HARAMAYA UNIVERSITY

COLLEGE OF HEALTH AND MEDICAL SCIENCE

SCHOOL OF GRADUATE STUDY
DEPARTMENT OF MATERNITY AND NEONATAL NURSING
Individual Assignment on: Contraceptive
Presenter: Addiswork Hailu

Supervisor: Tigist Gashaw Harar, Ethiopia

February 2023
Content
• Introduction
• Need of Contraception
• Ideal Contraception
• Types of Contraceptives
• Advantages & Disadvantages of Contraception
Objective

The end of this session learners able to

• Identify & understand of the Contraceptions
methods.
• Able to know about benefits of Contraception
Introduction
• Contraception also known as Birth control is the
use of medicines, devices, or surgery to prevent
pregnancy. There are many different types. Some are
reversible, while others are permanent. Some types
can also help prevent sexually transmitted diseases
(STDs).
Need of Contraception
• To prevent unwanted pregnancies.

• To regulate the timing of pregnancy

• To regulate the interval between pregnancy

Ideal contraceptive
• Safe
• Effective
• Acceptable
• Reversible
• Inexpensive
• Long lasting
• Require little or no medical Supervision
Types of Contraception

1. Hormonal Methods
2. Barrier Methods
3. Fertility Awareness-Based Methods
4. Emergency Contraception
5. Permanent Methods of Birth Control
 1. Hormonal Methods
• Levonorgestrel intrauterine system (LNG IUD); The LNG
IUD is a small T-shaped device like the Copper T IUD.
• It is placed inside the uterus. It releases a small amount of
progestin each day to keep you from getting pregnant.
• The LNG IUD stays in uterus for up to 3 to 8 years,
depending on the device.
• Typical use failure rate: 0.1-0.4%.
• Adv:- The amount Of menstrual bleeding & number of days
of menstrual bleeding are reduced.
Hormonal cont….
• Dis:- It can cause headache, upper limb neuropathic,
skin&respiratory condition, arthropathies, minor visual
disturbance, dizziness, malaise.
• Contraindication:- Pregnancy, uterine cavity depth
<5cm, hormone responsive tumors such as cervical
cancer & active liver disease.
Hormonal cont....
• Copper T intrauterine device (IUD)- A small device that is
shaped in the form of a “T.”
• It is placed inside the uterus to prevent pregnancy.
• It can stay in your uterus for up to 10 years.
• Typical use failure rate: 0.8%.
• Adv:- They are more safe to use if the women is
breastfeeding & doesn‘t cause hormonal side effects
which means acne, headache & breast tenderness.
 Hormonal cont….
• Dis:- Irregular periods, heavier or longer periods, pain
when IUD is put in, worse cramping during periods.
• Contraindication:- Pregnancy, uterine abnormality,
inflammation of inner genitals...
Hormonal cont....
• Implant—The implant is a single, thin rod that is
inserted under the skin of a women’s upper arm.
• The rod contains a progestin that is released into the
body over 3 years.
• Typical use failure rate: 0.1%.
• Adv:- It comes with a few risks, such as infection &
changes to the menstrual cycle.
• Dis:- In the first 6-12 months, there is irregular bleeding
(aka spotting).
Hormonal cont….
• Contraindication:- Pregnancy, liver disease, history of
breast cancer, undiagnosed abnormal vaginal bleeding.
Hormonal cont....
• Injection or “shot”—Women get shots of the hormone
progestin in the buttocks or arm every three months.
• Typical use failure rate: 4%.
• Adv:- Periods may be less painful, have no vaginal
bleeding at all or very light bleeding.
• Dis:- weight gain, headache, mood swings, breast
tenderness, periods may become more irregular, heavier,
Shorter, lighter or stop altogether.
Hormonal cont….
• Contraindication:- pregnancy, active thrombophlebitis
current or past history of thromboembolic, malignancy
of breast.
Oral contraceptives Pills (OCP)
• Synthetic Preparation of estrogen and progesterone.
• When taken orally, hormone level raises.
• Negative feedback Effect act on Anterior Pituitary.
• Inhibit Gonadotropins (FSH & LH).
• Inhibit ovulation.
• TYPES OF OCP:
1. Combined oral contraceptives
2. Progestin only pills
Hormonal cont....
• Combined oral contraceptives—Also called “the pill,” It
contain the hormones estrogen and progestin.
• The pill is taken at the same time each day.
• It prevent ovulation.
• It prevent implantation.
• Makes cervical secretion thick, viscid and prevent entry
of in female genital tract.
• Typical use failure rate: 7%.
• Adv:- Usually it makes periods regular, lighter & less
painful and it reduces the risk of cancer of the ovaries,
womb & colon.
Hormonal cont….
• Dis:- It can increase BP, breakthrough bleeding &
spotting is common the first few months and it has been
linked to an increased risk of some serious health
conditions such as blood clots & breast cancer.
• Contraindication:- current or past history of
VTE(Venous thromboembolism.
Hormonal cont....
• Progestin only pill—Unlike the combined pill, the progestin-only
pill (sometimes called the mini-pill) only has one hormone,
progestin, instead of both estrogen and progestin.
• It is taken at the same time each day. It may be a good option
for women who can’t take estrogen.
• Ovulation is not inhibited but prevent fertility.
• Makes Cervical mucosa thick and decrease motility of fallopian
tube.
• Typical use failure rate: 7%
• Adv:- Helpful if the women have heavy or pain painful periods.
• Dis:- It may cause regular periods while taking it.
• Contraindication:- breast cancer, undiagnosed vaginal bleeding,
active viral hepatitis and chronic liver disease.
 Hormonal cont....
• Patch—This skin patch is worn on the lower abdomen,
buttocks, or upper body (but not on the breasts).
• It releases hormones progestin and estrogen into the
bloodstream.
• A new patch put on once a week for three weeks. During the
fourth week, you do not wear a patch, so you can have a
menstrual period.
• Typical use failure rate: 7%.
• Adv:- Very easy to use, the hormones from the patch aren’t
absorbed by the stomach, so it still works if the women is
sick.
• Dis:- It can cause skin irritation, itching and soreness, breast
tenderness or pain, nausea & vomiting, headache.
Hormonal cont….
• Contraindication:- history of heart attack & blood clots,
