Family Planning

FAMILY
- It refers to two or more individuals who depend on
one another for emotional, physical, and financial
support.
FAMILY PLANNING
- To regulate the number and spacing of children in a
family through the practice of contraception or other
methods of birth control.
KEY FACTS
 214 million women of reproductive age in developing countries who want to avoid pregnancy
are not using a modern contraceptive method.
 Some family planning methods, such as condoms, help prevent the transmission of HIV and
other sexually transmitted infections.
 Family planning/ contraception reduces the need for abortion, especially unsafe abortion.
 Family planning reinforces people’s rights to determine the number and spacing of their
children.
 By preventing unintended pregnancy, family planning/ contraception prevents deaths of
mothers and children..
 BENEFITS
 Preventing pregnancy-related health risk in women
 Reducing infant mortality
 Helping to prevent HIV/AIDS
 Empowering people and enhancing education
 Reducing adolescent pregnancies
 Slowing population growth
 Who provides family planning/
contraceptives?
 It is important that family planning is widely available and easily accessible
through midwives and other trained health workers to anyone who is sexually
active, including adolescents.
 Midwives are trained to provide (where authorised) locally available and culturally
acceptable contraceptive methods.
 Other trained health workers, for example community health workers, also provide
counselling and some family planning methods, for example pills and condoms.
 For methods such as sterilization, women and men need to be referred to a clinician.
 Methods of contraception

1. SPACING METHODS
A.NATURAL METHODS
B.BARRIER METHODS
i. Physical barrier method
ii. Chemical barrier method
iii. Intra-uterine devices
iv. Hormonal methods
v. Post conceptional methods

2. TERMINAL METHODS
C.VASECTOMY
D.TUBECTOMY
1. SPACING METHODS
 Help in prevention of pregnancy as long as they are used
 These methods can help in timing and spacing of pregnancies, preventing
unwanted children.
 These methods are temporary methods.
A. NATURAL METHODS
 Do not involve the use of any man made devices
 These methods are useful for timing and spacing of pregnancies.
 1. COITUS INTERRUPTUS /
WITHDRAWAL
 In this method. The penis is withdrawn from the vagina before ejaculation. In this way semen
is prevented from entering the uterine cavity and pregnancy does not take place.
 Since the penis is withdrawn and ejaculation takes place outside the vagina, this method is
called INTERRUPTUS or WITHDRAWAL METHODS.

MERITS
• Involves no cost
• It does not require any other device
• With self-control and discipline it can be fairly effective

DEMERITS
• Required a great deal of self-control
• Thus failure rate is very high
• Slightest delay in withdrawal can lead to pregnancy.
 2. SAFE PERIOD / CALENDAR METHOD
 Based upon the process of ovulation and menstrual cycle which helps in determination of the
safe period when coitus can be done and unsafe period when coitus can be avoided to prevent
pregnancy.

MERITS
• It does not require any man made device

DEMERITS
• Require self-control by the partners during the highly unsafe period
• Not suitable for the women who does not have regular periods
• Failure rate is high
• Require great deal of will power and motivation
 3. ABSTINENCE
 The only method that is 100% effective.
 Delay sexual activity until financially, emotionally and physically ready for the
responsibilities of child-bearing.

MERITS
• It protects you from STD and pregnancy

DEMERITS
• Coping for peer pressure
 4. BASAL BODY TEMPERATURE
 Indicates the woman's temperature at rest.
 Before the day of ovulation and during ovulation, BBT falls at 0.5F; it increases to
a full degree because of progesterone and maintains its level throughout the
menstrual cycle.
 The woman must record her temperature every morning before any activity.

5. CERVICAL MUCUS METHOD

 The change in the cervical mucus during ovulation is the basis for this method.
 During ovulation, the cervical mucus is copious, thin, and watery. Wherein it can
be stretched up until at least 1 inch, and it's slippery. The woman is said to be fertile
as long as the cervical mucus is copious and watery.
A. BARRIER METHODS
 Those methods which prevent meeting of sperms with the ovum.
 PHYSICAL BARRIER METHODS

1.CONDOM
 a thin rubber sheath which is use by men. It is rolled over the erect penis before
having sex.
 This rubber sheath prevents the entry of semen into the vagina.
 The condom must be held carefully when taking out the penis from the vagina.
 It is available free of cost from urban or rural family welfare centers.

