TEACHING PLAN FOR BGH- FAMILY PLANNING

A. DESCRIPTION OF THE LEARNER-

The learner is a BGH- Family Planning client or couple who subjected herself or himself or themselves in the said institution. If the client is a female, she
may be a first time mother (primigravid) or a multigravid mother or even a woman who haven’t had a child who wishes to delay childbearing or who wishes to have
a child. If the client is a male, he may be a father or a future father who aims for child control methods. These clients may be clients who need complete teaching or
complementary teaching about family planning. Topic and language to be used in facilitating learning will depend on the preference of the client.

B. LEARNING NEED:
-Concepts and information about family planning; methods and concepts. Specific learning needs will be assessed.
C. LEARNING DIAGNOSIS:
Knowledge Deficit: Family planning methods and concepts related to lack of exposure or lack of information

GOAL:
The client will be able to apply in his activities of daily living the methods, concepts and information about family planning.

D. TEACHING PLAN PROPER

BEHAVIORAL
LEARNING OBJECTIVE
STATEMENTS
After the lecture-
demonstration of the topic on
Family Planning, the client
will be able to:
1. Define in his/her own
words, about the
functions and importance
of the reproductive
system and its simple
anatomy as well
LEARNING CONTENT
 Superficial definition of
the reproductive system
and its use and
importance to the human
body
TEACHING
STRATEGY/METHOD AND
ACTIVITIES
 One-on-one lecture
discussion importance of
the reproductive system
and its simple anatomy.
TIME ALLOTMENT AND
RESOURCES NEEDED
 4-5 minutes
-booklet prepared which
includes illustrations
- time, effort and cooperation
of the teacher and learner
-knowledge of the teacher
METHOD OF
EVALUATION
 Instant oral feedback:
The learner/client will
enumerate 3-4 parts of
the reproductive system
and name its uses and
importance
2. Differentiate on
his/her own words the  2-3 minutes  Instant oral
difference between  Definition of natural and  One- on-one lecture - booklet prepared which feedback: The client
natural and artificial artificial family planning discussion on natural and includes illustrations will differentiate the
family planning artificial family planning. - time, effort and cooperation two main types of
methods of the teacher and learner family planning
-knowledge of the teacher methods through his
- interest and readiness of or her own words
learner

3. Enumerate 2-3 Types  Different types of  One- on-one lecture  6-10 minutes  Instant oral feedback:
of natural family natural family planning discussion on types of - time, effort and The client Enumerate at
planning methods and it’s definition and natural family planning and cooperation of the teacher least 2 Types of natural
that he/she is use as well as its it’s definition and use and learner family planning
interested in and advantages and - booklet prepared which methods and define on
define on his/her own disadvantages includes illustrations his/her own words on
words on how these -knowledge of the teacher how these family
family planning - interest and readiness of planning methods work
methods work learner

4. Enumerate 2-3 Types  Different types of  One- on-one lecture  6-10 minutes  Instant oral feedback:
of artificial family artificial family planning discussion on types of - booklet prepared which The client Enumerate at
planning methods and and it’s definition and artificial family planning includes illustrations least 2-3 Types of
define on his/her own use as well as its and it’s definition and use - time, effort and cooperation natural family planning
words on how these advantages and of the teacher and learner methods and define on
family planning disadvantages -interest and readiness of his/her own words on
methods work learner how these family
planning methods work
 5. Express on own  Conclusions about the  One- on-one lecture  2 minutes  The client can
words on what he/she family planning methods discussion on the - booklet prepared which express on his or her
has learned and for conclusions on family includes illustrations words the things that
possible family planning - time, effort and cooperation he or she has learned
planning methods of the teacher and learner and possible family
that he or she wants -interest and readiness of planning methods
to choose learner that he or she may
want to choose and
the reason why

References:
- Doenges et.al, Nurse’s Pocket Guide; Diagnoses, Prioritized Interventions, and Rationales 10th Edition (2006), F.A. Davis Company
- Perry, Potter (2005). Fundamentals of Nursing 6th Edition. Singapore: Elsevier Mosby PTE LTD.
- http://en.wikipedia.org/wiki/Family_planning
- http://familydoctor.org/online/famdocen/home/women/contraceptive/126.html
- http://www.buzzle.com/articles/different-methods-of-family-planning.html
- http://www.mjbovo.com/Contracept/Instruct-NatCerv.htm
 Saint Louis University
School of Nursing
Baguio City

