BLACK- MODULE -Addresses the physical, emotional, and social well-being of

women in the postpartum period.

GREEN- MAAM YBOA SAID/ ADDED INFORMATION
-Provides support for postpartum recovery, breastfeeding
RED- IMPORTANT initiation and support, and newborn care education.

-Includes assessments for postpartum complications, postpartum

depression screening, and family planning counseling.
FRAMEWORK FOR MATERNAL AND CHILD HEALTH NURSING
(MCHN) 5.> NEONATAL- refers as to “0-28 days old or 1month” infants is
“0-1 year old”
*frist, what is the focus of Maternal and Child Health Nursing?
-Involves providing specialized care to newborn infants during the
1. >HEALTH PROMOTION AND DISEASE PREVENTION
first few weeks of life.
-Emphasizes the importance of promoting health and preventing
- Focuses on newborn assessments, promoting bonding and
diseases through education, counseling, and community
attachment, facilitating breastfeeding, and managing common
interventions.
neonatal conditions.
*Specifically sa cumminty health nursing more on prevention,
- Includes educating parents on newborn care, recognizing signs of
more on prevention tayo. Kaya sa community heallth nursing
illness, and promoting a safe home environment.
kasama na ang pre-natal.
6.> PEDIATRIC CARE- “0-18 YEARS OLD”
-Focuses on empowering individuals and families to make
informed decisions regarding their health. -Addresses the health and development of infants, children, and
adolescents.  Involves growth and developmental assessments,
-Includes promoting healthy lifestyles, encouraging immunizations,
immunizations, screenings, and management of common
facilitating breastfeeding, and providing education on nutrition
childhood illnesses.
and hygiene.
- Provides health education to children and families, supports
*take note, that all the program being implemented by the DOH is
positive parenting practices, and identifies and addresses
based on HEALTH PROMOTION and DISEASE PREVENTION.
psychosocial concerns.
2.> ANTEPARTUM CARE – also known as “pre-natal care”. Ante
7.> FAMILY-CENTERED CARE
means “Before”
*Sabi ko kanina na sa MHCN also involve the whole family
-Addresses the health needs of pregnant women before childbirth.
-Recognizes the importance of involving the family as partners in
*Btw, you will notice in your book the focuse of maternal health
care.
care delivery hindi lang sa nanay, at fetus kundi sa buong pamilya.
Laging kasama buong pamilya, kung sino kasama, kung may tatay , -promotes open communication, collaboration, and shared
kasama ang tatay. Focuses on the Family. decision-making with families.
-Involves prenatal assessments, monitoring of maternal health, -Considers the family's cultural, social, and economic context in
and providing education on healthy pregnancy practices. planning and delivering care.
-Identifies and manages high-risk pregnancies to optimize *you incorporate into take consideration an kamutangan an tawo.
maternal and fetal outcomes. Be open minded.
- Encourages prenatal care utilization and the establishment of a
supportive care plan.
8.> ADVOCACY AND COLLABORATION

-Advocates for the rights, well-being, and access to quality

3.> INTRAPARTUM CARE – INTRA means “DURING”
-Involves providing care and support to women during labor and
childbirth
-Focuses on ensuring a safe and positive childbirth experience for
the mother and infant.
-Includes monitoring maternal and fetal well-being, managing
pain, facilitating labor progression, and promoting effective
communication and collaboration within the healthcare team.
*Pagdadaanan natin lahat yan isa-isa. Before midterm dapat tapos
na.
healthcare services for women, infants, children, and adolescents.
-Collaborates with interdisciplinary healthcare teams, community
organizations, and policymakers to improve maternal and child
health outcomes.
-Addresses social determinants of health and works towards
reducing health disparities.
REPRODUCTIVE AND SEXUAL HEALTH
-Has the following key components:

