A Framework for Maternal and Child Health Nursing
attitudes and beliefs as these so strongly
Goals and Philosophies of Maternal and Child Health
Nursing
The primary goal of both maternal and child
health nursing is the promotion and maintenance of
optimal family health.
Examples of the scope of practice include:
● Preconception health care
● Care of women during three trimesters of
pregnancy and the puerperium (the 6 weeks after
childbirth, sometimes termed the fourth
trimester of pregnancy)
● Care of infants during the perinatal period (the
time span beginning at 20 weeks of pregnancy to
4 weeks [28 days] after birth)
● Care of children from birth through late
adolescent
● Care in a variety of hospital and home care
settings
Maternal and child health nursing is:
● Family centered; assessment should always
include the family as well as an individual.
● Community centered; the health of families is
both affected by and influences the health of
communities.
● Evidence based; this is the means whereby
critical knowledge increases.
● A challenging role for nurses and a major factor
in keeping families well and optimally
functioning.
A Philosophy of Maternal and Child Health Nursing
A maternal and child health nurse:
● Considers the family as a whole and as a partner
in care when planning or implementing or
evaluating the effectiveness of care.
● Serves as an advocate to protect the rights of all
family members, including the fetus.
● Demonstrates a high degree of independent
nursing functions because teaching and
counseling are major interventions.
● Promotes health and disease prevention because
these protect the health of the next generation.
● Serves as an important resource for families
during childbearing and childrearing as these
can be extremely stressful times in a life cycle.
● Respects personal, cultural, and spiritual
influence the meaning and impact of
childbearing and childrearing.
● Encourages developmental stimulation during
both health and illness so children can reach
their ultimate capacity in adult life.
● Assesses families for strengths as well as
specific needs or challenges.
● Encourages family bonding through rooming-in
and family visiting in maternal and child
healthcare settings.
● Encourages early hospital discharge options to
reunite families as soon as possible in order to
create a seamless, helpful transition process.
● Encourages families to reach out to their
community so the family can develop a wealth
of support people they can call on in a time of
family crisis.
Maternal and Child Health Goals and Standards
● Immunization, childhood diseases such as
measles and poliomyelitis almost have been
eradicated.
● New fertility drugs and fertility techniques allow
more couples to conceive.
● The ability to prevent preterm birth and improve
the quality of life for both preterm and late
preterm infants has increased dramatically.
● As specific genes responsible for children’s
health disorders are identified, stem cell therapy
may make it possible to replace diseased cells
with new growth cells and cure these illnesses.
GLOBAL HEALTH GOALS
● The United Nations (UN) and the World Health
Organization established millennium health
goals in 2000 in an effort to improve health
worldwide.
● The goals are to concentrate on improving the
health of women and children because
increasing the health in these two populations
can have such long-ranging effects on general
health.
➢ To end poverty and hunger.
➢ To achieve universal primary education.
➢ To promote gender equality and
empower women.
➢ To reduce child mortality.
 ➢ To improve maternal health.
➢ To combat HIV/AIDS, malaria, and
other diseases.
➢ To ensure environmental sustainability.
➢ To develop a global partnership for
development.
A Framework for Maternal and Child Health Nursing
Care
● Maternal and child health nursing can be
visualized within a framework in which nurses
use nursing process, nursing theory, and Quality
& Safety Education for Nurses (QSEN)
competencies to care for families during
childbearing and childrearing years and through
the four phases of health care:
Health promotion
Health maintenance
Health restoration
Health rehabilitation
NURSING PROCESS
“ADPIE”
1. Assessment
2. Nursing Diagnosis
3. Planning
4. Intervention
5. Evaluation
NURSING THEORY
● Designed to offer helpful ways to view patients
so nursing activities can be created to best meet
the patient needs.
Calista Roy “Adaptation Model”
Dorothea Orem “Self-Care Deficit Theory”
Patricia Benner “Novice to Expert Theory”
QSEN COMPETENCIES
● QSEN Learning Collaborative created 6
competencies necessary for quality care. 5
competencies originated from a study by the
Institute of Medicine.
1. Patient-Centered Care
2. Teamwork and Collaboration
3. Quality Improvement
4. Informatics
5. Evidenced-Based Practice
6. Safety
*viewed in SKILLS, KNOWLEDGE &
ATTITUDE
EVIDENCE-BASED PRACTICE
● It is the conscientious, explicit, and judicious use
of current best evidence to make decisions about
the care of patients.
● Evidence can be a combination of research,
clinical expertise, and patient preferences or
values.
NURSING RESEARCH
● Is the systematic investigation of problems that
have implications for nursing practice usually
carried out by nurses.
● Plays an important role in evidence-based
practice as bodies of professional knowledge
only grow and expand to the extent people in
that profession are able to carry out research.
● Examining nursing care in this way results in
improved and cost-effective patient care as it
provides evidence for action and justification for
implementing activities.
Roles and Responsibilities of a Maternal Child Health
Nurse
● M&C health nursing carries some legal concerns
above and beyond other areas of nursing because
care is often given to patients who are not of
legal age for giving consent.
● Reproductive healthcare rights and laws are
complex and varies.
➢ Understanding scope practice
➢ Documentation
➢ Informed Consent
Roles and Responsibilities of a Maternal Child Health
Nurse
● “Wrongful Birth” – birth of a disabled child
whose parents would have chosen to end if they
have been informed about the disability during
pregnancy.
● “Wrongful Life” – claim that negligent prenatal
testing on the part of a healthcare provider
resulted in the birth of a disabled child
● “Wrongful Conception” – denotes that a
contraceptive measure failed, allowing an
unwanted child to be conceived and born
Ethical Considerations of Practice
● Conception issues (in vitro fertilization, embryo
transfer, cryopreservation, surrogacy).
● Pregnancy termination
● Fetal rights vs. Maternal rights
● Stem cell research
● Resuscitation (DNR, length of continuation)
● Number of procedures and degree of pain
● Confidentiality of record with multiple
caregivers
17 SUSTAINABLE DEVELOPMENT GOALS
1. GOAL 1: No Poverty - To end poverty, everyone
should have basic healthcare, security and
education.
2. GOAL 2: Zero Hunger - Globally, one in nine
people are undernourished. This goal aims to
end hunger.
3. GOAL 3: Good Health and Well-being -
Ensuring people live healthy lives can cut child
mortality and raise life expectancy.
4. GOAL 4: Quality Education - The UN wants
everyone to have access to inclusive, equitable
quality education.
5. GOAL 5: Gender Equality - Gender equality is a
human right, and is vital for a peaceful,
prosperous world.
6. GOAL 6: Clean Water and Sanitation - Clean
water protects people from disease, yet three in
10 people lack access to it.
7. GOAL 7: Affordable and Clean Energy - Targets
for 2030 include using more renewable,
affordable energy.
8. GOAL 8: Decent Work and Economic Growth -
The aim is for sustainable economic growth and
decent employment for all.
9. GOAL 9: Industry, Innovation and Infrastructure
- This involves building resilient infrastructure
and fostering innovation.
10. GOAL 10: Reduced Inequality - The poorest 40
per cent of the population should be able to grow
their income faster than average.
11. GOAL 11: Sustainable Cities and Communities -
The UN wants to increase affordable housing
and make settlements inclusive, safe and
sustainable.
12. GOAL 12: Responsible Consumption and
Production - This goal aims to foster
eco-friendly production, reduce waste and boost
recycling.
13. GOAL 13: Climate Action - Urgent action is
needed, by regulating emissions and promoting
renewable energy.
14. GOAL 14: Life Below Water - The aim is to
conserve and sustainably use the oceans, seas
and marine resources.
15. GOAL 15: Life on Land - To stop degradation,
we must preserve forest, desert and mountain
ecosystems.
16. GOAL 16: Peace and Justice Strong Institutions
- The aim is inclusive societies with strong
institutions that provide justice for all.
17. GOAL 17: Partnerships to achieve the Goal - If
all countries are to achieve the goals,
international cooperation is vital.
The Family ● Intimacy and sexually unite (a defining reason
why many marriages stay together)
Definition of family ● Cooperate economically
● “... a group of persons united by ties of marriage, ● May give birth or adopt
blood, or adoption; constituting a single 50 years ago this was central reason for
household; interacting and communicating with marriage.
each other in their respective social roles of Purpose for marriage has become much
husband and wife, mother and father, son and more diverse.
daughter, brother and sister, and creating and ● Legally recognized union
maintaining a common culture.” (Burgess and ○ Marriage license
Locke, 1953). ■ Not open on Saturday.
● “ ... A basic unit of kinship composed of two or ■ Fee: $50 in the USA
more members who are united by ties of blood, ■ City & County offices on 21st
marriage or adoption, and who live together S. State.
constituting a single household.” (Wong, 1975) ■ Good for 30 days, good
● “The family is a social group characterized by immediately.
common residence, economic co-operation and ■ 18 years without parents
reproduction. It includes adults of both sexes, at consent.
least two of whom maintain a socially approved ■ Second cousins may marry.
sexual relationship, and one or more children, ■ No blood tests or physical
own or adopted, of the usually co-habiting exams required.
adults.” (George Peter Murdock, 1949). ■ Both bride & groom must be
● “... a social group made up of members related present place of birth.
to one another by blood or marital ties and ■ Need to know mothers maiden
usually constituting a household.”(Lee, 1991, name & parents.
p.42)
CULTURE DEFINES WHAT A MARRIAGE IS OR
Concepts of the Family NOT
Karpel and Strauss summarizes different concepts of the ● Monogamy - one man, one woman. All 1st
family: world countries are monogamous.
(1) the functional family - defined by shared household, ● Polygamy - more than one wife or husband.
shared activities, shared responsibility for daily life and Example: Islam & Fundamental Mormons
child rearing; ● Bigamy – Marrying another person while still
(2) the legal family - defined by legal structure, altered married to someone else. It is against the law.
by divorce and adoptive placement of children; ● Serial Monogamy or Modified Polygamy –
(3) the family as seen by its members - defined by the Succession of marriages over time. Typical of
perceptions of its members; and seen as “in” the family US marriages.
by family members;
(4) the family of long-term commitments - defined by Family Structure
long-term expectations of loyalty and commitment; trust, 2 Basic Family Structures
reliability, and fairness are basic expectation; 1. Family of Orientation – the family one is born
(5) the biological family - defined by blood into; or oneself, mother, father and siblings if
relationships; parent-child relationship. What are the any
strengths and weaknesses of these definitions? 2. Family of Procreation – a family one
establishes; or oneself, spouse or significant
WHAT IS MARRIAGE? other and children.
● A legal bond or union between a man & woman.
● Commitment
Family Types
1. The Dyad Family
2. The Nuclear Family
3. The Cohabitation Family
4. The Extended (Multigenerational) Family
5. The Single-Parent Family
6. The Blended Family
7. The Communal Family
8. The Gay or Lesbian Family
9. The Foster Family
1. The Dyad Family – refers to 2 people living together,
usually a woman and a man without children.
● Many young adults live together as a dyad in
shared apartments, dorms or homes for
companionship and financial security while
completing school or beginning their careers.
● Generally viewed as temporary arrangements.
The Childfree or Childless Family
● Positive aspects: companionship, possibly
shared resources
● Potential negative aspects: feelings of guilt for
the couple who decided to delay a family and
who then may experience infertility issue
2. The Nuclear Family – traditional structure that is
composed of a husband, wife and children.
● Positive aspects: support for family members;
sense of security
● Possible negative aspects: may lack support
people in a crisis situation
3. The Cohabitation Family – composed of
heterosexual couples who live together like a nuclear
family but remain unmarried.
4. The Extended (Multigenerational) Family –
includes not only the nuclear family but also other
family members such as grandparents, aunts, uncles,
cousins and grandchildren.
● Positive aspects: support for family members;
sense of security
● Possible negative aspects: may lack support
people in a crisis situation
5. The Single-Parent Family
● Positive aspects: support for family members;
sense of security
● Possible negative aspects: may lack support
people in a crisis situation
6. The Blended Family – the remarriage or reconstituted
family.
● Positive aspects: increased security and
resources; exposure to different customs or
culture may help children become more
adaptable to new situations
● Possible negative aspects: rivalry or competition
among children; difficulty adjusting to a
stepparent
7. The Communal Family – groups of people who have
chosen to live together as an extended family. Usually
motivated by social, religious values rather than kinship.
8. The Gay or Lesbian Family
9. The Foster Family- Children whose parents can no
longer care for them may be placed in a foster or
substitute home by a child protection agency.
● Positive aspects: prevents children from being
raised in large orphanage settings
● Possible negative aspects: insecurity and
inability to establish meaningful relationships
because of frequent moves
Adopted Family
● Positive aspects: Children grow up well cared
for and experiencing a sense of love; a woman
who relinquishes her child for adoption can feel
a sense of relief her baby will have a lifestyle
better than what she could provide.
● Possible negative aspects: Divorce of the
adopting parents can be devastating if the child
views himself as the cause of the separation or
as a child unable to find a secure family for a
second time.
Family Functions and Roles
● The family roles that people view as appropriate
are the ones they saw their own parents
fulfilling.
● As new generations takes on the values of the
previous generation, traditions and culture pass
from generation to generation.
● As nurse, it is important to identify the roles that
the family members assume because family
 roles are changing and often not as well defined Assessment of Family Structure and Function
as in the past. THE WELL FAMILY
Assessment of psychosocial family wellness
Family Task requires a measurement of how the family relates and
1. Physical Maintenance interacts as a unit, including communication patterns,
2. Socialization of Family Members bonding, roles and role relationships, division of tasks
3. Allocation of Resources and activities, governance, decision making, problem
4. Maintenance of Order solving, and leadership within the family unit.
5. Division of Labor
6. Reproduction, Recruitment and Release of
Family
7. Placement of Members into the Larger Society
8. Maintenance of Motivation and Morale

