FAMILY PLANNING Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and management, and infertility management. Family planning is sometimes used as a synonym for the use of birth control, though it often includes more. It is most usually applied to a female-male couple who wish to limit the number of children they have and/or to control the timing of pregnancy (also known as spacing children). Family planning services are defined as "educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved." HEALTH BENEFITS OF FAMILY PLANNING
Reduces the risk of pregnancies an the extremes of reproductive years ( less than 20 years old and more than 55 years old) Allows the woman to recover from illnesses before becoming pregnant. Helps improve maternal and child health. Helped improve the socioeconomic status of the family and eventually improve family health .Health problems related to poverty, malnutrition, common infections will reduced. Ensures planned and wanted pregnancies thus assuring the love and care of the family. Helps prevent the risk of abortion of unwanted pregnancy.
METHODS OF FAMILY PLANNING
A. INTRA-UTERINE DEVICE (IUD)
➢ This is a small device made of copper or plastic that is inserted inside the womb by
trained family planning health workers when the woman is menstruating or shortly after menstruation.
The IUD can be left inside the womb for 9 years before being replaced. A woman with IUD : • • Has to return to the Health Center after 1 month and 1 year after the IUD has been inserted then every year for follow up. Has to check the string attached to the IUD every month to see if the IUD is still in place.
The IUD prevents pregnancy by : • • • Preventing the ripe egg from being fertilized Interfering with the movement of the sperm Preventing implantation of the fertilized egg
➢ ADVANTAGES • • •
It is easy to use , there are very few instructions to remember The fertility of the woman returns to normal immediately after IUD removal. It is good for breastfeeding mothers because it does not affect breast milk production It is easy to remove by a trained family planning health worker if the couple wants to have a child It does not interfere with sexual intercourse
➢ DISADVANTAGE • • The IUD be expelled from the womb Does not protect against Acquired Immune Deficiency Syndrome and other sexually transmitted disease.
➢ CONTRAINDICATION • • • • The IUD is not advisable for a woman who: Is pregnant or thinks she is pregnant Has or had infection of the reproductive system Has breast cancer of the breast or womb
Has different sexual partner Has never had children
➢ POSSIBLE SIDE EFFECTS • • A woman may experience pain during and immediately after IUD insertion Heavy or irregular menstruation DANGER SIGNS P – Period Late (with signs of pregnancy)
A- Abdominal Pain or pain during sexual intercourse
I – Infection or Bad odor yellowish discharge coming out from vagina N- Not feeling well, has fever and chills S- String is missing or has become larger or shorter
A. PILLS ➢ A pill is taken by the woman everyday to prevent pregnancy • • A woman taking pills should not smoke Should have her blood pressure checked every 3 months
Should visit the health center every 6-12 months for follow up The pills prevent pregnancy by stopping the release of a ripe egg from the woman’s ovaries.
➢ ADVANTAGE • • • • • • • Safe and effective Easy to use Regulates irregular menstruation Reduces menstrual pains and tension Good for couples who do not want contraceptive devices placed inside the body. Good for anemic woman because it reduces the menstrual flow Does not interfere with sexual intercourse
➢ DISADVANTAGE • In some women it decreases milk production.
➢ CONTRAINDICATIONS • The pill is not advisable for a woman who is smoker • Is over 35 years old • Has hypertension ,diabetes heart disease cancer of the breast or womb • Has vaginal bleeding other than menstruation. • ➢ POSSIBLE SIDE EFFECTS • • • • • A. INJECTION Majority of the woman who use pill do not experience any side effects but some women experience Headache Vomiting Slight weight gain or weight loss Less bleeding than usual during her monthly period.
➢ This is given every 3 months to prevent pregnancy ➢ The injection prevents pregnancy by stopping the release of a ripe egg.
➢ ADVANTAGE • • • Very safe and effective Unlike the pill there is no daily routine Easy to use
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Can be used by breastfeeding mothers Protects against some kinds of cancer Effects lasts for 3 months Does not interfere with sexual intercourse
➢ DISADVANTAGE • • • Has to visit the health center every 3 months for her injection Effect of the injection is still present for 2-4 months even though the injection has been stopped. Does not protect against AIDS and STD
➢ CONTRAINDICATIONS • • • • Is pregnant or thinks she is pregnant Has vaginal bleeding of unknown cause Has breast cancer Has no menstruation not related to pregnancy or breastfeeding
➢ POSSIBLE SIDE EFFECTS
• • • A. CONDOM
Absence of menstruation by the 12th month use Irregular prolonged menstruation and spotting in the first 3-6 months of use Longer return to fertility ( 2-4 months after the contraceptive effect of the shot has worn off) Possible weight gain
➢ A sheet made out of latex rubber that is roiled over the erect penis before sexual intercourse, it keeps the sperm from getting into the vagina. • A condom user should know the following : • • • It is important to put the condom on the erect penis before the penis enters the vagina. Leave a little air space at the tip of the condom to catch the semen. He must hold on the rim of the condom as he pulls out his penis from the vagina. Do not use Vaseline or petroleum jelly as a lubricant because it can make the condom break.
• • • •
If the condom breaks during sexual intercourse wash the vagina with mild soap and water It is used only once It should be stored in a dark dry place, away from heat sunlight and fluorescent.
