Topic: FAMILY PLANNING AND CONTRACEPTIVE METHODS
Subject: Midwifery And Reproductive Health
All Nursing Student’s And general People
As defined by WHO “ a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitude and responsible decisions by individual and couples, in order to promote the health and welfare of the family group and thus contribute effectively to the social development of a country.”
Objectives of family planning:
- To avoid unwanted births.
- To bring about wanted births.
- To regulate the interval between conceptions.
- To control the time at which births occurs in relation to the ages of the parents; and
- To determine the number of the children in the family.
Scope of family planning services: (as described by WHO )
- The proper spacing and limitations of birth.
- Advice on fertility.
- Education for parenthood.
- Screening for pathological conditions related to reproductive system (e.g. cervical cancer).
- Genetic counseling.
- Sex education.
- Premarital consultation and examination.
- Carrying out pregnancy test.
- Marriage counseling.
- The preparation of the couples for arrival of their first child.
- Providing services for unmarried mothers.
- Teaching home economics and nutrition.
- Providing adoption services.
An “eligible couple” refers to a currently married couple wherein the wife is in the reproductive age, which is generally assumed to lie between the ages of 15 – 49. There will be at least 150 – 180 such couples per thousand populations in this subcontinent.
“Target couple can be defined as the couples who have two living children.”
Contraceptive: It includes all temporary and permanent measures designed to prevent pregnancy resulting from coitus.
Contraceptive method: These are the preventive methods to help women avoid unwanted pregnancies.
Characteristics of ideal contraceptive:
Free of side effects
Acceptable to the user and sexual partner
Types of methods of contraception:
Temporary methods ( reversible)
- Physical / mechanical methods-
- Male- condom
- Female- vaginal diaphragm, cervical cap, vaginal sponge
- Chemical methods- Foam, creams, Jellies and pastes, suppositories etc.
- Combined methods- Combined use of mechanical and chemical devices e.g. condom together with a spermicidal jelly.
Intrauterine contraceptive devices ( IUCD)
- Non-medicated: Lippes loop
- Copper devices
- Progestesart ( progesterone releasing)
- Oral contraceptives ( oral pills)
- Combined pill ( oestrogen and progesterone)
- Mini pill/ Progesterone only pill ( POP)
- Sequential pill ( 2 weeks oestrogen only and than in 3rd weeks oestrogen and progesterone)
- Post coital pill
- Once a month pill ( long acting pill)
- Male pill ( under research)
- Emergency contraceptive pill ( ECP)
- Parenteral preparations ( Progestogen)
- Injections- Hormone depots ( DMPA- Depo madroxy progesterone acetate, NET- EN- Northisterone enanthate).
- Subdermal implants: Norplant
- Intra-uterine system- Progestogen
- Safe period
- Basal body temperature method
- Cervical mucous method
- Breast feeding/ LAM- lactational amennorrhoea method
- Sexual abstinence
- Sex without coitus
- Incomplete coitus
- Withdrawl method
- Contraceptive immunization- birth control vaccine.
Permanent or terminal methods (sterilization).
- Tubal ligation