Family Stages/ Life Cycles

Stage 1: Marriage and the Family
Stage 2: The Early Child-Bearing Family Universal Characteristics of Families
Stage 3: The Family with Preschool Children ● Universality
Stage 4: The Family with School-Age Children ● Emotional basis
Stage 5: The Family with Adolescent Children ● Limited size
Stage 6: The Family of Middle Years ● Formative influence
Stage 7: The Family in Retirement or Older Age ● Nuclear position in the social structure
● Responsibility of the members
● Social regulation

Universal Characteristics of Families

A. Universality:
There is no human society in which some form
of the family does not appear. Malinowski writes the
typical family a group consisting of mother, father and
their progeny is found in all communities, savage,
barbarians and civilized. The irresistible sex need, the
urge for reproduction and the common economic needs
have contributed to this universality.

B. Emotional basis:
The family is grounded in emotions and
sentiments. It is based on our impulses of mating,
procreation, maternal devotion, fraternal love and
parental care. It is built upon sentiments of love,
affection, sympathy, cooperation and friendship.

C. Limited size:
The family is smaller in size. As a primary
group its size is necessarily limited. It is a smallest social
unit.
D. Formative influence:
The family welds an environment which
surrounds, trains and educates the child. It shapes the
personality and moulds the character of its members. It
emotionally conditions the child.
E. Nuclear position in the social structure:
The family is the nucleus of all other social
organizations. The whole social structure is built of
family units.
F. Responsibility of the members:
The members of the family has certain
responsibilities, duties and obligations. Maclver points
out that in times of crisis men may work and fight and
die for their country but they toil for their families all
their lives.
G. Social regulation:
The family is guarded both by social taboos and
by legal regulations. The society takes precaution to
safeguard this organization from any possible
breakdown.
● Abiding familiarity with others. Can know
ourselves and others well.
● Economic benefits.
CHARACTERISTICS OF HEALTHY FAMILIES
● Appreciation – notice the less obvious things,
express appreciation often.
● Kindness –tends to be catching.
● Communication – listen so others will talk, talk
so others will listen.
● Time Together – plan it, don’t wait to find it,
need quantity to have quality.
● Values and Standards – communicate them
clearly, follow them consistently.
● Strictness & Permissiveness – firm, fair, and
friendly.
● Problem Solving – look for solutions, not for
blame.
● Traditions –give a sense of identity.
● Fun & laughter – plan it, use props, bring home
jokes.