The condom prevents pregnancy by •
Collecting the semen containing the sperm that comes out from the penis thereby preventing the sperm from reaching the vagina. ➢ ADVANTAGE • • • • • • Effective if the man follows the correct way of using it. Easy to use and carry Easy to get (stores,bhws,family planning clinics) Helps protect women from genital tract infection and cancer of the cervix Helps prevent the transmission and spread of aids and other sexually transmitted disease. Does not require follow up
➢ DISADVANTAGE • • Woman may get pregnant if the condom breaks out or bursts Interferes with sexual intercourse
➢ CONTRAINDICATIONS • Has sexual partner who may be allergic to rubber • Fails to maintain an erect penis when the condom is used. ➢ POSSIBLE SIDE EFFECTS • Decrease sensitivity of the penis and loss of sexual arousal NATURAL METHODS
➢ Natural family planning methods are ways of preventing pregnancy without the use of drugs or devices. • This is done by observing the changes naturally occurring in the woman’s body. • • • • To use this method the couple must know when the woman body is producing a ripe egg that is when one is fertile. The changes in the woman’s body when she is fertile are noted and recorded. Around this time the couple must have a sexual intercourse To prevent pregnancy, sexual intercourse is done on days when the woman is not fertile. To achieve pregnancy, sexual intercourse is done on days when the woman is fertile.
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Can be used either to achieve or prevent pregnancy. Safe against the side effects of contraception method. No supplies or devices required, no procedures done. No need to go to the doctor Promotes active involvement of both sexual partners as well as foster and respect and understanding of each other. Helps the couple to discipline their mind and body Can be stopped anytime if the couple wants to have child.
➢ DISADVANTAGES • • • • • May be hard at first for the couple to follow the rules required in order to be successful. Difficult for the couples who seldom see each other Couple has mutually committed process Some couples develop emotional stress, because of the need to avoid sex during the woman fertile days. Two or more methods are usually followed.
➢ POSSIBLE SIDE EFFECTS • There are no known side effects on the natural family planning method.
A. EXAMINATION OF THE CERVICAL MUCUS / BILLING’S METHOD
➢ This is done by observing the consistency color and amount of the cervical mucus to determine if the woman can become pregnant (fertile or unsafe) or not. ➢ During the woman’s wet days the consistency of her cervical mucus ranger from a sticky, pasty mucus and becoming slippery stretchy wet mucus to very wet. ➢ On fertile or unsafe days, the consistency becomes very wet like the white of a raw egg. During this time, the couple should avoid sexual intercourse to prevent pregnancy from occurring. ➢ On dry days there is no mucus and the woman feels dry. During this time the woman is not fertile and the couple cam have sexual intercourse.
A. BODY TEMPERATURE
➢ The couple determines the fertile and unfertile in the woman’s cycle by observing and charting her basal body temperature daily. ➢ It has been known that during the ovulation (period when the ovary releases a ripe egg) the body temperature of the woman rises. ➢ Illnesses like colds, sore throat, vomiting and diarrhea however can affect the body temperature.
A. COMPLETE AND FULL BREAST FEEDING ➢ This is applicable to mother who only give breast milk and no others form of nutrition to their babies in the first 6 months. During this time her ovaries stop developing and releasing eggs.
➢ After 6 months, another family planning method is needed to prevent pregnancy even
if the mother still continues to breastfeed. ➢ Mother who do not breast feed start releasing eggs as early as 1-2 months after baby’s birth. A. RHYTM PETHOD
➢ The couple calculates the fertile days of the woman from menstrual cycle.It are important that the menses be regular. ➢ The release of the ripe egg is approximately fourteen days start of the menses .For the 4 days before and after this day are fertile or unsafe days. ➢ This is considered as the least effective Natural family planning method. ➢ The combination of recording body temperature, character of the cervical mucus and other changes the woman’s body increase the effectively of natural family planning .The couple can chart these methods simultaneously.
A. VASECTOMY ➢ Is a simple operation that makes a man sterile (cannot make a woman pregnant) It involves tying and cutting both the sperm tubes in the scrotum though which the sperm pass. ➢ With the tubes blocked sexual intercourse wall no longer result in pregnancy because the sperms will not reach the vagina. ➢ The operation done by a trained doctor, takes only 10-15 minutes under local anesthesia. ➢ Vasectomy prevents pregnancy by blocking the sperm from reaching the vagina.
➢ ADVANTAGES • • Effective and safe Easy to perform
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Permanent Minimal rest period required after the operation No long term side effects Does not decrease sexual ability or satisfaction Does not interfere with sexual intercourse
➢ DISADVANTAGES • • Requires assistance of a trained doctor Has to wear a condom or use any other family planning method or until the tubes have no more sperm cells in (15-20 ejaculation)
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Not advisable who may want more children because vasectomy is a permanent method A male below 25 years old or with les than 2 children. A male who has a lump in the scrotum A male who has hernia which must be corrected before the operation. A male who might allergy to the drug.
A. TUBAL LIGATION
➢ Tubal ligation is a simple operation that makes a woman sterile. (not able to have children) ➢ It involves tying and cutting both tubes where the egg travels from the ovaries to the womb. ➢ With the egg unable to pass through the tube to meet the sperm sexual intercourse will no longer result in pregnancy. ➢ The operation done by trained doctor takes for 15-30 minutes and does not normally require hospitalization. ➢ A woman who has been ligated will stop produce egg in her ovaries and will still menstruate but she will no longer get pregnant. ➢ Tubal ligation prevents pregnancy by blocking the ripe egg from reaching the womb.
➢ ADVANTAGES • • • • Effective and safe Easy to perform Permanent No long term side effects
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Does not decrease sexual activity or satisfaction Does interfere with sexual intercourse No need to use other family planning methods after the operation
➢ CONTRAINDICATIONS • • • • • • The operation is not advisable to couples who may want more children because it is permanent method. A woman below 25 years old or with less than 2 children A woman who is pregnant or thinks she is pregnant A woman who has goiter , diabetes or hypertension A woman who is severely malnourished A woman who is very fat