TYPES:
 DRY CONDOM
 DELUXE CONDOM
 SUPER DELUXE CONDOM
MERITS
 It is most simple and effective methods
 Easy to use
 Disposable
 No medical supervision is required
 Protects from sexually transmitted disease.

DEMERITS
 If not used correctly, it may slip or get tear of and the semen gets spilled into
vagina
 In some rare cases the person may have allergic to rubber
 Some people may not enjoy sex because of interference with the sensation.
 PHYSICAL BARRIER METHODS

2. DIAPHRAGM
 Used by women in her vagina to form a barrier in front of the cervix. The
diaphragm is a dome shaped and is like a shallow cap.
 It is made of soft synthetic rubber or plastic with a stiff but flexible rim around the
edge. It is also known as DUTCH CAP.
MERITS
 Very effective
 Failure rate is low
 There is no risk or any kind of contraindication

DEMERITS
 It requires the assistance of doctor and any other health personnel
 It requires a privacy and time to place it in the vagina
 It requires periodical check up
 It requires facilities for its proper care and storage
 PHYSICAL BARRIER METHODS
3. VAGINAL SPONGE
 It is a small polyurethane foam sponge, diffused with spermicide. The sponge is
shaped in a way that it can be filed on to the cervix and has a loop on its outer
surface which can be to pull out the sponge after use.
 Should be inserted before the coitus.
 It should remain be there for at least 6 hours after coitus.
 Sperms are trapped on in the sponge and are destroyed.
 It is better than not to use any method.
 CHEMICAL BARRIER METHODS
 These method usually kills the sperms and this way chemical
contraceptives help in preventing the pregnancy.

 Form of Tablet Arosols

 Cream Jelly
 Suppositories
MERITS
 They are easy to administer
 Available free in health centers
 Not very expensive

DEMERITS
 Most be inserted deep down and in all such points where sperms are likely
to reach.
 Must be applied each time before sex.
 May cause irritation and burning.
 INTRA UTERINE DEVICES
 These are the devices which are placed in the uterine cavity. Earlier these
devices were made up of silk worm gut, silk and gold.

Three different types of IUD’s generations are:

 First generation IUD’s
 Second generation IUD’s
 Third generation IUD’s
MERIT
 They’re among the most effective birth control methods available.
 They can last for 3 to 12 years, depending on the type.
 No pre-sex prep or reminders necessary.
 IUDs can be a bit costly upfront, but there are no costs beyond that for several years.
 If you want to get pregnant, have it removed, and you can start trying right away.
 Many people experience lighter periods and an improvement in cramps.

DEMERIT
 They don’t protect against sexually transmitted infections (STIs).
 Insertion can be painful.
 The upfront cost can be expensive if you don’t have insurance. Though rare, there are
some risks.
 HORMONAL METHODS
1. ORAL PILL
 birth control pill works by stopping sperm from joining with an egg. When sperm joins with
an egg it’s called fertilization.
 The hormones in the pill safely stop ovulation. No ovulation means there’s no egg for sperm
to fertilize, so pregnancy can’t happen.
 The pill’s hormones also thicken the mucus on the cervix. This thicker cervical mucus blocks
sperm so it can’t swim to an egg — kind of like a sticky security guard.

TWO TYPES:
A. Combined Oral Contraceptives (COC’s)
 Combination pills have 2 hormones: estrogen and progestin. Combination pills are the most
common type of birth control pill.
 As long as you take 1 pill every day, you’ll be protected from pregnancy. You don’t have to take
your combination pill at the exact same time every day. But taking it at the same time is a good
idea because it helps keep you in the habit of remembering your pill.

B. Progesterone-only Pills (POP’s)

 these pills don’t have any estrogen. You must take your progestin-only pill within the same 3 hours every
day to be protected from pregnancy.
 It can be used while breastfeeding.
MERIT
 Can regulate periods or lighten them
 Easy to use
 Does not harm future fertility
 Does not interrupt sex play
 May protect against uterine and ovarian cancers
 May reduce acne
 Can be used for emergency contraception

DEMERIT
 Does not protect against sexually transmitted infections, including HIV/AIDS.
 Must be taken everyday
 Less effective when taken with some medications
 Raises risk of heart attack and stroke
 Requires a prescription
 HORMONAL METHODS
2. DEPO PROVERA
 Pregnancy preventing hormone injection that last for three months.
 The injection has synthetic progesterone and no estrogen. This stops the ovaries from
releasing eggs
 It also thickens the cervical mucus and changes the uterine lining, so that its harder for
sperm to enter or survive in the uterus.