FAMILY PLANNING
A Teaching Plan

In Partial Fulfillment of the Requirements

of the Rotation in BGH- Family Planning

Submitted to:
Rowena C. Ochoco, RN
Clinical Instructor

Submitted by:
Visaya, Jed Andrew C.
BSN III- P2

Date Submitted:
September 13, 2010
 Saint Louis University
School of Nursing
Baguio City

TEACHING PLAN ON FAMILY PLANNING

In Partial Fulfillment of the Requirements

of the Rotation in BGH- Family Planning

Submitted to:
Ms. Rowena C. Ochoco
Clinical Instructor

Submitted by:
Ngina, Gemmalyn L.
BSN III- P2

Date Submitted:
September 13, 2010
 Learning Content

Female Reproductive System-

 Vagina: The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body. It also is known as the birth canal.
 Cervix: The cervix is the lower most part of the uterus and is made up of strong muscles. It also provides support to the uterus due to attachment of muscles
from the pelvic bone. The cervix protrudes and opens through a canal into the vagina. The function of the cervix is to allow flow of menstrual blood from the uterus
into the vagina, and direct the sperms into the uterus during intercourse.
 Uterus (womb): The uterus is a hollow, pear-shaped organ that is the home to a developing fetus. The uterus is divided into two parts: the cervix, which is the
lower part that opens into the vagina, and the main body of the uterus, called the corpus. The corpus can easily expand to hold a developing baby. A channel through
the cervix allows sperm to enter and menstrual blood to exit.
 Ovaries: The ovaries are small, oval-shaped glands that are located on either side of the uterus. The ovaries produce eggs and hormones.
 Fallopian tubes: These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to
the uterus. Conception, the fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants
to the uterine wall
Male Reproductive System-
 Penis — The penis is the male organ for sexual intercourse. It has three parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the
glans, which is the cone-shaped end of the penis. The glans, which also is called the head of the penis.
 Scrotum — The scrotum is the loose pouch-like sac of skin that hangs behind the penis. It contains the testicles (also called testes), as well as many nerves and
blood vessels. The scrotum has a protective function and acts as a climate control system for the testes.
 Testicles (testes) — The testes are oval organs about the size of large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord.
Most men have two testes. The testes are responsible for making testosterone, the primary male sex hormone, and for generating sperm. Within the testes are coiled
masses of tubes called seminiferous tubules. These tubules are responsible for producing the sperm cells through a process called spermatogenesis.
 Epididymis — The epididymis is a long, coiled tube that rests on the backside of each testicle. It functions in the transport and storage of the sperm cells that
are produced in the testes. It also is the job of the epididymis to bring the sperm to maturity, since the sperm that emerge from the testes are immature and incapable
of fertilization. During sexual arousal, contractions force the sperm into the vas deferens.
 Vas deferens — The vas deferens is a long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder. The vas deferens
transports mature sperm to the urethra in preparation for ejaculation.
 Urethra — The urethra is the tube that carries urine from the bladder to outside of the body. In males, it has the additional function of expelling (ejaculating)
semen when the man reaches orgasm. When the penis is erect during sex, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at
orgasm.
 Family Planning-

Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly
used include sexuality education, prevention and management of sexually transmitted infections, and infertility management.

Family planning is sometimes used as a synonym for the use of birth control, though it often includes more. It is most usually applied to a female-male
couple who wish to limit the number of children they have and/or to control the timing of pregnancy (also known as spacing children). Family planning may
encompass sterilization, as well as pregnancy termination.

Advantages:

-Raising a child requires significant amounts of resources: time, social, financial, environmental. Planning can help assure that resources are available.
Parents can take care of their children better if ability of parents is well assessed.

Artificial Family Planning Methods

Artificial methods are physical methods that may work in a variety of ways, among them: physically preventing sperm from entering the female reproductive
tract; hormonally preventing ovulation from occurring; making the woman's reproductive tract inhospitable to sperm; or surgically altering the male or
female reproductive tract to induce sterility. Some methods use more than one mechanism

 Condoms: Condoms are the most commonly used male contraceptive to escape pregnancy. Using condoms during sexual intercourse acts like a barrier for
sperms to enter the vagina, thus restricting their contact with the egg. In recent times, even female condoms are available in the market. Along with birth
control, a condom also helps in the prevention of sexually transmitted diseases. There have been cases where condoms have failed to avoid pregnancy, but
this is mostly due to defective condoms or incorrect use of the condom. The male condom has a shelf life of 3 years. The female condom has a flexible ring
at each end — one secures behind the pubic bone to hold the condom in place, while the other ring stays outside the vagina.
 Advantages
-it does not interfere with a man's or a woman's chance of conceiving a child in the future. Pregnancy is possible whenever sexual intercourse occurs
without a condom
-cheap and cost-effective
-Prevents STD
 Advantages
-may slip off
 -less sensation

 Birth Control Pills: Another method of artificial family planning is the use of birth control pills by women. Birth control pills also known as oral
contraceptives, stops the development of the egg and also helps in the thickening of the cervical mucus in the uterus, thus restricting the passage of the
sperms to the egg. This can be an effective method if the pills are taken regularly and in the correct manner. If contraceptives do not work out, another way
of precluding pregnancy is to take emergency contraceptive pills. If a couple has indulged in unsafe sex, the woman can take emergency pills to reduce the
chances of getting pregnant.