sever BP, Wt > 90 kg, history of breast, uterine or liver
cancer, age > 35 & smoke.
 What affect hormonal contraception
• Hormonal contraception(coc, implant, patch & vaginal ring)
affected by enzyme inducing medicines Like;
• Rifampicin (antibiotic)
• Some drug used to treat epilepsy (carbazepine,
phenytoin, phenobarbital & primidone)
• Some Antiretroviral drugs used to treat HIV (Nevirapine)
• Hormonal Contraception (IUD, progestin only pill) not
affected by enzyme inducing medicines.
 2. Barrier Methods
• Diaphragm or cervical cap—Each of these barrier
methods are placed inside the vagina to cover the cervix
to block sperm.
• The diaphragm is shaped like a shallow cup.
• Flexible rim made up of springs.
• The cervical cap is a thimble-shaped cup. Before sexual
intercourse, insert them with spermicide to block or kill
sperm.
• Typical use failure rate for the diaphragm: 17%.
Barrier cont….
• Adv:- There is no serious associated health risks or side
effects.
• Dis:- It’s not as effective as other types of Contraception And
it takes time to learn how to use it.
• Contraindication:- current history of pelvic, cervical, vaginal
or urinary tract infection.
Barrier cont....
• Hormonal vaginal contraceptive ring—The ring releases
the hormones progestin and estrogen.
• Progesterone absorbed through vaginal mucosa.
• The ring is placed inside the vagina.
• The ring is wear for three weeks, take it out for the week
the women have her period, and then put in a new ring.
• Typical use failure rate: 7%
• Adv:- It may help premenstrual symptoms, period becom
lighter, more regular & less painful, it isn’t affected by if the
women is sick(vomiting) or having diarrhoea.
Barrier cont….
• Dis:- Increased vaginally discharge, headache, nausea,
breast tenderness and mood change, may feel
uncomfortable inserting or removing it from vagina.
• Contraindication:- Age > 35 & smoke, stroke, have had
heart attack, current or history of blood clots.
Barrier cont....
• Sponge—The contraceptive sponge contains spermicide
and is placed in the vagina where it fits over the cervix.
• The sponge works for up to 24 hours, and must be left in
the vagina for at least 6 hours after the last act of
intercourse, at which time it is removed and discarded.
• Typical use failure rate: 14% for women who have never
had a baby and 27% for women who have had a baby.
Barrier cont…
• Adv:- Safe during breastfeeding, doesn’t affect menstrual
cycle, doesn’t use hormones, so is safe for women’s who
have certain health problems or concerns with hormonal
Contraceptive.
• Dis:- May increase risk of contracting HIV infection,
irritating or allergic reaction can occur, less effective than
other methods, may cause vaginal dryness.
Barrier cont...
• Male condom— male condom keeps sperm from getting
into a woman’s body.
• Latex condoms, the most common type, help prevent
pregnancy, and HIV and other STDs, as do the newer
synthetic condoms.
• “Natural” or “lambskin” condoms also help prevent
pregnancy, but may not provide protection against
STDs, including HIV.
• Typical use failure rate: 13%.
Barrier cont….
• Adv:- Reduce risk of spreading STI, Including HIV.
• Dis:- may decrease sexual sensation, the latex can cause
allergy, may break or leak.
Barrier cont....
• Female condom— the female condom helps keeps sperm from
getting into her body.
• It is packaged with a lubricant. It can be inserted up to eight
hours before sexual intercourse.
• Typical use failure rate: 21%, and also may help prevent STDs.
• Adv:- Help to protect both partners from STIs, prevent pregnancy,
have no serious side effects.
• Dis:- may split or tear if not used properly.
Barrier cont....
• Spermicides—These products work by killing sperm and come in
several forms such as ;
1. Foam
2. Gel
3. Cream
4. Film
5. Suppository, or Tablet.
• They are placed in the vagina no more than one hour before
intercourse.
• And leave them in place at least six to eight hours after
intercourse.
• Also can use a spermicide in addition to a male condom,
diaphragm, or cervical cap.
Barrier cont….
• Typical use failure rate: 21%.
• Adv:- Don’t contain hormones, so they are good for a
person who can’t use hormonal methods is
contraception, gives extra lubrication.
• Dis:- may cause irritation or pain, may cause the risk of
urinary tract infection.
• Spermicidal agents that destroy sperm;
• Ricinoleic acid
• Nanoxynol-9
• Octaxynol-8
 Barrier cont….
• Barrier methods such as; Condoms, diaphragm, Sponges,
spermicide, vaginal rings Prevents sperm from entering
the uterus.
• Condom also prevent STIs. If it’s used with spermicide,
Condoms nearly 100% effective.
 3. Fertility Awareness-Based Methods
• Fertility awareness-based methods—this method work
by understanding monthly fertility pattern external icon
can help plan to get pregnant or avoid getting pregnant.
• The fertility pattern is the number of days in the month
when women's are fertile, days when you are infertile,
and days when fertility is unlikely, but possible.
Fertility cont….
• If the women have a regular menstrual cycle, she have about
nine or more fertile days each month. If She don’t want to get
pregnant, she don’t have sex on the days or she can use a barrier
method of birth control on those days.
• Failure rates vary across these methods. Range of typical use
failure rates: 2-23%
Fertility cont....
• Lactational Amenorrhea Methods -For women who
have recently had a baby and are breastfeeding, the
Lactational Amenorrhea Method (LAM) can be used as
birth control when three conditions are met:
1) amenorrhea(not having any menstrual periods after
delivering a baby)
2) fully or nearly fully breastfeeding, and
3) less than 6 months after delivering a baby.
Fertility cont….
• LAM is a temporary method of birth control, and
another birth control method must be used when any
of the three conditions are not met.
4. Emergency Contraception
• Emergency contraception is NOT a regular method of
birth control. Emergency contraception can be used
after no birth control was used during sex, or if the birth
control method failed, such as if a condom broke.

