FAMILY
PLANNING
BY: PROF. JACKIELYN L. DELA CRUZ RN, LPT
PHILIPPINE FAMILY PROGRAM
Principal recipients of information, education, communication, and motivation in
family planning:
- married couples of reproductive age
It requires all couples who want to receive a marriage license first to undergo a
seminar in family planning and responsible parenthood.
- PD 965
ADVANTAGES:
1. FP helps families improve their standard of living
2. FP reduces/eliminates fears of unwanted pregnancy
3. FP affords family members time to study or pursue occupational interests
MAJOR TARGET (HIGH-RISK WOMEN)
Women under 20 years old Women over 35 years old
Women that suffering from certain medical conditions that contradict
pregnancy Women who have had at least 4 deliveries
THE FAMILY CODE OF THE PHILIPPINES?
- Executive Order No. 209
REPRODUCTIVE LIFE PALNNING
It includes all the decisions an individual or couple make
about whether and when to have children, how many
children to have, and how they are spaced.
Intentional pregnancies are important for the health of
children because when a pregnancy is unintended or
mistimed, both short term and long term consequences
can result.
TYPES OF CONTRACEPTION
NATURAL FAMILY PLANNING
Methods that involve no introduction of chemicals or foreign material into
the body
ABSTINENCE
LAM
BBT
OVULATION METHOD
SYMPTOTHERMAL
WITHDRAWAL
ABSTINENCE
Refraining from sexual relations
Theoretical 0% failure rate
Most effective way to prevent STIs
Difficult for many couples to adhere and with high failure rate
Acceptable to all religions group
Requires high motivation and periods of abstinence
Periodic abstinence
--is a method to avoid pregnancy by avoiding sex on the days a woman may
conceive.
LACTATION AMENORRHEA METHOD
temporary introductory postpartum method of postponing pregnancy based on
physiological infertility experienced by Breast Feeding women.
Criteria:
1) Amenorrhea- menses is not returned
2) Infant is less than 6 months
3) Being totally breastfed at least every 4 hours during the day and every 6hrs at night
4) Receives no supplementary feedings
A-EFFECTIVE WHILE INFANT IS TOTALLY BREASTFED
- NOCOST
D-TEMPORARY MEASURE, NOT RELIABLE IF INFANT TAKES SUPPLEMENTAL FEEDINGS
BASAL BAODY TEMPERATURE
used to be sure changes of in temperature during ovulation.
woman's takes orally or tympanic thermometer
Temp. slightly decreases before ovulation and increases during ovulation
day.
It must be measured on the same time of the day, before rising, with the
same thermometer.
A woman notices a slight dip temperature followed by an increase she
knows she was ovulated and refrain from having coitus for the next 3 days
With 25% ideal failure rate
OVULATION METHODS
Cervical mucus method(billing’s method)
Change in cervical mucus
Copious, thin, watery and transparent
Feels slippery and stretchy (spinnbarkeit) with 25% failure rate
Requires motivation and cooperation by male partner
Marquette model
Combination of cervical mucus, BBT, cervix position and softness
Develop on 1990 by nurses and doctors at Marquette University in Wisconsin
STANDARD METHOD
A new method of natural family planning in which all users with menstrual
cycles between 26 and 32 days are counseled to abstain from sexual
intercourse on days 8-19 to avoid pregnancy.
The couples use color-coded cycle beads to mark the fertile and infertile
days of the menstrual cycle.
SYMPTOTHERMAL
It is a combination of cervical mucus and BBT methods
Women takes daily temperature and watching for rise that marks for
ovulation also monitoring her cervical mucus.
Couple abstain from coitus fro 3 days if positive sign
25% failure rate
Requires motivation and cooperation by male partner
WITHDARWAL
COITUS INTERRUPTUS
OLDEST METHOD
A male controlled method
The couple proceeds with coitus until the moment of ejaculation
The man withdraws and spermatozoa are emitted outside the vagina
82% effective but needs caution in using this method
Disadvantage- sperm may be present in pre ejaculatory fluid
TYPES OF CONTRACEPTION
BARRIER METHODS
Forms of birth control that place a chemical or latex barrier between the
cervix and advancing sperm as sperm cannot reach and fertilize an ovum
SPERMICIDE
MALE CONDOM
FEMALE SPONGE CONDOM
DIAPHRAGM
CERVICAL CAP
SPERMICIDE
An agent that causes the death of spermatozoa before they can enter
the cervix
Kills sperm and change vaginal ph to a strong acid level to not conducive
to sperm survival
Can be purchased without prescription
Various preparation are available including gels, creams, sponges, films,
foams, and vaginal suppositories
Contraindicated with acute cervicitis
MALE CONDOM
A latex rubber or synthetic sheath that is placed over the erect penis
before coitus to trap sperm.