 Advantages
 Birth control pills cause menstrual cycles to occur regularly and predictably
 These can offer significant relief to women with painful menstrual cramps
 Reduce the amount of blood flow during the period. Less blood loss is helpful in preventing anemia.
 The risk of developing ovarian cysts is greatly reduced for birth control pills users because they help prevent ovulation
 Provide some protection against pelvic inflammatory disease (PID)
 Birth control pills can improve acne
 Women with excessive facial or body hair may notice an improvement while taking the Pill, because androgens and testosterone are suppressed by
oral contraceptives
 Because birth control pills work primarily by suppressing ovulation, they effectively prevent ectopic pregnancy as well as normal pregnancy
 Several studies show that by regulating hormones, the pill can help prevent osteoporosis, a gradual weakening of the bones
 Using pills will not affect a woman’s future fertility
 Safe for many women
 Disadvantages
 The chances of birth control pills contributing to a heart attack are small unless you smoke
 Women taking birth control pills usually have a small increase in both systolic and diastolic blood pressure, although readings usually remain
within the normal range
 Headaches may start in women who have not previously had headaches, or can get worse in those who do
 Depression (sometimes severe) and other mood changes may occur
 Your breasts may become tender or may get larger
 Some women experience a decreased interest in sex or a decreased ability to have orgasms
 Some women report slight weight gain
 Birth control pill does not offer any protection against sexually transmitted infections
 You must remember to take the pills at the same time every day.
 The pill costs more than some other methods
 Intrauterine device (IUD): The IUD or Copper T as it is commonly known is a very convenient, safe and reversible method of family planning which does
not require a daily routine. It is a small device made of metal, copper or plastic that is inserted into the uterus of a woman of reproductive age, for as long as
she does not want a pregnancy. Normally once it is inserted, it stays in place for 5 to 10 years and inhibits the entry of sperms into the inner recesses of the
vagina and also prevents fertilization. It is the most popular and widely used female contraceptive method . The IUD should be inserted and removed (when
pregnancy is desired) by a qualified medical practitioner, to avoid complications.
 Advantages
 Extremely effective in protecting against pregnancy
 One of the least expensive methods of birth control on the market
 Does not interrupt lovemaking
 Women who cannot take hormones can use the Copper T
 Mirena can lessen the amount of blood lost during menstruation; 20% of women eventually stop having periods

 Disadvantages
 Increased risk of infection in the first 4 months
 Can be expelled (pushed out) without the woman knowing it
 The Copper T can increase menstrual blood loss and increase menstrual cramps
 It is very rare, but possible, that the IUD punctures the uterus (this happens in 1 to 3 out of 1,000 insertions)

 Sterilization: refers to permanent contraception by surgical procedures, to avoid future pregnancies. It is a method of birth control suited for couples who do
not want to have any more children or couples who don't want to have even a single child. Vasectomy is the procedure for men and tubectomy or tubal
ligation for women. It is by far the safest and most effective method of pregnancy control, though irreversible. Sterilizing is done permanently and is a full
proof method.

 Tubal Ligation It is a permanent form of female sterilization, in which the fallopian tubes are severed and sealed or "pinched shut", in order to prevent
fertilization. Hormone production, libido, and the menstrual cycle can be affected by a tubal ligation.
 Effectiveness
 A tubal ligation is approximately 99% effective in the first year following the procedure. In the following years the effectiveness may be reduced
slightly since the fallopian tubes can, in some cases, reform or reconnect which can cause unwanted pregnancy.

 Advantages
- It is a permanent procedure
- Tubal ligation does not require any attention once it is done
- It's extremely effective

 Disadvantages
- It is a more major surgery than vasectomy, and carries greater risks.
- Postoperative complications are more likely than with vasectomy, and more costly.
- Tubal ligation has a larger initial cost than other contraceptive methods.
- It is a permanent procedure
- It's not 100 percent effective
- A tubal does not guard against sexually transmitted infections

 Vasectomy- A vasectomy is considered a permanent method of birth control. A vasectomy prevents the release of sperm when a man ejaculates. During
a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated
from the penis. An egg cannot be fertilized when there are no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed
by the body.