4. POSTPARTUM CARE – what do we mean by post, postpartum? * SEXUAL EDUCATION

Means “AFTER” DELIVERY.
*FAMILY PLANNING
*CONTRACEPTION
*PREVENTION AND TREATMENT OF SEXUALLY TRANSMITTED
INFECTIONS (STI)
*REPRODUCTIVE HEALTH SERVICES
*SEXUAL AND GENDER IDENTITY
*REPRODUCTIVE RIGHTS
>SEXUAL EDUCATION
-*When we say sexual education we are talking about promoting
reproductive and sexual health. age-appropriate information
about human sexuality, consent, contraception, sexually
transmitted infections (STIs), and healthy relationships. Sexual
education aims to empower individuals to make informed
decisions about their sexual health and behavior.
*kung nakikipag sex ka, be responsible. You have the choices now.
What is the best method to prevent un-intended pregnancy?
ABSTENENCE.
>FAMILY PLANNING
assist individuals and couples in making choices about when to
have children, the spacing between pregnancies, and the methods
of contraception to use. Access to family planning methods and
services allows individuals to plan their families according to their
desires and circumstances, promoting their reproductive
autonomy.
>CONTRACEPTION
Contraception refers to methods and devices used to prevent
pregnancy. There is a wide range of contraceptive options
available, including barrier methods (e.g., condoms), hormonal
methods (e.g., birth control pills, patches, injections), intrauterine
devices (IUDs), and permanent methods (e.g., sterilization)
*”VASECTOMY” MALE STERILIZATION
>PREVENTION AND TREATMENT OF SEXUALLY TRANSMITTED
INFECTIONS (STIs)
-our age bracket (19-20 or early 20s) usually ang biktima ng HIV
-These services include routine check-ups, prenatal care, safe and
supported childbirth, postnatal care, infertility diagnosis and
treatment, and management of reproductive disorders. Timely
access to these services promotes healthy pregnancies, safe
childbirth, and the prevention or early detection of reproductive
health issues.
These services include routine check-ups, prenatal care, safe and
supported childbirth, postnatal care, infertility diagnosis and
treatment, and management of reproductive disorders. Timely
access to these services promotes healthy pregnancies, safe
childbirth, and the prevention or early detection of reproductive
health issues.
>REPRODUCTIVE HEALTH SERVICES
-Access to quality reproductive healthcare services is crucial for
maintaining reproductive health.
*Saan pupunta kung may problima kayo? HEALTH CENTER kung
walang pera o sa HOSPITAL
>SEXUAL AND GENDER IDENTITY: Recognizing and respecting
diverse sexual orientations and gender identities is an integral part
of reproductive and sexual health. Providing a supportive and
nondiscriminatory environment for individuals of all sexual
orientations and gender identities ensures that everyone can
access appropriate healthcare services and information without
stigma or discrimination
>REPRODUCTIVE RIGHT.
*First time in Philippines history na ang birth rate natin ay lower,
due to the new generation ayaw na ng anak na 4 or 5 ang gusto
na ay 1-2.
- Reproductive rights encompass the rights of individuals to make
decisions about their reproductive lives, including the right to
choose whether or not to have children, access to safe and legal
abortion services, and the right to be free from coercion,
discrimination, and violence related to reproductive and sexual
health
FEMALE REPRODUCTIVE SYSTEM
PARTS: (all the meaning of every part are from the ppt of ma’am
yboa)
EXTERNAL GENITILIA- Refers to the parts that are visible
*Mons pubis- “an tambok” triangular mountain cavities
that cover the pubic thick bon. It’s purpose for
protection.
*Labia majora- protect the introitus and urethral
opening.
*labia is also believe to secrete generate mucus which
act as a lubricant during sexual intercourse.
*Labia Minora- made up the rectal cognitive tissue that
target during sexual intercourse. Located inside the labia
minora, they are more sensitive and responsive to touch
than the labia majora. Labia minora THIGHTEN during
intercourse.
*Clitoris- highly sensitive. Composed of nerve that
present in erectile pressure. Becoming endorse with
blood during sexual stimulation.
*Urethral Opening- where the urine comes out
*Vaginal Opening- is the introitus opening, maybe
covered by thickness of hymen. Using the presence of
intact hymen for determining virgenity wrong.
*Hymen
*Perineum – the muscle located between the vagina
and perineum canal.
bakit kasama ang perineum?kasi it is the one that
doctors cut during labor. In Filipino people it is cut
“pahalang” due to it’s short Perineum to avoid the cut
going to the anus.
EPISIOTOMY- an pag CUT an perineum
EPISIORAPHY- an pag TAHI an samad ha perineum
-all vagina ay pare-pareho, kakaiba lang sya sa kulay mayroon
maitim may maputi, shape (round, long)