Functions of Families
● Family ties like intimacy.
● Economic cooperation - families are consuming
and producing units.
● Reproduction and socialization.
● Only a family can produce a socialized adult.

WHAT SHOULD A CHILD LEARN IN A FAMILY?

● Values, moral
● Culture and traditions
● Self concept
● How to solve problems/conflict resolution
● Commitment to family is first
● Each member must contribute
● Change is possible
● How to make a decision
● Communication

WHY LIVE IN A FAMILY?

● Love and closeness
● Offer continuity in emotional attachments,
rights, and obligations.
● Close proximity which facilitates cooperation
and communication.
 Sociocultural Aspects of Mother
& Child Health
Diversity in a population means there is
a mixture or variety of
sociodemographic groups, experiences,
and beliefs in the population.
Culture is a view of the world and a set
of traditions a specific social group uses
and transmits to the next generation.
Transcultural nursing is care guided
by cultural aspects and respects
individual differences (Darnell &
Hickson, 2015)
Techniques of Sociocultural
Assessment
Communication Pattern/Language
- (not only what people say but also
how they say it) are determined by
culture and are increasingly
important during times of stress.
- Confirm it to the patient
- Written Information or Interpreter
- Cultural variations are respected
- Using short, easy sentence
b. Nonverbal Communication
• Eye to eye contact
• Touch
• Shaking hands
• Tattoos
c. Use of Conversational Space –
being aware of that use of space is
culturally determined helps you to
respect the use of space. Respect
to modesty is a way to respect
close space.
c. Time Orientation
- Cultural pattern that is geared
toward punctuality regarding
appointments or concern for time.
- Differs whether a culture
concentrates on the past, present
& future.
d. Family Orientation
- Family and structure and roles may
be culturally determined.
- Identifying the family decision-
maker is important.
e. Male and Female Roles
- In most culture, man is the
dominant figure.
- In contrast, in some culture, the
woman may be the dominant
person in the family, esp. the oldest
woman.

g. Religion
– because religion guides a person’s
overall life philosophy, it influences
how he or she feels about health
and illness.
h. Health Belief
- Health beliefs are not universal
I.Nutrition Practices
- Food and methods of preparation are
strongly culturally related.
j. Pain Responses
- A person’s response to pain is both
individually and culturally
determined.
- Threshold sensation-amount of
stimulus that results in pain
- Pain Threshold-individual reports
that a stimulus is painful
- Pain Tolerance-individual
withdraws from a stimulus
Chapter 5: Reproductive and Sexual
Health
Reproductive Development
• Physiologic readiness for
childbearing begins during
intrauterine life
• Puberty
Reproductive Development
1. Intrauterine Development
- The sex of an individual is
determined at the moment of
conception by the chromosome
information of the particular ovum
and sperm that joined.
- Week 5 of intrauterine life-
primitive gonad is formed.
Mesonephric (wolffian) &
Paramesonephric (műllerian)
undifferentiated ducts are
present.
- Week 7 or 8 – in chromosomal
males, early gonadal tissues
differentiates into primitive testes
and begins formation of
testosterone.
- Week 10 – if testosterone is not
present, the gonadal tissue
differentiates into ovaries.
2. Pubertal Development
- The Hypothalamus, under the direction
of the Central Nervous System
may serve as a gonadostat or
regulation mechanism set to
“turn on” gonad functioning.
- The theory that the girl must reach
a critical weight of approximately
95 lbs (43 kg) or develop a critical
mass of fat before the
hypothalamus is triggered to send
initial stimulation to APG to begin
gonadotropic hormone formation.
Pubertal Development
• Role of Androgen
- Responsible for muscular
developement, physical growth and
increase in sebaceous gland
secretions.
- Males- produced by the adrenal
cortex and testes
- Females- produced by the adrenal • Growth of face, axillary and pubic
cortex and ovaries hair

- Adrenarche- development of pubic • Voice Changes

and axillary hair
• Penile Growth
• Role of Estrogen
• Increase in Height
- Increse in levels during puberty
• Spermatogenesis
(females) influences the
development of the uterus,
fallopian tubes and vagina; typical
fat distribution; hair pattern; breast Anatomy & Physiology of the
development and end to growth Reproductive System
(epiphesial closure). Male Reproductive System

- Thelarche- the beginning of breast

development.

Secondary Sex Characteristics

Females

• Growth Spurt

• Increase in the transverse diameter

of pelvis

• Breast development

• Growth of Pubic Hair

• Onset of Menstruation

• Growth of Axillary Hair

• Vaginal Secretions
Suppose Kevin Matthews tells the nurse
he is planning on having a vasectomy
• Menarche – first menstrual period
after the birth of his new child but is
worried about having his testes removed
this way. The nurse would want the
clinic’s educational material on
Secondary Sex Characteristics
vasectomy to clearly state that this
Males
procedure involves which of the
• Increase in Weight following structures?
a. The seminal vesicles
• Growth of Testes b. The epididymis
c. The vas deferens
d. The ducts of the bulbourethral glands
 Physiology of Menstruation (Secretory Phase)

CHARACTERISTICS DESCRIPTION

Beginning (menarche) Average age onset, 12-13 years; average range 9-17 years

Interval between cycles Average of 28 days; cycles of 23 to 35 days not usual

Duration of menstrual flow Average flow, 2-7 days; ranges 1-9 days not abnormalPhysiology of Menstru

Amount of menstrual flow Difficult to estimate; average 30-80 ml

Color of menstrual flow Dark red; a combination of blood mucus and endometrial cells

Odor Similar to that of marigolds

Female reproductive system

• Menstruation • Third Phase of Menstrual Cycle
Defined as episodic uterine (Ischemic Phase)
bleeding in response to cyclic
hormonal changes. • Fourth/Final Phase of Menstrual
Cycle
(Menses)
Characteristics of Normal Menstrual
Cycle

Menstrual Cycle

• First Phase of Menstrual Cycle

(Proliferative Phase)

• Second Phase of Menstrual Cycle

 participants in helping plan or
prevent conception of children

Menopause

•The cessation of menstrual

cycles.

•Usually occurs between 40-55

years old.

•Both age of menarche and age

of menopause is familial.

CERVICAL CHANGES
•The earlier the age of
menarche, he earlier the age of
menopause.

Sexuality and Sexual Identity

• Sexuality is a multidimensional
phenomenon that includes
feelings, attitudes and actions.

• It encompasses and gives direction

to a person’s physical, emotional,
social and intellectual responses
throughout life

• Each person is born a sexual being

and his or her gender identity and
role behavior evolve from and
usually conform to the societal
expectations within that person’s
culture.

• Nurses can play a major role in

promoting sexual health through
education and discussion.
Education Regarding Menstruation

- Vital to girls’ future child-bearing

and their self concept as women.

- Equally important for boys so that

they can appreciate the cyclic
process of women’s reproductive
system and can be active
Human Sexual Response
• The plateau stage is reached just
before orgasm.