 Effectiveness
Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in
the first year after their partners have had a vasectomy.

 Advantages
 It is a permanent method of birth control.
 It is a safer, cheaper procedure that causes fewer complications than tubal ligation in women.
 Although vasectomy is expensive, it is a one-time cost and is often covered by medical insurance.
  Disadvantages
 A vasectomy does not protect against sexually transmitted diseases (STDs), including infection with the human immunodeficiency
virus (HIV).
 It is not reversible if ever you still want to have a child.
 Some older studies showed a risk of prostate cancer in men who have had vasectomies.

 Cervical barriers are devices that are contained completely within the vagina.

 The contraceptive sponge has a depression to hold it in place over the cervix.
 The cervical cap is the smallest cervical barrier. Depending on the type of cap, it stays in place by suction to the cervix or to the vaginal walls.
 The diaphragm fits into place behind the woman's pubic bone and has a firm but flexible ring, which helps it press against the vaginal walls.

 Spermicide may be placed in the vagina before intercourse and creates a chemical barrier. Spermicide may be used alone, or in combination with a physical
barrier.

 Injectibles Eg. Depo- Provera -Depo-Provera is a birth control method for women. It is made up of a hormone similar to progesterone and is given as a shot
by a doctor into the woman's arm or buttocks. Each shot provides protection against pregnancy for up to 14 weeks, but the shot must be received once every
12 weeks to remain fully protected.

 Effectiveness
Depo-Provera is 99% effective in preventing pregnancy. However, it does not prevent spreading of STDs. To help protect yourself
from STDs, use a latex male condom each time you and your partner have sex.

 Advantages
 You don't have to remember to take it every day or use it before sex
 It provides long-term protection as long as you get the shot every three months
 It doesn't interfere with sexual activity
 It's over 99% effective
 It's less expensive than the Pill
 Disadvantages
 It can cause unwanted side effects
 It does not provide protection against sexually transmitted diseases
 It can cause irregular menstrual periods
 You need to stop taking Depo-Provera several months ahead of time if you plan to become pregnant
 Regular doctor visits can be inconvenient

Natural Family Planning Methods

Natural family planning methods are behavioral methods that involve regulating the timing or methods of intercourse to prevent the introduction of
sperm into the female reproductive tract, either altogether or when an egg may be present.

 Basal Body Temperature Method

A woman's body temperature varies throughout her menstrual cycle.  This temperature variation is mediated by the hormone progesterone and, to a
minor extent, the hormone LH.  You can use this information to predict ovulation.  Using a thermometer, you must take your temperature every morning
BEFORE getting out of bed and record this on a chart (such as the one below).  Your temperature rises between 0.4°F and 0.8°F on the day of ovulation. 
(Your temperature will begin to rise on Day 13 of a 28 day cycle and continue to rise until approximately day 15 - these are the three days you are
COMPLETELY UNSAFE.)  From the day after ovulation until a few days before your period, it will remain elevated.  Your temperature will begin to drop a
few days before your period.  You should refrain from intercourse seven days before the temperature rise until four days after. Just because temperature
changes are very accurate in predicting the day of ovulation, they do not predict it before it happens.  To be completely safe, you should consider unsafe days
from the first day of your period until the fourth day after the temperature rise.  Don't forget, sperm can live up to seven days after intercourse.

o Effectiveness
On average, the basal body temperature method has a failure rate of 15% but as low as 2% per year for perfect users. To help make your
readings more accurate, and therefore make your charting more reliable, you should try to take your temperature at about the same time everyday. If
you are sick during the month or forget to take your temperature, your charting for that month may be inaccurate.
o Advantages
 It's absolutely free!
 There are no side effects or complications from hormones
 This method may actually be used to help couples achieve pregnancy
 Some religions and cultures approve of this method as the only acceptable form of contraception
  You and your partner rely on each other for mutual support and commitment to make this method work

 Cervical Mucus Billings Method

As you get closer to ovulation, your cervical mucus will become thinner and stickier. When ovulation is about to occur, your cervical mucus will be
clear, slippery and very stretchy, similar to a raw egg white. This type of mucus is ideal for sperm to swim in and helps the sperm swim up to your uterus.
While this is great for women who are trying to conceive, women who are trying to avoid pregnancy will want to abstain from sex or use another form of
birth control, like condoms or the sponge, during this time.

