
breakthrough bleeding (bleeding •Depression
outside the normal menstrual flow) •increase blood clotting

Ptogesterone only pills

containdications
•Also known as "Minipill".
•ABSOLUTE:
• Contains just progesterone or
• Circulatory diseases
progesterone hormone.
•Severe HTN
•Causing plug of mucus in the
•Angina,ischemic heart dis.
neck of cervix
•Liver disease
block the entry of the sperm.
•Tumors
Example: levonorgesrol 75 μg,
•Pregnancy
desogestrel 75 μg
•breast cancer, breast feeding.
advantages
No side effect on breast feeding or
RELATIVE:
lactation
Age>40 yrs.
May be prescribed in patient
Smoker, history of jaundice
having diabetes, HTN, smoking
Diabetes
etc.
Reduce risk of PID
Benefits
contraceptive benefits:
DISADVANTAGES
• Protection against unwanted
Acne, mastalgia, headache
pregnancy
•Convenient to use.
Long acting contraceptives
Non-contraceptives benefits:
These are more suitable for
•Regulation of menstrual cycle
women who do not want to
• Reduction of dysmenorrhea
pregnant again or for few years.
• Protection against PID, fibroids,
THESE ARE:
ovarian cysts, chances
CONTRACEPTIVE INJECTIONS
of cancer.
IMPLANTS
PATCHES
•Side effects
•Dizziness
•Nausea
CONTRACEPTIVE INJECTIONS of accidental intercourse.
DEPOPROVERA & • drugs used ethinyl oestradiol
NORISTERET 2.5mg, premarin(conjugated
• Contain progesterone hormone. oestrogen) 15 mg.
Prevents ovulation. • Drug is taken orally twice daily
• Commonly used as for 5 days.
Depomedroxyl progesterone
acetate (DMPA) administered on STERILIZATION
deltoid muscle within 5 days of It is most effective method its
cycle. failure rate is 1/2000 so in this
• DOSE: 150 mg there is permanent termination .
• Provide protection for 3 months. VASECTOMY:
Small incision made on each side
Contraceptive implants of scrotum vas deferens is then
•It is a small device placed under cut and tied, cauterized or plugged
the skin •Contains progesterone . Blocking the passage of
hormone. spermatozoa.
•Works in a similar way to injection Does not interfere with production
•Contains 3 ketodesogestrel of sperms but does not pass
•Releases hormone about 60 mcg, beyond vas deferens .
gradually reduced to 30 mcg per
day over year. Before you decide
•Inhibts ovulation. •Let's discuss:
•Lasts for 3 years. Temporary methods are also
•NORPLANT – II available
•Vasectomy is a surgical
Emergency contraceptives procedure
•Used whithin 72 hrs, ovulation is • Has risks and benefits
either prevented or delayed. It •Prevents having any more
may be in form of: hormones, IUD, children
antiprogesterone •Permanent-decision should be
carefully considered
INDICATIONS •You can decide against
•Unprotected intercourse procedure any time before surgery
•Condom rupture
•Sexual assault •Very effective after 3 months of
procedure •Permanent and safe
HORMONES: •No apparent long term risks.
•MORNING AFTER PILLS:
• It preventing conception in case
 The procedure
DISADVANTAGES: 1. Medication helps you keep calm
•Slightly uncomfortable due and helps prevent pain
slightly pain and swelling after 2-3 2. You stay awake
days of the of the procedure 3. Small cut is made - not painful
•Bleeding may result in the 4. Tubes are blocked or cut
hematoma in scrotum . 5. Opening closed with stitches
6. Rest a few hours
The procedure Afterwards:
1.You will stay awake and get You should rest for 2 or 3 days
medication Avoid heavy lifting for a week
to stop pain No sex for at least 1 week
2. Small opening made in scrotum
- not painful Medical reasons to return
3. Tubes that carry sperm are cut In first week, come at once if:
and tied >High fever
4. The opening is closed >Pus or bleeding from wound
5. Rest 15 to 30 minutes >Pain, heat, swelling, redness of
Afterwards: wound
"You should rest for 2 days >Steady or worsening pain,
• Avoid heavy work for a few days cramps, tenderness in belly
• Important! Use condoms for >Fainting or very dizzy
next 3 months
At any time in the future, come at
Medical reasons to return once if:
Come at once if: >You think you may be pregnant
⚫ Swelling in first few hours after >Pain or tenderness in belly, or
surgery fainting
⚫ Fever in first 3 days
MINILAPROTOMY:
⚫ Pus or bleeding from wound
When the tubectomy is done
⚫ Pain, heat, redness of wound through small abdominal incision
along with some device.
PERMANENT/SURGICAL
METHODS VAGINAL LIGATION:
FemaleSterilization Tubectomy through vaginal route
Bilateral Tubal Ligation- Cutting or may be done along with vaginal
blocking of fallopian tube under plastic operation or on isolation.
local anesthesia with light sedation