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Ariana Katrin 12310055
Desy Arianti 12310102
Fadliansyah Sutisna 12310151
Lolla Silviani 12310264
Septa Setiawanto 12310430
Vera Farida

Language Center of Malahayati

B. She fears any form of surgery and has not excluded having another child. She occasionally drinks alcohol and smokes half a pack of cigarettes a day. divorced executive presents to your clinic for contraceptive advice. She is looking for the “best contraceptive method” for she situation. She and her boyfriend are sexually transmitted disease (STD ) – free based on their recent checkups. All of her three children were born via vaginal delivery without complication. Her laboratory workup is normal.A. Key Words  A 38-year-old  G3P3  Monogamous relationship  Allergy (-)  Drinks alcohol and smokes  She and her boyfriend are sexually transmitted disease (STD ) – free  She used to take birth control pills without any problems  All of her three children were born via vaginal delivery without complication  Her life is very busy because of work  Haboratory workup and physical examination are normal . Her physical examination is normal. She denies any allergy. She is currently in a monogamous relationship and has been in it for several months. She repots that she is tired of using over-the-counter contraceptives because they are inconvenient. She said that her life is very busy because of work. Case A 38-year-old G3P3. She mentions that she used to take birth control pills without any problems.

provision and use of birth control is called family planning. also known as contraception and fertility control. are methods or devices used to prevent pregnancy.C. Reducing the birth rate to raise the living standard of the people and the nation. and child health and prevention of reproductive health problems. 2. Definition Birth control. but effective and safe methods only became available in the 20th century. infant. or politically undesirable. increased resilience and well-being of the family.Other objectives include the setting of birth. Meet the public demand for quality family planning services. religiously. 3. Birth control methods have been used since ancient times. Some cultures limit or discourage access to birth control because they consider it to be morally. Improving the health and welfare of mothers. Analysis  Objective 1. how often you have sex and whether you . D. children. families and nations. The general objective is to form a small family in accordance with the socio-economic strength of a family by way of setting the child's birth. Planning. maturation age of marriage. Simple contraception a) Condom How effective are condoms? How effective any contraceptive is depends on how old you are. in order to obtain a happy and prosperous family that can meet their needs.  Classification 1. including efforts to reduce maternal mortality.

b) Coitus interuptus c) Natural contraceptive d) Diafragma e) Spermicida 2. follow the instructions. They help to protect both partners from some sexually transmitted infections. If 100 sexually active women don’t use any contraception. They differ in the type and dose of the 2 hormones they contain. Male condoms are easily available. . Hormonal contraception a) Pill What is the pill contraceptive? The Pill contains low doses of 2 hormones an oestrogen and a progestogen. . What are the advantages of condoms? . How does the Pill work? The Pill works by: preventing ovulation (egg release from the ovary) thickening mucus in the cervix so sperm cannot enter the . 80 to 90 will become pregnant in a year. . Male condoms come in a variety of shapes and sizes. . . You only need to use them when you have sex. There are no serious side-effects from using condoms. including HIV. These are similar to the hormones naturally produced in the female body. A female condom can be put in any time before sex. There are many combined pills available.

It is less effective than this if not taken according to instructions. Depo-provera protects you from pregnancy for 12 weeks . uterus (womb) changing the lining of the uterus. how often you have sex and whether you follow the instructions Contraceptive injections are over 99 percent effective. Noristerat protects you from pregnancy for 8 weeks . The injections is a method of long-acting reversible contraception (LARC). This means that if 100 women take the Pill. 1 woman could become pregnant in a year. Sayana press protects you for 13 weeks How effective is contraceptive injection? Depend on how old are you. making it unsuitable for pregnancy How effective is the Pill? The Pill is 99% effective when taken correctly. This rate reflects the fact that the Pill may not always be taken consistently b) Contraceptive injection What is contraceptive injection? Contraceptive injections contain a progestogen hormone which is similar to the natural progesterone that women produce in their ovaries. All LARC is very effective because . there are three types of injection: . The typical effectiveness rate in studies of women using the Pill is 92%.

Unexplained vaginal bleeding . How do contraceptive injections work The main way they work is to stop your ovaries releasing an egg each month (ovulation). Risk factor for osteoporosis . Arterial disease or history of serious heart disease or stroke . Some of the condition which may mean you should not use the injections are: . They are not affected by other medicines . You don’t have to think about contraception for as long as the injection lasts . Make the lining of your uterus (womb) thinner so it is less likely to accept a fertilised egg. Thicken the mucus from your cervix.while It is being used you do not have to remember to take or use contraceptions. Disease of the liver . Diabetes with complication . Systemic lupus erymatous What are the advantages of a contraceptive injection? . It may reduce heavy painful periods and help with premenstrual symptomps for some women . You can use it if you are breastfeeding . Can anyone use contraceptive injection? Most women can have a contraceptive injection. They also: . This makes it difficult for sperm to move through it and reach an egg . Breast cancer within the last 5 years .

or 8. In most women periods will stop completely . so if you have any side effects. . It cannot be removed from your bodt. Some women will have irregular periods or spotting . depending on which type you have it. like those in the combined pill.. Some women will have periods that last longer and are heavier. but only after careful evaluation by a doctor or nurse When can I start using a contraceptive injection? You can start a contraceptive injection any time in your menstrual cycle if it is certain that you are not pregnant Will contraceptive injection affect my periods? Your periods will probably change . Women under 18 years old may use depo-provera. or 13. Irregular bleeding may continue for some month after you stop the injections . you have to be prepared for them to conbtinue during this time and for problem for women who already have risk factors for osteoporosis . Women may put on weight when they use depo- provera . The injection works for 12. Your periods may chage in a way that is not acceptable to you . the contraceptive patch and the contraceptive vaginal ring What are the disadvantages of a contraceptive injection? . It is good method if you cannot use estrogens.

They also thicken the mucus in the cervix so that sperm cannot travel up to meet an egg. making it unsuitable for pregnancy How well does it work? Implants are more than 99% effective in preventing pregnancy (this means that only a few women out of a thousand will get pregnant each year How is it put in and taken out? You need to see someone who is trained to insert and remove implants. It is removed in the same way. Thickening of the mucus of the cervix so that sperm cannot enter the uterus womb . Preventing ovulation egg release from the ovary . It is suitable for women who may forget pills. The implant works by: . A local injection is used to numb the area. changing the lining of the uterus.c) Implant How do they work? Implants can stop the body from releasing an egg each month. The rods are placed under the skin and steristrips are used to hold the skin together until the skin heals. You will have a small scar from each procedure Who can use it? Almost every woman can use it whatever her age. injection .

Inexpensive . . Long acting – once inserted it will be effective for several years. Fertility most women ovulate within . . Reversible and rapid return to usual . Implant . Women who have had breast cancer . What are the advantages? . Return to fertility – rapid return once it is removed .check with your doctor if you are taking regular medication How is it put in and taken out? You need to see someone who is trained to insert and remove implants. . The first month after removal of the .appointments or who may have a medical reason that stops them using the combined pill Who should not use it? . Does not require daily pill taking . Effective – it is extremely effective as a contraceptive. You will have a small scar from each procedure. Or regular injections . Easy to use – there is nothing to do or remember once it has been inserted. A local injection is used to numb the area. It is removed in the same way. The rods are placed under the skin and steristrips are used to hold the skin together until the skin heals. Women who are taking some medications .

or periods that last longer. but . Wound problem – you may have bruising. . headaches or libido Does it protect you from sexually transmissible infections (STIs)? No. Insertion and removal – needs to be done by a trained health practitioner. . Occasionally there can be soreness or infection. No bleeding – periods stop for some women. The research does NOT show that implants cause any change in weight. This is quite common especially in the first 6 months and may last for the whole 5 years. . While it can be annoying. . it is not harmful and does not mean the implant is less effective. . A few women have no periods. a few women have their normal periods.What are the disadvantages? . There are treatments to control irregular bleeding so ask Family Planning or your health professional about it if this is a problem for you. you need to use condoms (and lubricant) as well to protect against Sexually Transmissible infections (STIs) What will I notice? Your periods are likely to change. This is safe for your body. Irregular bleeding. Difficulty in removing implant – occasionally the implant cannot be easily felt under the skin and you may need to be referred to someone else to remove it. mood.

a small scar . most women have a change in bleeding pattern. headaches . bruising and soreness at the site for to up to 1 to 2 weeks . may reduce painful periods. acne . frequent bleeding. premenstrual symptoms PMS and acne in some women What are the possible side effects of Implant ? Side effects include: . decreased sexual interest What are the possible risks associated with Implant ? The risks associated with include: . mood changes . This is safe for your body. some women will have no bleeding or minimal bleeding only . This may be infrequent bleeding.a small number of women are predisposed to the development of thickened scars d) IUD What Is an IUD? . What are the possible health benefits of Implant ? . light bleeding or heavy bleeding. breast tenderness . and there are pills to treat this if it happens. Research has shown that about one woman in every seven has the implant removed because of bleeding problems.

It is effective for 12 years. Mirena is effective for five years. If sperm cannot join with an egg. IUDs are one of the most effective forms of birth control available. "T-shaped" devices made of flexible plastic. hormonal IUDs may prevent the egg from leaving the ovary. pregnancy cannot happen. How Does an IUD Work? Both the copper and hormonal IUDs work mainly by affecting the way sperm move so they can't join with an egg. A health care provider inserts an IUD into a woman's uterus to prevent pregnancy." IUDs are small. Pregnancy cannot happen if there is no egg to join with sperm. For some women. The hormonal IUD releases a small amount of progestin. The letters IUD stand for "intrauterine device. There are two brands. The ParaGard IUD contains copper. Skyla is slightly smaller and effective for three years. Progestin also prevents pregnancy by thickening a woman's cervical mucus. There are two types of IUD available in the United States — copper (ParaGard) and hormonal (Mirena or Skyla). How Effective Is the IUD? Effectiveness is an important and common concern when choosing a birth control method. Less than 1 out of 100 women will get pregnant each year if they use an IUD. . The mucus blocks sperm and keeps it from joining with an egg.

Certain conditions increase the risk of side effects. Use a condom along with the IUD to reduce the risk of infection. How Safe Is the IUD? Most women can use an IUD safely. have pelvic tuberculosis . an allergy to copper or have Wilson's Disease — an inherited disease that blocks the body’s ability to get rid of copper. so safety is a common concern when choosing a birth control method. You should not use an IUD if you : .Keep in mind that the IUD doesn't protect against sexually transmitted infections. or may have. Talk with your health care provider about your health and whether an IUD is likely to be safe for you. But all medications have some risks. have or may have a sexually transmitted infection or other pelvic infection . think you might be pregnant . have cervical cancer that hasn't been treated . There are many other methods of birth control that may be safe for you if you cannot use an IUD. have a uterine perforation during IUD insertion You should not use the ParaGard IUD if you : . have. have unexplained bleeding in your vagina . . have cancer of the uterus . have had a pelvic infection following either childbirth or an abortion in the past three months .

Hormonal IUDs may reduce period cramps and make your period lighter. periods stop altogether. . IUDs can be used during breastfeeding. cramping or backache for a few days . longest lasting forms of birth control available to women today. . mild to moderate pain when the IUD is put in . have severe liver disease . There is nothing to put in place before intercourse to prevent pregnancy. The ParaGard IUD does not change a woman's hormone levels. or may have. For some women. . On average. .You should not use a hormonal IUD if you : . IUDs may improve your sex life. The ability to become pregnant returns quickly once the IUD is removed. have. What Are the Disadvantages of an IUD? It's important to think about the possible side effects of using an IUD. Some women say that they feel free to be more spontaneous because they do not have to worry about becoming pregnant. menstrual flow is reduced by 90 percent. breast cancer What are the Benefits of an IUD? IUDs are some of the least expensive. There are many other benefits. spotting between periods in the first 3–6 months . You may have : . .

the IUD can move around and harm other parts of the body. when the IUD is inserted. but it usually isn't. If the infection is not treated. This might sound painful. it can affect a woman's ability to become pregnant in the future. it has to be removed. This happens if bacteria get into the uterus when the IUD is inserted. surgery may be needed to remove the IUD. Surgery a) Tubectomy . This is more likely to happen to women who are younger and who have never had a baby. when this happens. The IUD can sometimes slip out of the uterus. In rare situations. Most infections develop within three weeks of having the IUD inserted. heavier periods and worse menstrual cramps — with ParaGard Serious problems with the IUD are rare. a woman could develop an infection when using the IUD. When this happens. the health care provider will notice it and it can be fixed right away. . irregular periods in the first 3–6 months — with Mirena or Skyla . it can push through the wall of the uterus. Sometimes it comes all the way out. There are three main things to watch out for when using an IUD: . Sometimes it only comes out a little. If it comes out only part of the way. pregnancy can happen. . In very rare situations. Usually. But if not. . 3. If the IUD slips out of place.

Contraindication: Contra indications steady contraception in women is a matter of relationships. . Minilaporatomi is tubal sterilization is performed through a small suprapubic incision with a length of usually 3-5 cm. and ease of adaptation to the surgical environment. Types Tubektomi : . once the action and does not require further scrutiny is ongoing. b) Vasectomy . Laparoscopy is an endoscopic examination of the inside of the peritoneal cavity by means of a laparoscope is inserted through the anterior wall of the abdomen. just need a motivation. disagreements on the operation of one of the spouses. sterilization is only suitable for couples who do not want more children. The failure rate is low and highly effective in preventing pregnancy and the fewest side effects. simplicity. Tubektomi has advantages as follows. What is tubectomy? Tubectomy can be binding and cutting. cheap and safe. and illness or disability that may increase the risk of the operation. can also Tubektomi for women is also known as tubal occlusion or sterilization. Indication : With a permanent nature. Minilaparotomi is a method of female sterilization is the most frequently performed worldwide since keamananya. how relatively easy.

000 women whose partners have had vasectomies will not become pregnant. . . less than 1 pregnancy per 100 women over the first year after their partners have had vasectomies (2 per 1. pregnancy rates are about 2 to 3 per 100 women over the first year after their partners have had a vasectomy. Permanent contraception for men who will not want more children. Semen is ejaculated. Also called male sterilization and male surgical contraception. . the provider locates each of the 2 tubes that carries sperm to the penis (vas deferens) and cuts or blocks it by cutting and tying it closed or by applying heat or electricity (cautery). Through a puncture or small incision in the scrotum. This means that 998 of every 1. Works by closing off each vas deferens.What Is vasectomy? . This means that 97 to 98 of every 100 women whose partners have had vasectomies will not become pregnant. How Effective? One of the most effective methods but carries a small risk of failure: . Where men can have their semen examined after vasectomy. . keeping sperm out of semen. but it cannot cause pregnancy. Where men cannot have their semen examined 3 months after the procedure to see if it still contains sperm.000). .

Implant . because she fears any form of surgery and has not excluded having another child and condom to protect against sexually transmissible infections (STIs). Cervix caps . Injections We suggest to this women to choose implant contraception because the implant has a prolonged period of time suitable for career women and has no contraindications to a sexually transmitted diseases (STDs). Conclusion We suggest implant to this women. Combination injection G. Condom . Which contraceptive are contraindicated for her? . IUD . F. .  What contraceptive options are avaible to this women? The options to this women are: .