Checking the Mucus

There are three ways in which you can check your cervical mucus:
 Use your finger or toilet paper to wipe across the opening of vagina and then take a look at the mucus.
 Wear a panty liner and examine any cervical mucus that may be left on it (this can be hard to detect, though)
 The best way: reach in and get a sample of your cervical mucus. Examine the consistency and try to stretch the mucus between your fingers. If you can
stretch it at least three inches without it breaking, then ovulation is about to occur.

*If you do not want to get pregnant, then sex should be avoided from the time you begin to notice the slippery, stretchy mucus until at least two days after it is gone.

 Effectiveness
By itself, this method is not as reliable as other methods of birth control and has an average failure rate of 20% per year. However, using the cervical mucus
method along with another form of fertility awareness, like the symptom-thermal method, can offer you more insight as to when you are most fertile.

 Advantages
- This method of Fertility Awareness teaches a woman how to read the signals of her body
- The Ovulation Method also teaches a woman how to interpret the texture of her cervical mucus, which is a fairly precise signal of ovulation
- There is no equipment needed in order to apply this method
- This Natural Family Planning works better for women, who have irregular menstrual cycles

 Disadvantages
- The Ovulation Method can be messy enough
- This method of Fertility Awareness is not a convenient one, because the cervical mucus must be checked every day, without taking any
circumstances into consideration
 - It is necessary that a woman, who is going to apply this method of Fertility Awareness, would receive training by a well – experienced professional

 Disadvantages
- Before you ovulate, though, it can be a bit harder to determine exactly when the "safest" time is to have sex.
- Sperm can remain viable inside a woman for as long as seven days. Therefore, it is possible to become pregnant even if you don't have sex during your most fertile time.
- The symptom-thermal method requires the use of a special type of thermometer that is designed to read the minute changes in your temperature and only has a range of a
few degrees. Some may not afford it.
- This method is not a good choice if your periods don’t come at a regular time each month, your temperature pattern is different each month, you just stopped birth control
pills, you just started having your periods, you are close to menopause, you can’t keep a calendar chart, or you don’t like going without sex for a least two weeks.
- This method of birth control does not protect you from HIV/AIDS or other sexually transmitted diseases
- This method is often unreliable during times of stress or illness because cycles may be irregular and /or basal body temperature fluctuations may occur
- It takes at least 6 months of recording cycles to learn how to use natural family planning. During this time, you must abstain from sex or use a barrier method

 Abstinence: Couples who do not want to have a baby and want to avoid taking artificial contraceptives, should keep away from sexual intercourse during
the fertile days of the woman. For this method to work out, the women should keep track of their menstrual cycles to know the timing of their ovulation and
the period during when there is high risk of getting pregnant.

 Withdrawal: Withdrawal is another method of natural pregnancy prevention. In this method, the man withdraws his penis from the vagina before
ejaculation while having sex. However, this is not a full proof method of birth control, as the fluid which is secreted before ejaculation also contains sperms
and are sufficient to fertilize an ovum.

 2 Days Method- The method rules are quite simple. A woman asks herself two questions: "Did I notice any secretions today?" and "Did I notice any
secretions yesterday?" If she noticed any secretions yesterday and today, she is potentially fertile. If she did not notice any secretions either yesterday or
today (two consecutive days with no secretions), her probability of becoming pregnant is very low and it is safe to have intercourse that day. Couples using
the TwoDay Method should avoid unprotected intercourse on days when the woman is potentially fertile.

For simplicity, women can note the presence or absence of cervical secretions at the same times each day. Checking after noon and just before going
to bed at night is adequate for identifying fertile days, and also reduces the potential for confusing semen and cervical secretions.
 The lactational amenorrhea method (LAM) is a method of avoiding pregnancies which is based on the natural postnatal infertility that occurs when a
woman is amenorrheic and fully breastfeeding. If not combined with chemicals or devices, LAM may be considered natural family planning.

For women who meet the criteria (listed below), LAM is 98% - 99.5% effective during the first six months postpartum.

 Breastfeeding must be the infant’s only (or almost only) source of nutrition. Feeding formula, pumping instead of nursing, and feeding solids all reduce the
effectiveness of LAM.
 The infant must breastfeed at least every four hours during the day and at least every six hours at night.
 The infant must be less than six months old.
 The mother must not have had a period after 56 days post-partum (when determining fertility, bleeding prior to 56 days post-partum can be ignored).

Combining All Methods for Reliability

 None of the above methods are reliable enough alone to consistently prevent an unwanted pregnancy.  The BEST METHOD is to combine all of
them into one called the Sympto-Thermal Method.