• Copper IUD—Women can have the copper T IUD

inserted within 120 hours (5 days) of unprotected sex.
Emergency cont….
• Emergency contraceptive pills—Women can take
emergency contraceptive pills up to 72 hours (3 days)
after unprotected sex.
• Prevent fertilization & implantation by hypermotility
of fallopian tube & uterus.
• If fertilization & implantation occurred then it
prevents implantation of blastocyst.
• Contain 2 combined pills immediately followed by 2
pills after 12 hours.
5. Permanent Methods of Birth Control
• Female Sterilization—Tubal ligation or “tying tubes”—
A woman can have her fallopian tubes tied (or closed) so
that sperm and eggs cannot meet for fertilization.
• The procedure can be done in a hospital or in an
outpatient surgical center and she can go home the
same day of the surgery and resume your normal
activities within a few days.
Permanent cont….
• This method is effective immediately.
• Typical use failure rate: 0.5%.
Permanent cont....
• Male Sterilization–Vasectomy—This operation is done
to keep a man’s sperm from going to his penis, so his
ejaculate never has any sperm in it that can fertilize an
egg.
• The procedure is typically done at an outpatient
surgical center. The man can go home the same day.
Recovery time is less than one week. After the
operation, a man visits his doctor for tests to count his
sperm and to make sure the sperm count has dropped
to zero; this takes about 12 weeks.
Permanent cont….
• Another form of birth control should be used until the
man’s sperm count has dropped to zero.
• Typical use failure rate: 0.15%.
Reference
• https://medlineplus.gov/birthcontrol.html
• https://www.cdc.gov/reproductivehealth/contraception/ind
ex.htm
• https://www.who.int/news-room/fact-sheets/detail/family-p
lanning-contraception