Male responsibility
Protects against STIs
Disadvantage- requires interruption of sexual activity
FEMALE CONDOM
Sheaths made of latex or polyurethane, prelubricated with a spermicide
Offer protection against conception and STIs
Sheath may be inserted any time before sexual activity begins and then
removed after ejaculation occurs
DIAPHRAGM
A circular rubber disk that is placed over the cervix before intercourse to
mechanically halt the passage of sperm
Diaphragm is prescribe and fitted initially by a health care provider to
ensure a correct fit.
Placed before coitus and should remain in place for at least 6hrs after
coitus may be left for as long as 24hrs
After use washed with mild soap and water, dried gently and stored in its
protective case
Last for 2 yrs
CERVICAL CAP
Made of soft rubber shaped like a thimble
Precautions of use is same as diaphragm
Can leave in place for several days if desired 48hrs
Disadvantage- difficult to insert, can irritate cervix
Contraindicated to women with abnormally short or long cervix, allergy to
latex or spermicide
TYPES OF CONTRACEPTION
HORMONAL METHODS
Hormones that can be taken orally, transdermally, intravaginally or intramuscularly
cause such fluctuations in a normal menstrual cycle that ovulation or sperm transport
does not occur.
TRANSDERMAL PATCH
VAGINAL RING
COC’S
PROGISTIN ONLY PILLS
INJECTABLES PROGESTERONE(DMPA)
INTRADERMAL IMPLANT
IUD
TRANSDERMAL PATCH
Patches that slowly but continuously release a combination of estrogen
and progesterone
Applied each week for 3weeks, on the week 4 no patches need and
menstrual flow will occur
Easy to apply
Can irritate skin at local site
VAGINAL RING
An etonogestrel/ethinyl estradiol vaginal ring (NUVA RING)
a flexible silicone vaginal ring that placed in the vagina, continually
releases a combination of estrogen and progesterone.
EASY TO INSERT
ORAL CONTRACEPTIVE
contains hormones estrogen and progesterone taken daily to prevent
contraception. Advised for women who are anemic because of the
reduced menstrual flow.
taken some time every day preferably at night.
COMBINATION ORAL CONTRACEPTIVES
IMPORTANT TO REMEMBER ABOUT PILL
Pills are advised for women who are anemic because of the reduced menstrual flow
Take pills same time every day
A packet of pills contains 28 tablets; 21 pills are “active pills”,7 contain no hormones, only
iron
Follow the direction of the arrows of the pill. When empty, start a new pack the next day
without missing a day
For 1 missed pill: take the pill as soon as possible; take the regular pill at night
For 2 missed pill:take 2 pills next day,then take 2 pills the next day again
For 3 missed pills: discard and substitute method, start on next pack on next menstrual
period.
PROGESTIN ONLY PILLS
OC containing only progestins
Must taken conscientiously every day
Without estrogen content ovulation may occur but because the progestin
have not allowed the endometrium to develop fully or sperm to freely
access the cervix, fertilization and implantation will not take place.
INJECTABLES PROGESTERONE
DMPA- DEPOT MEDROXY PROGESTERONE ACETATE
Depo-Provera
IM administration on major muscle buttocks, deltoid or thigh
a progesterone given every 12 weeks
Inhibits ovulation, alters the endometrium and thickens the cervical mucus
so sperm progress is difficult.
Can be used during breast feeding, long term effect
Common side effects include headache, weight gain, depression,
irregular or heavy menstrual cycle for 1 year
INTRADERMAL IMPLANT
IUD( COPPER T)
Intra uteine device- small plastic device that is inserted into the uterus
through the vagina.
Either hormonal or non hormonal
No memory motivation needed
changes the nature of internal secretions of a woman’s body., disturbs
transport, and decreases the number of viable sperms.
TYPES OF CONTRACEPTION
SURGICAL METHODS
FEMALE STERILIZATION (BTL)
MALE STERILIZATION (VASECTOMY)
FEMALE STERILIZATION
a safe and simple surgical procedure that provides permanent
contraception for women who do not want more children.
Also known as BTL that involves cutting or blocking the two fallopian tubes.
performed during the first 2 weeks of her menstrual cycle OR
within the first 3 days after delivery.
MALE STERILIZATION
the permanent method wherein the vas deferens (passage of sperm) is
tied and cut or blocked through a small opening on the scrotal skin. It is
also known as vasectomy.