-check your own reproductive and sexual health,check your
external genitalia it’s only way to know if you have an abnormality
or not.
EXTERNAL GENITILIA
*vagina- connects the cervix to the external genitals. Located
between the bladder and rectum. Passage for the menstrual flow.
Located between the bladder and rectum.
*Uterus- commonly referred to as womb. It expand to
accommodate the fetus. It is made of 3 tissue layers called :
ENDOMETRIUM- the most active layer responsible for the cyclic
ovarian hormone changes and highly specialized and essential for
menstrual and reproductive function.(due to its responsible to
hold the fertilized egg) (it should be enrich in blood supply couse if
not the woman is “makukunan” )
MYOMETRIUM- makes up most of the uterine volume and is the
muscular layer, composed prinarily of smooth muscle cells.
SEROSA or PERIMETRIUM- a thin layer of tissue made of epithelial
cells that envelop the uterus variations in uterine position.
*Cervix- is connecting the uterus to the vagina, cervical opening to
the vagina is small. It act as a safety precaution against foreign
bodies entering the uterus.
There are 3 divisions
*FUNDUS- can be palpated abdominally to determine the anoxius
during pregnancy
*CORPUS or the BODY- The upper most part and forms the body
of the organ. The lining of the cavity continues to swell that the…
(dre na maaram an next)
*CERVIX- is a cylinder-shaped neck of tissue that connects the
vagina and uterus. It is made of cartilage covered by smooth,moist
tissue and 1 inch across.
ECTOCERVIX- The part of the cervix that can be seen during
gynecologic examination.
EXTERNAL OS- the opening in the center of the ectocervix, it
allows passage between vagina and uterus.
-cervix produces cervix mucus that changes its consistency during
the during menstrual cycle to prevent or promote pregnancy.
ANTEVERSION- The entire uterus is tipped forward
RETROVERSION- The uterus is tipped backward
ANTEFLEXION- The body of the uterus is bent forward at the
junction with the cervix.
RETROFLEXION- the body of the uterus is bent sharply back just
above the cervix.
*Fallopian Tube- -also known as oviducts. serves as a pathway
that transport the ova from ovary the uterus each month (where
the egg cell past through). It is the site for fertilization.( the outer
part)(dito nag m-meet si sperm cell and egg cell). The uterine tube
transport the fertilized egg in the uterus for implantation. (it takes
about 6-10 days to travel from fallopian tube to the uterus.
-4 portion:
*interstitial- part of the tube that lies within the utrerine
wall
*isthmus- about 2cm, the part that is being cut and
sealed during ligation or tubal sterilization procedure.
*ampulla- the 3rd largest portion, about 5cm where the
fertilization takes place.
*Infundibullar – the most distal segment, the rime of the
funnel is covered by fimbrae (small hairs) that help to
guide the ovum into the fallopian tubes.
*Ovaries- the female gonads, primary female organs. They
develop and expel the ovum. (if hindi ka mabuntis ang ovum
magiging regla) a woman after birth already has 2 million eggs and
during a lifetime only about 400-500 fully matured ovum or eggs is
released for fertilization. ( as long as you have a menstruation you
produce an egg, but at some cases even though you are not
having your menstruation you are still producing an egg especially
after pregnancy)(like mabbaro nala an nanay after niya manganak
na pregnant na liwat hiya biski wary pa hiya mag regla utro)
-they produce the female sex hormone called estrogen and
progesterone . It’s purpose is to prepare the uterus for possible
fertilization.
(take not the SEX HORMONE IS ESTROGEN AND PROGESTERON
and the PREGNANCY HORMONE IS THE PROGESTERON.)
*BREAST- the organ of Sexual arousal. They contain the mammry
glands consist of nestrogen so breastmilk occurred.
-Pre- sex is determine primarily by heredity.
-also depend on the existing fat and granular tissue.
( parts an breast are discuss also by maam)
MALE REPRODUCTIVE SYSTEM
Puberty -Burst of hormone that activates maturation of the
gonads known as testes. Being sexually mature. Usually happen
between 10-14 of age in girls and 12-16 in boys.
-abnormally early is what we called precocious puberty and
abnormally delayed is called ….
General physical Changes
*Enlargement of the external and internal genitalia
*Voice changes
*Hair growth
*Mental changes
*Changes in body conformation and skin
* Sebaceous glands secretions thicken/increase
*acne
MALE EXTERNAL GENITALIA
 Testes- each testes is an oval structure about 5cm
long and 3cm in diameter, covered by tunica
albuginea. There are 250 tubules in testes, it
contain seminiferous tubules within lobule.
 The intertesial cells, (the cells of Leydig) which
produce male sex hormoneare located bewtween
the seminiferous tubules within lobule