• In the woman, the clitoris is drawn

forward and retracts under the
clitoral prepuce, the lower part of
the vagina becomes extremely
congested (formation of the
orgasmic platform), and there is
increased breast nipple elevation

• Orgasm occurs when stimulation

proceeds through the plateau
stage to a point at which a vigorous
contraction of muscles in the pelvic
Sexual Response Cycle
area expels or dissipates blood
and fluid from the area of
congestion

• As the shortest stage in the sexual

response cycle, orgasm is usually
experienced as intense pleasure
affecting the whole body, not just
the pelvic area

1. Excitement • The resolution is a 30-minute

2. Plateau period during which the external
3. Orgasm and internal genital organs return
4. Resolution to an unaroused state

• Excitement occurs with physical

Men VS Women
and psychological stimulation Female Sexual Response Cycle
(sight, sound, emotion, or
thought) that causes
parasympathetic nerve
stimulation. This leads to arterial
dilation 251 and venous
constriction in the genital area.
The resulting increased blood
supply leads to vasocongestion
and increasing muscular tension
 Types of Sexual Expression
Female Sexual Response Cycle
• Celibacy

• Masturbation

• Erotic Stimulation

• Fetishism

• Transvestism

• Voyeurism

• Sadomasochism
Other types of sexual expression
- Exhibitionism
- Pedophiles
Male Sexual Response Cycle
Disorders of Sexual Function

• Primary Sexual Dysfunction

• Erectile Dysfunction
• Premature Ejaculation
• Failure to achieve orgasm/
decreased sexual desire
• Vaginismus
• Dyspareunia
• Inhibited sexual desire

Secondary Sexual Dysfunction

Types of Sexual Orientation

• Caused by chronic diseases such
• Heterosexuality as peptic ulcers, chronic pulmonary
ds, obesity, STDs and other
• Homosexuality debilitating ds.

• Bisexuality

• Transsexuality
Chapter 6: Reproductive Life
Planning
Reproductive life planning
• Includes all the decisions an
individual or couple make about
having children.
• An individual or couples choice of
contraceptive method should be
made carefully with complete
knowledge about the advantages,
disadvantages, and side effects
of the various options.
▪ Things to consider are
✓ Personal Values
✓ Ability to use method correctly
✓ How the method will affect sexual
enjoyment
✓ Financial factors
✓ Status of couple’s relationship
✓ Prior experiences
✓ Future plans
Assessment for Contraception
Options and Possible
Contraindication
Important things to consider when
helping a couple choose a method that
will be right for them include:
• Personal values
• Ability to use a method correctly
• If the method will affect sexual
enjoyment
• Financial factors
• If a couple’s relationship is short term
or long term
• Prior experiences with contraception
• Future plan
An ideal contraceptive should be:
• Safe
• Effective
• Compatible with spiritual and cultural
beliefs and personal preferences of
both
the user and sexual partner
• Free of bothersome side effects
• Convenient to use and easily
obtainable
• Affordable and needing few
instructions for effective use
• Free of effects (after discontinuation)
on future pregnancies
Information that needs to be
assessed:
• Vital signs, possibly a Pap smear,
pregnancy test, gonococcal and
chlamydial screening, and perhaps
hemoglobin for detection of anemia
 • Obstetric history, including STIs,
past pregnancies, previous
elective abortions, failure of
previously used methods, and
compliance history with
previously used methods
• Subjective assessment of the
patient’s desires, needs, feelings,
and understanding of conception
(a teen may believe she is too
young to get pregnant; a woman
in the immediate postpartum
period may believe she cannot
conceive immediately, especially
if she is breastfeeding)
• Sexual practices, such as
frequency, number of partners,
feelings about sex, and body
image
Abstinence
Refraining from sexual relations, has a
theoretical 0% failure rate and is also
the most effective way to prevent STIs.
Lactation Amenorrhea
- As long as a woman is breast-
feeding an infant , there is some
natural suppression of ovulation.
- However, the method is not
dependable because a woman
may ovulate but not menstruate.
- After 6 months of breast-feeding
the woman should be advised to
choose another method of
contraception.

Family planning methods

1. Natural Methods of Reproductive
Life Planning
2. Artificial Methods of
Reproductive Life Planning
3. Surgical Methods of
Reproductive Life Planning
4. Abstinence
Coitus Interruptus
- The couple proceeds with coitus
until the moment of ejaculation.
The man withdraws and
spermatozoa are emitted outside
the vagina.
- Unfortunately, ejaculation may
occur before withdrawal is
complete and despite the care
 used, some spermatozoa may be
deposited in the vagina.
- It offers little protection against
conception.
Natural Methods of Reproductive Life
Planning
- To use the method, a woman takes
her body temp. each morning
immediately after waking before
she undertakes any activity
Cervical Mucus (Billings) Method

Calendar/ Rhythm Method

- Uses the changes in cervical
mucus that occur naturally with
- Requires a couple to abstain from
ovulation. Before ovulation each
coitus on the days of a menstrual
month, the cervical mucus is thick
cycle when the woman is most
and does not stretch when pulled
likely to conceived (3 to 4 days
between the thumb and finger
before and 3 to 4 days after
(Spinnbarkeit).
ovulation).

- Woman should keep a diary of

- Just before ovulation, mucus
secretion increases.
six menstrual cycles.

- To calculate “safe days “ she

- With ovulation (the peak day),
cervical mucus before copious,
subtracts 18 from the shortest
thin, watery and transparent. It
cycle and 11 from her longest
feels slippery and stretches at least
cycle documented.
1 inch before the strand breaks.

Basal Body Temperature Method

Two-Day Method
- Before the day of ovulation, a
woman’s BBT falls about half a - A woman assess for vaginal

degree and at the time of ovulation, secretions daily. If she feels

her BBT rises a full degree secretions for 2 days in a row, she

because of the influence of avoids coitus that day and the day

progesterone.
 following as the presence of
secretions suggests fertility.
- A woman can plan or prevent
pregnancy easily and effectively

- The method requires conscientious with this easy to use tool.

daily assessment.

Symptothermal Method Ovulation Awareness

- Combines the cervical mucus and
BBT methods
- This is the use of over-the-counter
ovulation detection kit. It detect the
midcycle surge of luteinizing hormone
that can be detected in urine 12 to 24
hours before ovulation.

Fertility Beads/ Cycle Beads Artificial Methods of Reproductive

Life Planning
- A hands-on visual tool used by
millions of women worldwide,
BARRIER METHODS
Cycle Beads is the original way
✓ SPERMICIDES
to identify your fertile days
using the Standard Days
Method® of family planning.

- Cycle Beads is a color-coded

string of beads representing a
woman's menstrual cycle. It
helps a woman track her cycle,
identify when are fertile days
and non-fertile days, and
monitor that her cycles are in
range for effective use of this
family planning method.
Male Condoms
- A latex rubber or synthetic sheath
that is placed over the erect penis
before coitus.
- Prevents pregnancy by depositing
the spermatozoa in the tip of the
condom.
Female Condom
- Latex sheaths made by
polyurethane and lubricated by
nonoxynol-9.
- The inner ring (closed end) covers
the cervix and the outer ring (open
end) rests against the vaginal
opening.
- Male and female condom should
not be used together.
Diaphragms
- A circular rubber disc that is placed
over the cervix prior to intercourse.
- They should be left in place for 6
hours afterwards.
- Should not be place longer than 24
hours
Cervical Caps
- Caps are made of soft rubber, are
shaped like a thimble and fit snugly
over the uterine cervix.
- Many women cannot use cervical
cap because their cervix is too
short for the cap to fit properly.
- It can remain longer than
diaphragms because they do not
put pressure on the vaginal walls or
urethra.
- Length of time should not exceeds
to 24- 48 hours.
Barrier methods and their effects
• Pregnancy
• Sexual Enjoyment
• Adolescent-girls: uses
spermicide,fitted for diaphrams
or cervical cap
• Boys: Condom (never reused)
• Perimenopuase: cervical caps
not ideal
HORMONAL CONTRACEPTION
Oral Contraceptives / Pills
- Composed of varying amount of
synthetic estrogen combined
with small amount of
progesterone.
- Commonly packed in 28 pills
(21 active pill and 7 placebo
pills)
- Estrogen suppresses LH and
FSH
• Sunday start
• Quick Start
• First Day
• After Childbirth
Mini Pills
- Known as the progestin only pills.
Progestin not allowed the
endometrium to develop
- Taken by women who cannot take
an estrogen-based pill because of
the dangrer of thrombophlebitis.
- Risk for clotting due to increased
estrogen
Estrogen/Progesterone Transdermal
Patch
- Refers to the patches that slowly,
but continuously release a
combination of estrogen and
progesterone.
- 3 weeks applied on, 4th week to
take it out
- May be applied to one of four
areas: upper outer arm, upper
torso (front or back, excluding the
breast), abdomen or buttocks.
Vaginal Rings
- Commonly known as the
NuvaRings
- Consist of a thin, flexible plastic
ring that contains a combination of
estrogen and progestin.
 ✓ Progestin impregnated rings or
- Inserted in the vagina and left in
progestin patches
place for 21 days then removed for
✓ Subdermal implants
7 days.
✓ DMPA
Subcutaneous/ Subdermal Implants

- The implants slowly release the Intrauterine Devices

hormone, suppressing ovulation,

stimulating thick cervical mucus, - A small plastic device inserted into the

and changing the endometrium so uterus through the vagina.

that implantation is difficult.