HOW TO USE:
 Usually given in the arm or hip delivering a high level of progesterone into the body.
 The first shot usually given during or a few days after the start of a menstrual period.
After 24 hours, the shot is effective birth control for the next 13 weeks
MERIT
 Private
 Effective after 24 hours
 Does not require regular attention
 Does not interrupt sex play
 Has no estrogen
 May decrease risk for ovarian and uterine cancers
 Can be used starting six weeks after giving birth

DEMERIT
 Causes loss of bone density, increasing the risk of osteoporosis
 Does not protect against sexually transmitted infections, including HIV/AIDS.
 Requires injection every 3 months
 Delays the return to fertility
 Could cause irregular bleeding
 Leads to weight gain for many women
 HORMONAL METHODS

3. IMPLANT
 is a contraceptive method that is applied under the skin. It consists of a flexible rod that is
placed on the inside of the arm.
 Its mechanism of action is based on releasing progestogens, i.e. hormones. Release takes
place continuously, preventing ovulation among other effects.
 This contraceptive method is designed to be used for a prolonged period of time, without
the need to change it in 3 or 5 years. During all this time it continues to offer 99%
protection against pregnancy.
 Once the implant is removed, the contraceptive effect disappears. Therefore, ovulatory
cycles resume normally.
MERIT
 It’s one of the most effective birth control methods available.
 Once inserted, the implant lasts 3 years before needing to be replaced.
 No pre-sex prep or reminders.
 It can be a bit costly upfront, but there are no costs beyond that for 3 years.
 It can improve cramps, make periods lighter, or stop them entirely for some.
 You can remove it at any time and your fertility will return as soon as it’s removed.
 It’s safe for people who can’t use birth control that contains estrogen.

DEMERIT
 It doesn’t protect against sexually transmitted infections (STI’s)
 Insertion requires a visit to a healthcare professional.
 The device must be removed after 3 years.
 Though rare, the implant can migrate from the insertion site, making it difficult for a clinician to find
and remove.
 HORMONAL METHODS
4. HORMONAL PATCH
 It looks like a square bandage
 It is applied to the abdomen, buttocks, upper arm or upper torso
 The patch is used on a four week rotation: it changed each week for three and is absent
for the fourth week
 Works by slowly releasing a combination of estrogen and progestin hormones through the
skin.
 These hormones prevent ovulation (release of an egg from the ovary) and thicken the
cervical mucus, creating a barrier to prevent sperm from entering the uterus.
MERIT
 Easy to use
 Can be worn for three weeks
 Effects fertility one month at a time
 Does not interrupt sex play

DEMERIT
 Does not protects against sexually transmitted infections including HIV/AIDS
 Raises woman’s risk of heart attack and stroke
 Requires a prescription
B. TERMINATION METHODS
 Sterilization is only method which gives permanent protection from
conception . Either husband and wife can undergo sterilization by a simple
surgical operation.

 VASECTOMY
 TUBECTOMY
 VASECTOMY
 a small operation to prevent pregnant. It blocks sperm from getting to your semen
when you ejaculate. With no sperm leaving your body, you can’t get
someone pregnant. You can still have an orgasm and ejaculate.
 The operation involves a small cut on both sides of scrotum then a small portion of
vas deferens (about 1cm) on either
 During the procedure, local anesthesia is used. The doctor makes a small opening
in the skin of the scrotum. This allows the sperm tubes or vas deferens to be seen
and cut. The procedure itself takes about 15 minutes.
 TUBECTOMY
 also known as tubal sterilization, is a permanent method of contraception in women.
 It is a surgical process that blocks the fallopian tubes, thereby preventing the egg released
by the ovary from reaching the uterus.
 Tubectomy is a major surgical procedure in which the fallopian tubes are cut open and
clipped or tied up to block the passage of the egg into the uterus.

MERIT
 More than 99% effective
 Convenient and permanent
 Decreases risk of ovarian cancer
 Does not cause serious side effects

DEMERIT
 Requires certainty and long-term planning
 Failure rate is 0.5%
 Increases the risk of ectopic pregnancy
 Does not protect against STD
WHO (World Health Organization)
 working to promote family planning by producing evidence-based
guidelines on safety and service delivery of contraceptive methods,
developing quality standards and providing pre-qualification of
contraceptive commodities, and helping countries introduce, adapt and
implement these tools to meet their needs.
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