 penes
 INTERNAL GENITALIA
Scrotum- consist the skin of subcutaneous tissue. A
vertical set of subcutaneous tissue in the center,
dived in two parts each containing the ….(forgot it)
-ayaw ng testes sa mainit kaya kapag may sakit or
elevated ang body temperature na “laylay”
-once the testes are immature, uncapable in
fertilizing the ovum
(in donating in sperm bank the man needed to
ejaculate because they connot get it directly on the
scrotum due to the reason that sperm there are still
immature, they go to a process muna so they prefer
the ejaculated one because it’s mature already.
*epididymis- long tube about 6 meters that is
located along the superior of the testes.
- msturing the spem happen in epididymis and
matored sperm are stored in lower portion
*Spermatic Cord- contain the proximal ductus
deferens, testicular artery and veins, lymph
vvessels, testiculr nerve, cremaster muscle and
connective tissue covering.
*Duct system – sperm cells pass through a series of
ducts to reach the outside of the body. After they
leave the testes, the sperm passes through the
epididmis, duct deferens, ejaculatory duuct, urethra
*Ductus deferens/VAS DEFERENS- a fibromuscular
tube that is continuous with the epididymis.
Each ductus deferens enlarges to form an ampulla.
Sperm are stored in the proximal portion of the
ductus deferens, near the epididymis
-Ejaculatory Duct- Each ductus deferens, at the
ampulla, joins the duct from the adjacent seminal
vesicle (one of the accessory glands) to form a short
ejaculatory duct.
 Each ejaculatory duct passes through the prostate
gland and empties into the urethra.
-Urethra- extends from the urinary bladder to the external
urethral orifice at the tip of the penis.  It is a passageway for
sperm and fluids from the reproductive system and urine from the
urinary system.
-Accessory Glands - are the seminal vesicles, prostate gland, and
the bulbourethral glands. These glands secrete fluids that enter
the urethra.
Seminal Vesicles - glands posterior to the urinary bladder.
- Each has a short duct that joins with the ductus deferens at the
ampulla to form an ejaculatory duct, which then empties into the
urethra.
- The fluid is viscous and contains fructose, prostaglandins and
proteins
-Prostate- A firm, dense structure that is located just inferior to
the urinary bladder.  It is about the size of a walnut and encircles
the urethra as it leaves the urinary bladder.
 Numerous short ducts from the substance of the prostate gland
empty into the prostatic urethra. The secretions of the prostate
are thin, milky colored, and alkaline. They function to enhance the
motility of the sperm.
Bulbourethral Glands (Cowper's)  small, about the size of a pea,
and located near the base of the penis. A short duct from each
enters the proximal end of the penile urethra.
 In response to sexual stimulation, the bulbourethral glands
secrete an alkaline mucus-like fluid
Seminal Fluid or Semen  a slightly alkaline mixture of sperm cells
and secretions from the accessory glands.  Secretions from the
seminal vesicles make up about 60 percent of the volume of the
semen, with most of the remainder coming from the prostate
gland. The sperm and secretions from the bulbourethral gland
contribute only a small volume.
 The volume of semen in a single ejaculation may vary from 1.5
to 6.0 ml. There are between 50 to 150 million sperm per milliliter
of semen. Sperm counts below 10 to 20 million per milliliter
usually present fertility problems.
Erection- Involves increase in length, width & firmness  Changes
in blood supply: arterioles dilate, veins constrict  The spongy
erectile tissue fills with blood
- Erectile Dysfunction [ED] also known as impotence
Hormones- Follicle-stimulating hormone (FSH) stimulates
spermatogenesis  Interstitial Cell Stimulating Hormone (ICSH)
stimulates the production of testosterone
- Testosterone stimulates the development of male secondary sex
characteristics & spermatogenesis.
*Spermatogenesis
- Sperm are produced within the seminiferous tubules. -
Interspersed within the tubules are large cells which are the
sustentacular cells (Sertoli's cells), which support and nourish the
other cells.
 Early in embryonic development, primordial germ cells enter the
testes and differentiate into spermatogonia
 Spermatogonia are diploid cells, each with 46 chromosomes (23
pairs) located around the periphery of the seminiferous tubules.
 At puberty, hormones stimulate these cells to begin dividing by
mitosis. Some remain at the periphery as spermatogonia.
 Others become primary spermatocytes. Because they are
produced by mitosis,
What is the menstrual cycle?
The process in which females ripen or release one mature egg.
The average menstrual cycle will repeat itself about every 28 days,
but normal menstrual cycles can range from 21 to 40 days.