IUD Insertion & removal
- Inserted and removed using local
anethesia.

- Costly

Artificial Methods of Reproductive Life

Planning
Intramuscular Injections

- A single injection of
medroxyprogesterone acetate
(DMPA or Depo-Provera).

- Given every 12 weeks to inhibit

ovulation, alter the endometrium
and change the cervical mucus.
Hormonal contraception and its
effects
✓ Estrogen/progestin combination
Surgical Methods of Reproductive
Life Planning
a. Vasectomy
- A small incision is made in each
side of the scrotum. The vas
deferens is then cut and tied ,
cauterized or plugged, blocking the
passage of spermatozoa.
- Done in an ambulatory setting such
as physician’s office or
reproductive life planning clinic.
AND CONTINUE TO PRODUCE
TESTOSTERONE. BECAUSE HE
ALSO CONTINUES TO FORM
SEMINAL FLUID, HE WILL
EJACULATE SEMINAL FLUID; IT WILL
JUST NOT CONTAIN SPERM
b. Tubal Ligation
- The fallopian tubes are occluded
by cautery, crushing, clamping or
blocking the tubes (Essure),
thereby preventing passage of both
sperm and ova.

- Should not be undertaken unless

the woman does view it as a
permanent irreversible procedure.
Thank you

VASECTOMY DOES NOT INTERFERE

WITH THE PRODUCTION OF SPERM;
THE TESTES CONTINUE TO
PRODUCE SPERM AS ALWAYS, BUT
THE SPERM SIMPLY DO NOT PASS
BEYOND THE PLUGGED VAS
DEFERENS AND ARE ABSORBED AT
THAT POINT. THE MAN WILL STILL
HAVE FULL ERECTION CAPACITY
 EXUALLY TRANSMITTED INFECTIONS (STIS)
S SYPHILIS
 IT IS CAUSED BY AN ORGANISM CALLED
What is STI?
Sexually transmitted infections (STIs) are
infections transmitted through sexual contact. While
some STIS are easily treated, others are dangerous and
can lead to serious illness, infertility or even death. It is
important that we know how STIS are transmitted and
how we can protect ourselves and sexual partners from
infection. Anyone can catch an STI. Don't believe that
only one certain sorts of people get STIs. It's not true. It's
not who you are but what you do that put's you at risk of
getting infected with STIs.
GONORRHEA
GONORRHEA IS CAUSED BY A BACTERIA
CALLED NEISSERIA GONORRHEA. It is spread
through sexual contact. It can't be picked up from toilet
seats, towels etc.
S/S: Symptoms don't always occur. If they do, it is
usually 3 to 7 days after sexual contact with an infected
partner.
Men experience a burning sensation when
urinating and there is a white or yellow discharge from
the penis (urethral gonorrhea). Women may experience a
burning sensation when urinating and sometimes a
heavier-than-usual vaginal discharge, abnormal
menstruation. Gonorrhea in women can move up from
cervix to uterus and fallopian tube (Pelvic Inflammatory
Disease) and cause a severe illness with pain in your
abdomen and fever for which may need hospitalization.
This can be threatening situation. In males it can
cause secretal pain and swelling which can lead to
infertility. Both men and women may catch gonorrhea in
the anus (rectal gonorrhea) or throat (pharyngeal
gonorrhea). Rectal and pharyngeal gonorrhea often have
no symptoms. Gonorrhea and chlamydia often go
together. Pregnant mothers with gonorrhea can infect the
child when it passes through the birth canal causing
blindness to the newborn child.
Treatment: Gonorrhea is usually treated with a single
dose of an antibiotic, either a tablet or a capsule, or an
injection.
SPIROCHETE THAT MOVES THROUGH THE
SKIN OR MUCUS MEMBRANE AND INTO THE
BLOODSTREAM.
S/S: A painless sore called a chancre appears in the point
area where the organism enters the body usually the
genital organs: sometimes the mouth and anus in their
early stages, 2 to 3 weeks after- infection. Usually, it
clears up after 2 to 3 weeks, but the bacteria still remain.
Women may not notice symptoms because sooner it can
be painless and out of sight on the vaginal walls. The
next sign appears three to twelve weeks later. They may
include a rash and ulcers in the mouth and genital area.
Years later syphilis can damage the brain and the heart.
A mother can also infect her baby. These are very
serious complications. They only occur if the infection
has not been diagnosed and treated.
Treatment: It is important that it is diagnosed in its early
stages and treated
with antibiotics.
CHLAMYDIA
CHLAMYDIA ONE IS OF THE COMMON
STIs. It is called the silent STI because it causes mild
symptoms in men and usually no symptoms in women. It
is caused by chlamydia trachomatis, which can infect
the cervix, uretha, rectum and throat and eyes. Like
gonorrhea, the chlamydia can move up from your vagina
and cervix to uterus and fallopian tube to cause Pelvic
Inflammatory Disease (PID). It can result to a fatal
blockage in the fallopian tube from searing which can
make you sterile (unable to have children). If the tubes
are partially blocked, the baby can start to grow outside
of the normal place in the uterus (Ectopic Pregnancy),
for instance in one of the tubes or abdominal cavity. In
men it can cause infection in the testicles, resulting to
swelling then scarring that can lead to infertility.
Treatment: Chlamydia is treated with 7 day course of
antibiotics from the tetracycline group.
GENITAL HERPES
IT IS CAUSED BY A VIRUS CALLED
HERPES SIMPLEX VIRUS. It is spread by vaginal, or
anal or oral sex, or direct skin to skin contact.
S/S: Clusters of blisters or ulcers on the genitals which is
painful, tingling or itchy. It may be accompanied by
flu-like symptoms and occasionally pain on urinating.
The Virus remains in the body and can cause on-and-off
outbreaks, usually of decreasing frequency and severity.
The attack eventually stops.
Treatment: An anti-herpes drug (e.g. acyclovir) may be
prescribed, though it may not sure but help speed of
healing. Also the Sores in salty water would relieve pain
and discomfort.
HEPATITIS B
HEPATITIS B IS A VIRUS THAT CAN
CAUSE AN INFECTION IN THE LIVER. It is
transmitted when semen, mucus or blood from an
infectious person enters the body of another person. This
can occur during vaginal and anal sex and through
needle-sharing among drug users. Hepa B does not
usually enter the body through the mouth, but it can
during oral sex if semen or mucus enter a mouth with
inflamed gums. Hepa B is not spread by food or drink.
S/S: It can vary from a mild, unnoticed infection to an
obvious illness with jaundice (this means a yellow color
of the skin and white of the eyes, dark urine and pale
stools), fever, loss of appetite, body weakness and joints
pain.
Treatment: Rest and avoiding alcohol seem to be the best
ways of dealing with it, although recovery may take
some months. Hepa. B is the only STI which has a
preventive vaccine. This is useful to protect partners of
people who carry the virus.
HIV/AIDS
HIV stands for HUMAN
IMMUNODEFICIENCY VIRUS. It is the virus that
causes (AIDS) Acquired Immunodeficiency Syndrome.
When someone is infected with HIV, the virus attacks
the person's Immune system (the system that defends the
body from illness.) A person develops AIDS when his or
her immune system becomes so damaged that it can no
longer fight off diseases and infection, HIV is spread
mainly in on of three ways.
● through unprotected penetrative sexual
intercourse (vaginal and anal)
● through blood transfusion and sharing of
injecting instruments such as needless and
syringes
● from an HIV-positive mother to her baby during
pregnancy, delivery and breast feeding.
The virus cannot be passed on through touching,
shaking hands, hugging/embracing food, drink or
mosquitoes.
S/S: HIV infection causes no signs or symptoms for 5-10
years or longer. Nevertheless, it is a chronic infection
and people with it are chronic carriers. They can infect
other people for the rest of their lives. Unless they have
been tested for HIV, they are not aware that they are
infected.
When an HIV infection progresses to AIDS,
there are many possible signs and symptoms that would
arise. The most common are: unexplained weight loss
and persistent tiredness, night sweats, persistent or on
and off LBMs, swollen glands in the neck, armpits and
groin; shortness of breath and persistent dry cough.
Treatment: Currently there is no cure and treatment is
experimental.
SCABIES
INFECTION BY SCABIES MITES CALLED
SARCOPTES SCABICI. It is passed on through
skin-to-skin contact.
S/S: Red itchy lumps in hairy parts of the body and other
places such as wrists, forearms and penis.
Treatment: Application of lotion to the affected areas
and elsewhere.
PUBIC LICE (CRABS)
INFESTATION BY THE CRAB-LIKE LICE
CALLED PTHIRIUS PUBIS. It is spread directly from
one person to another during intimate contact.
S/S: Itchiness in the public hair or occasionally other
hairy parts of the body. A close look can spot the tiny
lice clinging to the pubic hair.
Treatment: Application on lotion to the affected areas
and elsewhere.

