Family planning

Family planning, also known as contraception or birth control, is a way to control unwanted pregnancies. Many methods of family planning are available, so each couple should be able to find one that is right for them. Talk to your health-care provider to determine the best type of birth control for you.

Type of Family Planning Natural family planning
Natural family planning involves no introduction of chemical of foreign material into the body or sustaining from sexual intercourse during fertile period. Calendar Method. The calendar method requires a couple to abstain from coitus (sexual relations) on the days of a menstrual cycle when the woman is most likely to conceive (3 or 4 days before until 3 or 4 days after ovulation). To plan for this, the woman keeps a diary of six menstrual shortest cycles. To calculate safe days, she subtracts 18 from the shortest cycle documented. This number represents her first fertile day. She subtracts 11 from her longest cycle. This represents her last fertile day. If she had six menstrual cycles raging from 25 to 29 days, her fertile period would be from the 7th day (25 minus 18) to the 18th day (29 minus 11). To avoid pregnancy, she would avoid coitus during those days. Abstinence. Is the act of avoiding sex, whether sexual contact altogether or just intercourse. This method of family planning is the only one that is 100 percent effective in preventing pregnancy and protecting against sexually transmitted diseases (STDs). Abstinence can be difficult to maintain and allows for little spontaneity. Coitus Interruptus. Is the oldest known methods of contraception. The couple proceeds with coitus until the moment of ejaculation. Then the man withdraws and spermatozoa. Unfortunately, ejaculation may occur before withdrawal is complete and, despite the care used, some spermatozoa may be deposited in the vagina. Lactation Amenorrhea Method. As long as a woman is breastfeeding an infant there is some natural suppression of ovulation. Because women may ovulate, however, but not menstruate, a woman may still be fertile even she has not had a period since childbirth. If the infant is receiving a supplemental feeding or not sucking well, the use of lactation as an effective birth control method is questionable. As a rule, after 3 months of breastfeeding, the woman should be advised to choose another method of contraception.

Effect on Sexual Enjoyment
Once a couple is certain of a woman s nonfertile days using one of the natural planning methods that involve sexual relations is possible with the methods that involve vaginal insertion products. On the other hand, the required days of abstinence may make a natural planning method unsatisfactory and

unenjoyable for couple. Coitus interruptus may be unenjoyable because of the need to withdraw before ejaculation.

Barrier methods
Barrier methods are forms of birth control that work by the placement of a chemical or other barrier between the cervix and advancing sperm so that sperm cannot enter the uterus or fallopian tubes and fertilize the ovum. A major advantage of barrier methods is that they lack the hormonal side effects association with COCs. However, compared with COCs, their failure rates are higher and sexual enjoyment may be lessened.

Diaphragm. Is a circular rubber disk that is placed over the cervix before intercourse. A diaphragm is prescribed and fitted initially by a physician, nurse practitioner, or nurse-midwife to ensure a correct fit. A diaphragm is inserted into the vagina, after first coating the rim and center portion with spermicidal gel, by sliding it along the posterior wall and pressing it up against the cervix so hat it is held in place by the vaginal fornices. A woman should check her diaphragm with her finger after insertion to be certain that is fitted well up over the cervix; she can palpate the cervical or through the diaphragm. A diaphragm should remain in place for at least 6 hours after coitus, because spermatozoa remain viable in the vagina for that length of time. It may be left in place for as long as 24 hours. If it is left in the vagina longer than this, the stasis of fluid may cause cervical inflammation(erosion) or urethral irritation. Diaphragm is removed by inserting a finger into the vagina and loosening the diaphragm by pressing against the anterior rim and then withdrawing it vaginally. Cervical cap. Is made soft rubber, shaped like a thimble with a thin rim, and fit snugly over the uterine cervix. The advantage of cervical cap is it can remain in place longer than diaphragms, because they do not put pressure o the vaginal walls or urethra; however, this time period should not exceed 48 hours, to prevent cervical irritation.

The female condom. Is a soft, loose-fitting thin plastic pouch that goes inside a woman's vagina. You plan ahead and put it in before sex and use a new condom each time you have sex. Female condoms are plastic so people who are allergic to latex can use them. You can get them at drug stores and most health clinics.

The male condom. Is a late rubber or synthetic sheath that is placed over the erect penis before coitus to trap sperm. A major advantage of condoms is that they are one of the few male responsibility birth control measures available, and no healthcare visit or prescription is needed. Latex condoms protect you from STDs, including HIV.

Hormonal Methods
Hormonal contraceptives are, as the name implies, hormones that cause such fluctuations in a normal menstrual cycle that ovulation does not occur. Hormonal contraceptives may be administered orally, transdermally, vaginally, by implantation, or through injection. Vaginal Ring This small, soft plastic ring has hormones to prevent pregnancy. You place a new ring in your vagina every month. The ring is easy to use and is almost 100 percent effective.

Injectable progesterone (Depo Provera) You get a birth control shot once every 3 months from a doctor or nurse. The shot is an easy method and almost 100 percent effective if you get your shot ON TIME.

Intradermal Implant The Intradermal implant is a thin, 2-inch plastic rod that uses hormones to prevent pregnancy for 3 years. A clinic doctor or nurse inserts it under the skin on the inside of your arm. The implant is VERY effective.

IUD These small devices are inserted into your uterus. They work for 5-10 years. They are VERY effective.

Combination oral contraceptives (COCs) Also called pills. You take one pill at the same time every day. Missing a pill increases your chance of pregnancy. Pills are easy to take and are effective birth control that doesn't interrupt sex.

Transdermal patch The patch is a thin, stick-on square that is placed on your body to prevent the release of an egg. A new patch is used once a week for three weeks and the fourth week is patchfree. The patch is almost 100 percent effective when used the right way.

Surgical Methods
Surgical methods include vasectomy for men and tubal ligation for women.

Vasectomy
In vasectomy, a small incision or puncture would is made on each side of the scrotum. The vas deferens at the point is then located, cut and tied, cauterized, or plugged, blocking the passage of spermatozoa. Spermatozoa that were present in the vas deferens at the time of surgery can remain viable for as long as 6 months. Therefore, although the man ca resume sexual intercourse within 1 week, and additional birth control method should be used until two negative sperm reports have been obtained (proof that all sperm in the vas deferens have been eliminate, usually requiring 10 to 20 ejaculations).

Tubal Ligation
Sterilization of women could include removal of the uterus of ovaries (hysterectomy), but it is usually refers to a minor surgical procedure, such as tubal ligation, where the fallopian tubes are occluded by cautery, crushing, clamping, or blocking, thereby preventing passage of both sperm and ova. The most common operation to achieve tubal ligation is laparoscopy. After a menstrual flow and before ovulation, an incision as small as 1 cm is made just under the woman s umbilicus with the woman under general or local anesthesia. A lighted laparoscope is inserted through the incision. Carbon dioxide is then pumped into the incision to lift the abdominal wall upward and out of the line vision. The surgeon locates the fallopian tubes by viewing the field through a laparoscope. An electrical current to coagulate tissue is then passed thorugh the instrument for 3 to 5 seconds, or the tubes are clamped by plastic, metal, or rubber rings, then cut or filled with silicon gel to seal them. A woman may return to having coitus as soon as 2 to 3 days after the procedure. Effect on Sexual Enjoyment. Both tubal ligation and vasectomy may lead to increased sexual enjoyment, because they largely eliminate the possibility of pregnancy. However, if either partner changes his or her mind about having children, the surgery may become an issue between that that interferes not only with sexual enjoyment but also with their entire relationship.

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