 4 body Structures involved during menstrual cycle
o Hypothalamus, Pituitary Glands, Ovaries , Uterus o these 4
structures must contribute their part for the menstrual cycle to be
complete; inactivity of one would result to ineffective or
incomplete cycle
Menstrual cycle menstrual cycle: The monthly cycle of changes in
the ovaries and the lining of the uterus (endometrium), starting
with the preparation of an egg for fertilization. When the follicle of
the prepared egg in the ovary breaks, it is released for fertilization
and ovulation occurs.
The four main phases of the menstrual cycle are
:  Menstruation: Menstruation is the elimination of the thickened
lining of the uterus (endometrium) from the body through the
vagina. Menstrual fluid contains blood, cells from the lining of the
uterus (endometrial cells) and mucus. The average length of a
period is between three days and one week.
 The follicular phase: The follicular phase starts on the first day
of menstruation and ends with ovulation. Prompted by the
hypothalamus, the pituitary gland releases follicle stimulating
hormone (FSH). This hormone stimulates the ovary to produce
around five to 20 follicles (tiny nodules or cysts), which bead on
the surface.
- Each follicle houses an immature egg. Usually, only one follicle
will mature into an egg, while the others die. This can occur
around day 10 of a 28-day cycle. The growth of the follicles
stimulates the lining of the uterus to thicken in preparation for
possible pregnancy.
 Ovulation: Ovulation is the release of a mature egg from the
surface of the ovary. This usually occurs mid-cycle, around two
weeks or so before menstruation starts.
- During the follicular phase, the developing follicle causes a rise in
the level of oestrogen. The hypothalamus in the brain recognises
these rising levels and releases a chemical called gonadotrophin-
releasing hormone (GnRH). This hormone prompts the pituitary
gland to produce raised levels of luteinising hormone (LH) and
FSH.
o Within two days, ovulation is triggered by the high levels of LH.
The egg is funnelled into the fallopian tube and toward the uterus
by waves of small, hair-like projections. The life span of the typical
egg is only around 24 hours. Unless it meets a sperm during this
time, it will die.
o When you want to have a baby you can improve your chance of
getting pregnant if you know about ovulation and the ‘fertile
window’ in the menstrual cycle
 The luteal phase: During ovulation, the egg bursts from its
follicle, but the ruptured follicle stays on the surface of the ovary.
For the next two weeks or so, the follicle transforms into a
structure known as the corpus luteum. This structure starts
releasing progesterone, along with small amounts of oestrogen.
This combination of hormones maintains the thickened lining of
the uterus, waiting for a fertilised egg to stick (implant). o If a
fertilised egg implants in the lining of the uterus, it produces the
hormones that are necessary to maintain the corpus luteum. This
includes human chorionic gonadotrophin (HCG), the hormone
that is detected in a urine test for pregnancy. The corpus luteum
keeps producing the raised levels of progesterone that are needed
to maintain the thickened lining of the uterus.
o If pregnancy does not occur, the corpus luteum withers and dies,
usually around day 22 in a 28-day cycle. The drop in progesterone
levels causes the lining of the uterus to fall away. This is known as
menstruation. The cycle then repeats.
FAMILY PLANNING/RESPONSBILE PARENTHOOD
o Responsible Parenthood, as defined in the Directional Plan of
POPCOM, is the will and ability of parents to respond to the needs
and aspirations of the family and children. It is a shared
responsibility of the husband and the wife to determine and
achieve the desired number, spacing, and timing of their children
according to their own family life aspirations, taking into account
psychological preparedness, health status, socio-cultural, and
economic concerns (DOH)
Contraception methods
1. Physiological methods: o Hormonal contraceptives (the pill,
the patch, and the vaginal ring) all contain a small amount of man-
made estrogen and progestin hormones. These hormones work to
inhibit the body's natural cyclical hormones to prevent pregnancy.
Pregnancy is prevented by a combination of factors.
2. Mechanical methods:
o IUD is a small plastic and copper device that is put into your
uterus (womb).
-  An IUD is a small plastic and copper device that is put into your
uterus (womb). It has one or two threads on the end. These thin
threads hang through the opening at the entrance of your uterus
(cervix) into the top of your vagina.
Diaphragm / Cervical caps:
- The diaphragm is inserted into the vagina before sex, positioning
it so that it keeps sperms from getting anywhere near your cervix.
3. Chemical methods:
- Spermicides come in several different forms: cream, gel, foam,
film, and suppositories. Most spermicides contain nonoxynol-9, a
chemical that kills sperm
4. Biological method:
o The rhythm method, also called the calendar method or the
calendar rhythm method, is a form of natural family planning.
o To use the rhythm method, you track your menstrual history to
predict when you'll ovulate. This helps you determine when you're
most likely to conceive.
o If you're hoping to get pregnant, you can use the rhythm
method to determine the best days to have sex
5. Natural Family planning:
o The Standard Days Method  The Standard Days Method (SDM)
is a new simple fertility awareness-based method. It relies on a
"standard rule" or a fixed "window" of fertility that makes it easy
for women to know when they are likely to become pregnant
o The TwoDay Method- It relies on a simple algorithm to help
women identify when they are fertile, based upon the presence or
absence of cervical secretions.
 If the woman notices any secretions on the current or previous provide continuous contraception for up to 3 years. o Brand
day, then she is probably fertile today and should not have Name: Implanon, Nexplanon
unprotected intercourse if she wants to avoid pregnancy

 If she notices no secretions today and yesterday (two days in a

row without secretions), then she is not fertile today

o The Ovulation Method -The Ovulation Method, also call the

Cervical Mucus Method, is based on understanding and
interpreting changing cervical secretions that are produced at the
neck of the uterus (cervix). At the time of greatest fertility, these
secretions become clear, stretchy, slippery and wet.

 Couples who wish to avoid pregnancy abstain from intercourse

from the onset of cervical mucus symptom until three days after
the last day of fertile-type secretions

o Basal Body Temperature (BBT)- Women using the Basal Body

Temperature (BBT) Method identify their fertility by observing
their body temperature each morning before beginning any
activity. The body temperature is lower before ovulation and rises
slightly to about .2 degrees Celsius or .4 degrees Fahrenheit after
ovulation.

 Couples who wish to avoid a pregnancy abstain from intercourse

from the onset of menses until three days after the woman's basal
body temperature has risen, to about .2 degrees Celsius or .4
degrees Fahrenheit, signifying the end of the fertile phase.

o Symptothermal Method  The Symptothermal Method involves

observing changes in the cervical secretions, along with changes in
the basal body temperature, and the position and feel of the
opening of the cervix. Other fertility signs such as mid-cycle pain
or bleeding may accompany ovulation.

o Lactational Amenorrhea Method  The Lactational Amenorrhea

Method (LAM) is based on scientific evidence that a woman is not
fertile and unlikely to become pregnant during full lactation or
exclusive breastfeeding.

 Full lactation describes breastfeeding when no regular

supplemental feeding of any type is given (not even water) and
the infant is feeding both day and night with little separation from
the mother.

 LAM provides maximum protection as long as:  Menstruation

has not resumed and  Bottle feeds or regular food supplements
are not introduced and  Baby is less than 6 months of age. 
Effectiveness of Natural Family Planning Methods

6. Surgical methods o Vasectomy  A vasectomy is considered a

permanent birth control method. A vasectomy prevents the
release of sperm when a man ejaculates. Male sterilization is
extremely effective and is recommended for men who do not wish
to have any more children.

o Tubal Ligation

 Tubal ligation (also known as having one's tubes tied) is a

permanent form of female sterilization. This is a surgical
procedure that closes off a woman's fallopian tubes.

7. Social methods: o Abstinence o Withdrawal or coitus

interruptus

8. Etonogestrel implant Radiopaque o is used as contraception to

prevent pregnancy. The medicine is contained in a small plastic rod
that is implanted into the skin of your upper arm. The medicine is
released slowly into the body. The rod can remain in place and