GENITAL WARTS
IT IS CAUSED BY THE VIRUS CALLED
HUMAN PAPILLOMA TRANSMITTED DIRECTLY
FROM SKIN TO SKIN DURING SEXUAL
CONTACT. It is spread through vaginal, or anal sex or
other direct contact.
S/S: Small, painless lump looking like small
cauliflowers appear on the penis, on the vulva or cervix
or in or around the anus. Some women may have warts
inside the vagina or in the cervix and be quite unaware
of them. In men the warts are more obvious. In both
sexes, warts can also appear around the anus.
Treatment: Warts are easily treated by applying
chemicals or freezing them or by operating on them.
Other treatments are laser and diathermy (heat
treatments). Sometimes warts don't clear up with the first
course of treatment, so follow up checks are important.
CANDIDIASIS (MONILIASIS)
INFECTION IS FROM THE FUNGUS
CALLED CANDIDA ALBICANS. Candidiasis is
usually a vaginal infection. It maybe worsen by sexual
activity but occurs in women who are not sexually
active. Pregnancy, diabetes or the use of birth control
pills and antibiotics can make a women more prone to
develop this infection.
S/S: In women there is an abnormal white or yellow
vaginal discharge, with redness and itching. In men,
there is an itchy rash on the head of the penis or under
the foreskin.
Treatment: Vaginal tables and antifungal
Creams.
TRICHOMONIASIS
IT IS CAUSED BY A PARASITE CALLED
TRICHOMONAS VAGINALIS SPREAD THROUGH
VAFINAL SEX.
S/S: Women develop an abundant watery, bubbly
yellowish discharge with a fishy smell and an itch. Men
carry the organism often without symptoms or they may
not feel comfortable when urinating.
Treatment: A course of antibiotics for a week or less in
both men and women.
BACTERIAL VAGINOSIS(BV)
BV IS A BACTERIAL INFECTION OF THE
VAGINA CAUSED BY ONE OR SEVERAL TYPES
OF BACTERIA, MOST COMMONLY
GARDNERELLA VAGINALIS.
S/S: A small amount, white, sticking homogenous foul
smelling vaginal discharge could be bacterial vaginosis.
Treatment: A course of antibiotics for
a week or less.
What should you do if you think you have STI?
If you notice signs and symptoms of any of the
STI mentioned or have had unprotected sex (Vaginal or
anal) with a person who has an STI, you should see a
doctor immediately. Remember that some STI do not
show any signs and symptoms especially in women. An
infected person may infect others without knowing it.
You do not have to wait in the hope that the STI will go
away. Even if they do, the disease may still be present.
IF YOU HAVE AN STI...
1. Take the complete course of antibiotics or
medicine prescribed
2. Return for a follow up with your doctor to make
sure that you are completely treated.
3. Do not have sex until you are certain that you
are cured. But if you do, use a condom. Use a
waterbased lubricant (KY) jelly to prevent
irritation.
4. Have your sexual partner treated.
PREVENTION
DIFFERENT WAYS TO BE SAFE:
1. Abstinence - no sex at all. People make this
choice at certain times in their lives, perhaps
until they have established a trusting
relationship.
2. Be faithful - maintain a mutually single-partner
relationship. Have a partner who is not having
sex with anyone.
3. Condoms - correct and consistent use of
condom during penetrative sex reduces the risk
of getting an STD.
For accurate, credible and confidential information call:
Remedios AIDS Hotline:
225-2535
Dumaguete City Health Office
500-551
500-921
597-450
Women's AIDS Hotline:
504-427
504-508
ReachOut AIDS Hotline:
895-1660
Iloilo City AIDS Hotline:
798-80
Legaspi City AIDS Hotline:
447-39
Cebu City AIDS Hotline:
214-58
Davao City AIDS Hotline:
221-0422
Baguio City AIDS Hotline:
422-8096
METHAMPHETAMINE HYDROCHLORIDE
What you should know about
SHABU
GENERAL FACTS
Methamphetamine hydrochloride, a type of
amphetamine is also known as "poor man's cocaine."
Other names are "shabu," "ubas," "siopao," "sha," and
"ice."
SOURCE
This chemical substance is being smuggled into
the country by drug traffickers, and syndicates. It has
been reported that there are clandestine laboratories in
the Philippines suspected of manufacturing this
substance.
USUAL FORM OF THE PRODUCT
"Shabu" is a white, odorless crystal or crystalline
powder with a bitter numbing taste.
METHOD OF USE
Abusers are known to take this drug through
ingestion inhalation (chasing the dragon), sniffing
(snorting) or by injection. Amphetamines are taken
orally and are associated with a rapid onset of action,
within one hour. If taken intravenously or through
injection, they have an almost immediate effect.
ADVERSE EFFECTS
● Produces anxiety, tension, irritability, irrational
behavior, talkativeness, and loss of self-control.
● Results in loss of appetite and inability to sleep.
● Euphoria, elation.
● Can lead to acute psychotic reactions, violent
and destructive behavior and recklessness that
may result in accidents
PHYSIOLOGICAL EFFECTS
Includes chest pain, irregularity of heartbeat,
elevated or lowered blood pressure, evidence of weight
loss, convulsion and death from cardiac arrest.
LONG TERM EFFECTS
Psychiatric consequences are the major feature
of chronic "Shabu" abuse and dependency. Prolonged
use and even a single exposure especially if administered
intravenously can lead to psychosis, resulting to
schizophrenia, characterized by the presence of
paranoid, auditory and visual hallucinations.
Some chronic users have difficulty concentrating
and remembering things. Diminished ability to cope with
problems and difficulties in facing reality are common.
Lack of interest, ambition and motivation may also result
from long term use.
Chronic snorters may suffer from severe
irritation of the nasal passages and at times may develop
tissue perforation of the nasal septum so that they
become prone to frequent nose bleed. Renal damage,
heart disease and stroke have been documented among
chronic abusers.
Injecting "shabu" from contaminated needles
may lead to risk of infections resulting in inflammation
of blood vessels (phlebitis), infections of the heart valves
(endocarditis), blood posioning (septicemia), and HIV/
AIDS, all of which can lead to death.
TOLERANCE
Abusers who frequently take the substance
require higher doses to achieve the desired effects.
Tolerance sets in after a few weeks of regular use.
PSYCHOLOGICAL AND PHYSICAL
DEPENDENCY
The chemical substance is known to produce
psychological and physical dependency. These are
characterized by anxiety, tension and craving for the
substance. This substance-seeking behavior can lead to
various crimes and other anti-social acts.
These are feeling of apathy, hypersomnia
(excessive period of sleep) and depression which may
lead to suicide.
PENALTY: Article II Section 11, RA9165
Section 11. Possession of Dangerous Drugs - the
penalty of LIFE IMPRISONMENT TO DEATH and a
fine ranging from Five Hundred Thousand Pesos
(P500,000.00) to Ten Million Pesos (P10,000,000.00)
shall be imposed upon any person, who, unless
authorized by law, shall possess any dangerous drug
regardless of the degree of purity thereof (50 grams or
more of methamphetamine hydrochloride or "shabu").
BREAST CARE
Self Examination Guide for Women
STEP 1: VISUAL EXAMINATION
● Face the mirror with arms at your side and look
at both breasts carefully for lumps, puckering,
any change in skin color, fluid around the nipple
or other changes in appearance.
● Repeat the procedure with your arms raised over
your head.
● Next, place your hands on your hips and with
your chest muscles tensed. Repeat the careful
visual inspection.
● Finally gently squeeze each nipple and check for
discharge
● Humarap sa salamin nang nakalagay ang mga
braso sa iyong tagiliran. Suriing mabuti ang
iyong suso sa maaring pagbabago ng hugis o
laki nito. Tingnan ang balat nito kung mayroong
pangungulubot o may lumabas mula sa utong.
● Itaas ang dalawang braso nang lagpas sa iyong
ulo. Ulitin ang buong nabanggit na paraan ng
pagsusuri.
● Ilagay naman ang iyong braso sa magkabilang
balakang. Patigasin ang iyong mga muscles sa
dibdib at ulitin ang nabanggit na pagsusuri.
● Dahan-dahang pigain ang iyong utong at
tinignan kung may lumabas na discharge.
● Atubang sa salamin samtang pinahimutang ang
imong bukton sa masigkakilid. Tan-awa pag-ayo
ang imong mga suso kung aduna bay mga bukol
o tibugol, o bisan unsang kausaban sa porma o
gidak-on niini.
● Usba ang unang gibuhat nga paagi samtang
gi-isa ang imong duhang bukton sa imong ulo.
● Sunod, ibutang ang imong duha ka kamot sa
imong bat-ang samtang pinatigson ang dughan.
Usba ang maayong pag-usisa pinaagi sa
pagtan-aw sa imong suso.
● Sa katapusan, pislita ang matag atngal ug
usisaha kung aduna bay tolobig nga mugavas
gikan niini.
STEP 2: CLOCK EXAMINATION (Standing/Taking a
Bath)
● Put one hand behind your head.
● Soap your other hand
Press it firmly against your breast with your
fingers held flat.
● Make small circles from the breast bone towards
the nipple feeling your entire breast and
underarm area for lumps.
● Then raise your other arm and examine your
other breast.
● It is normai to feel a ridge of firm tissue around
the lower curve of each breast.
● Ilagay ang kamay sa likod ng ulo
● Sabunin ang kabilang kamay at idiin sa iyong
suso na nakalapat ang mga daliri.
● Paikot na imasahie ang iyong suso mula sa
breast bone hanggang sa may utong. Kung may
makapang isang matigas na laman dito, huwag
matakot sapagkat ito ay normal na bagay
lamang.
● Ibutang ang usang kamot luyo sa imong ulo
● Saboni ang pikas kamot ug iduot imong suso
samtang maaayong pagkadapat ang mga tudlo.
● Hapuhapa ang palibot sa imong suso gikan sa
bukog sa dughan ngadto sa atngal ug pamatia
ang tibuok suso ngadto na gayudsa dapit ilok,
kung aduna bay bukol o tibugol.
STEP 2: CLOCK EXAMINATION (Lying Down)
● Lie on your back in a comfortable position.
● Place a pillow under your left shoulder.
● Place your left hand under your head, then
examine you're your left breast with your right
hand using the same procedure you used in the
shower.
● Now move the pillow under your right shoulder
and examine your right breast using your left
hand. Repeat the procedure for self-examination.
.
● Humiga nang nakalapit ang katawan
● Maglagay ng unan o tuwalya sailalim ng iyong
ulo at suriin ang kaliwang suso sa pamamagitan
ng kanang kamay. Gamitin ang nabanggit na
paraan.
● Ulitin ito sa kabilang suso na ginagamit naman
ang kaliwang kamay.
● Higda nga hamugaway ang imong posisyon.
● Butangig unlan ilalum sa walang abaga
 ● lbutang ang walang kamot ilalom sa imong ulo
dayon susi- hon ang walang suso gamit ang
tuong kamot sa samang paagi nga imong gibuhat
samtang naligo.
● Karon, ibalhin ang unlan sa tuong abaga ug
susihon ang tuong suso pinaagi sa walang
kamot. Himoa pag-usab ang pamaagi alang sa
kinaugalingong pag usisa.
makabatyag o makakita ug talagsaong tibugol sa imong
suso, pakunsulta gayud dayon sa doktor, AYAW
KAHADLOK. Kadaghan sa mga tibugol dili
maka-kanser, apan ang imo rang doktor ang makasulti
niini.

IMPORTANT REMINDERS
➢ Examine your breast every month one week
after menstruation
➢ It is still necessary for post-menopausal women
to examine themselves.
➢ For mothers who are breastfeeding, it is best to
examine themselves after nursing.
➢ It is necessarty for women ages 35 and above to
undergo PAP SMEAR once a year for two
consecutive years. If results are negative for two
consecutive years, PAP SMEAR should be done
once every three years thereafter.

Do not hesitate to discuss anything unusual with

your doctor What you report can help you stay healthy.
If you feel or see a lump in your brest consult your
doctor at once. DO NOT BE AFRAID. Most lumps are
not cancerous, but only the doctor can determine this.

MGA MAHINUNGDANONG PAHINUMDUM

➢ Usisahon ang imong suso kada bulan o use ka
semana pagkahuman sa imong binulang regla.
➢ Gikinahanglan pa gihapong usisahon ang
kaugalingong suso bisan pa sa mga babayeng
nagmenopos
➢ Alang sa mga inahan nga nagpasuso, labing
maayo nga susihon usab ang kaugalingong suso
human magpasuso.
➢ Gikinahanglan sa mga babaye nga nag-edad ug
35 pataas pa, nga magpa-PAP SMEAR. Buhaton
kini ka-usa sa usa ka tuig sulod sa nagsunod nga
duha ka tuig. Kung negatibo ang resulta sulod sa
nagsunod nga duha ka tuig, ang PAP SMEAR
buhaton kausa sa matag tulo ka tuig human
niana.

Ayaw pagduhaduhag adto sa doktor ug hisgoti

gayud dayon ang bisan unsang dili normal nga
mamatikdan sa suso. Ang pagkabana maoy makatabang
pagbaton ug maayong panglawas Kung ikaw
10 KA BUTANG NGA ANGAY MAHIBALOAN
KABAHIN SA COVID-19 NGA MGA BAKUNA
RESBAKUNA KASANGGA NG BIDA
 magpakisusi ug magpakisayod gikan sa mga kasaligan
UNSA NGA MGA BAKUNA ANG GAMITON SA
PILIPINAS?
Sa pagkakaron, limitado ang supply sa bakuna
sa tibook kalibutan. Ang 80% niini nga mga bakuna
napalit na sa mga adunahan nga nasud.
Tungod kay walay usa nga kompanya nga
mahimong makahatag sa 110 milyones ka mga bakuna.
Tungod niini ang atong kagamhanan nakigsabot sa 7 ka
mga tigbuhat sa bakuna.
Ang kagamhanan naningkamot nga ang bakuna
nga pagakuhaon adunay Emergency Use Authorization
(EAU). Kini naghatag og pagmatuod nga kini miagi sa
makuti nga pagsusi ug gisuportahan sa gawas o lain nga
pundok sa mga eksperto.
Dili angay nga mabalaka nga ang pagbakuna
makahatag kanimo sa sakit nga COVID-19.
PILA ANG AKONG MABAYRAN KONAKO
MAGPABAKUNA?
Ihatag sa gobyerno ang bakuna nga libre. Wala
kay bayaran para magpabakuna.
KINSA ANG UNA NGA MAKADAWAT SA
BAKUNA?
Tungod kay kinahanglan natong maseguro nga
ang atong sistema sa maayong panglawas nga padayong
maglihok, ang mga frontliner sa medisina mao ang una
nga makadawat sa bakuna.
Ang mosunod mao ang kwalipikado nga mga
senior citizens kay sila ang daling mataptan og sakit o
kamatayon, kini tungod base sa among lokal nga datos
nga ang COVID-19 labi ka peligro sa mga tigulang.
Ang pagkahan-ay kong kinsa ang ma
makadawat sa bakuna gitino sa tabang sa mga eksperto.
Alang sa pinakaulahi nga kamanduan, palihug sa
pagpakli sa pinakabag-ong kasayuran gikan sa
Department of Health.
KANUS-A UG ASA MAGPABAKUNA?
Ang national government nakipaglambigit lokal
nga kagamhanan aron mahatod ang bakuna. Ang lokal
nga panggobyerno ang marehistro ug matarong ang
pagbakuna. Atangi ang mga pahibalo nga nagakigan sa
mga mayor ug gobernador mahitungod niini.
UNSA ANG ANDAMON SA DILI PA
MAGPABAKUNA?
INFORMED CONSENT
Samtang nagpaabot sa pag-abot sa mga bakuna,
nga tinubdan. Mas maayo nga adto mangutana sa mga
lisensyado nga mga medical professionals sa tukmang
pagbakuna alang sa COVID-19. Ato usab nga susihon
ang mga kasayuran nga atong nahibaluan aron
mahatagan kita og giya sa hukom nga pagpabakuna.
SCREENING
Ang imong kahimtang sa panglawas sa
pagkakaron ug sa nilabay nga mga panahon
gikinahanglan nga mahibaloan sanglit kini ang mohatag
og giya kon ikaw angay nga bakunahan, ug unsa ang
bakuna nga angay kanimo. Kinahanglan nga isugilon
ang tinuoray nga kahimtang sa imong panglawas. Dili ka
mahimong mahatagan og schedule kon wala ka moagi sa
screening.
UNSA ANG ANGAY BUHATON SA
ADLAW SA PAGPABAKUNA?
Moadto sa vaccination site diin ikaw nakalista.
Magsul-ot sa face mask ug face shield. Kinahanglan nga
mopirma sa "informed consent." Kini ang dokumento
nga magpamatuod nga boluntaryo ang imong
pagpabakuna. Motuman sa pagsubay sa minimum health
standards sama sa usa ka metro nga distansya,
paghugas/pagsanitize sa kamot. Human mabakunahan,
hatagan ka og vaccination card aron nga masulatan sa
imong pagbakuna ug ang sunod nga pagpabakuna.
Magpabilin sa vaccination site sulod sa usa ka
oras aron maobserbahan sa mga reaksyon o simtomas
human sa pag bakuna. Kay mahinungdanon man ang
imong kahimtang sa imong panglawas, pagasubayon ka
sulod sa 12 ka bulan.
UNSA ANG ANGAY BUHATON HUMAN
MAGPABAKUNA? ADVERSE EVENTS
Mamahimo nga makasinati og mga side effects
sama sa trangkaso apan mawala ra kini sa pipila ka
adlaw. Ayaw kabalaka, senyales ra kini nga naay
nahimong panalipod batok sa sakit sa lawas nimo. Ang
uban makabati og hilanat o sakit ug normal ra kini.
Tawagi ang imong health care provider kong anaay
pagpamula o panakit sa dapit nga naigo sa dagum
pakahuman sa 24 oras ug kong nabalaka ka sa imong
mga simtomas, o tan-aw nimo nga wala kini mawala
paghuman sa pipila ka adlaw. Mahinungdanon nga
masibya sa imong health authorities aron tun-an sa mga
eksperto kung konektado kini sa bakuna o dili. Dili
namo gusto nga ang publiko mabalaka nga dili
kinahanglan.
GIDAGHANON SA DOSES
Sa mga bakuna sa COVID-19 sa atong nasud
kinahanglan ang 2 ka tusok aron pagsiguro sa
proteksyon mahimong magpabakuna sa ikaduhang dose
bisan makasinati sa mga side effects, gawas kon
moingon ang health care worker nga dili una ihatag ang
bakuna.
UNSAY ANGAY NGA BUHATON ARON PADAYON
NGA MAPANALIPDAN ANG ATONG
KAUGALINGON UG ANG ATONG KABANAY?
Sama sa ubang pagbakuna, manginahanglan og
panahon ang imong lawas nga makahimo sa panalipod
sa COVID-19. Kinahanglan gihapon nga motuman sa
mga health protocols sama sa pagsul-ot sa face mask pag
distansya usa ka metro nga gilay-on sa laing tawo;
paglikay sa mga pagpundok ug ang kanunay nga
paghugas sa kamot, aron maghatag ug proteksyon sa
kaugalingon ug ang imong pamilya.
● Atong malikayan ang mga sintomas sa
impeksyon
● Malikayan ang grabe nga empeksyon
● Mapugngan ang pagtakod niini
Bisan pa man niini, sama sa mga bakuna nga
gigamit sa nakalabay nga mga dekada, ang pagpanalipod
batok sa sakit mahimong epektibo kon 70% sa tibook
nga gidaghanon sa populasyon maong lugar
nabakunahan Pananglitan kon ang imong barangay
adunay 100,000 ka mga lumulopyo, kinahanglan nga dili
moubos sa 70,000 ang proteksyon sa tibook nga
komunidad. Busa atong sa mga lumulupyo ang
nabakunahan aron maseguro hinumduman nga ang
pagpabakuna dili lamang alang kanimo ug sa imong
pamilya kini alang sa imong barangay, lungsod ug
probinsya.
MAGKUYOG KITA SA BIDA BAKUNATION!

AUTHENTICITY & COLD CHAIN

Ang pagdumala ug pagpahiluna sa bakuna
kinahanglan ang pagpahimutang ug pagsiguro nga mga
bakuna nahimutang sa mga sudlanan nga nagsubay sa
mga lagda. Sanglit ang mga bakuna gitawag og
biological products ug kini sensitibo sa temperatura ug
ang kahimtang sa palibot. Subay nini kinahanglan ang
pagseguro nga kini may pagmatuod nga nagagikan sa
lehitimo ug aprobado nga tinubdan.

NGANO NGA GIKINAHANGLAN NGA

MAGPABAKUNA? NGANO NGA RESBAKUNA?
Ang pandemya karon mikalas na sa daghang
kinabuhi ug padayon nga nagdala sa peligro sa kinabuhi
sa kadaghanan. Kini nagpaluya sa atong ekonomiya ug
daghan nga mga Pilipinhon ang nawad-an sa trabaho
tungod niini.

Sa pagkaplag sa bakuna batok sa COVID-19 kita

nahatagan sa kahigayunan nga masumpo kining maong
pandemya. Sa tabang sa bakuna: