EMERGENCY CONTRACEPTION

Subject- COMMUNITY HEALTH NURSING –I

Unit –VII
By- Mrs. Simarjot Kaur
Assistant professor
MODH
FAMILY PLANNING

Family planning is defined as the voluntary, responsible

decision made by individuals and couples as to the
desired family size and timing of births.
 FAMILY PLANNING

Family planning is the ability for a woman or couple

to determine when and how many children they are
going to have by practicing safe sexual practices.
 OBJECTIVES FAMILY PLANNING

According to WHO expert committee-----

❖ To avoid unwanted births

❖ To regulate the interval between pregnancies
❖ To control the time at which birth occurs.
❖ To determine the number of children in a family.
 DEFINITION OF ELIGIBLE COUPLE-

An eligible couple refers to a currently married couple

wherein the wife is in the reproductive age, which is
generally assumed to lie between the ages of 15-45 years.
There will be at least 150-180 such couples per 1000
populations in India.
 DEFINITION OF TARGET COUPLE

The term target couples are applied who have 2-3

living children, and family planning was largely
directed to such couples.
 DEFINITION OF SMALL FAMILY NORM

it is composed of mother , father and few children.

 HEALTH ASPECT OF FAMILY PLANNING

ADVANTAGES TO MOTHER
•Reasonable gap between two children will give the
mother sufficient time to replenish her body nutrients
depleted due to the earlier pregnancy.
•Loss of fear about unwanted pregnancy.
-More time and energy to give proper attention and
love to her children.
-More time to participate in other fruitful activities like
education, vocational training, community projects etc.
-Can avail of better job opportunities when not tied
down by small children.
 HEALTH ASPECT OF FAMILY PLANNING

ADVANTAGES TO FATHER

- Can provide sound economic base for the family.

-Can provide children with better education,
comfort, food, clothing, recreation etc.
-Can be more relaxed and enjoy good
health.
-Improved living standards, better health,
more productive labour force
 HEALTH ASPECT OF FAMILY PLANNING

ADVANTAGES TO CHILD
❖Less chances of foetal death, birth
defects, mortality during infancy and
childhood.
❖ Conducive atmosphere for proper
physical and psychological growth of the child.
❖Get proper nutrition, education,
parental care and love.
 HEALTH ASPECT OF FAMILY PLANNING

ADVANTAGES TO COMMUNITY AND COUNTRY

-Conversation of natural resources and savings.
- Enough schools, hospitals and other basic services.
- More employment
-Planned families would gradually bring happiness,
peace, harmony, prosperity.
 CONCEPTION

It is the fertilization of a
female ovum by a male
sperm. Every 28 days, in an
adult female, one ovum
leaves the ovary and is
directed into fallopian tube
by the fimbriated end, which
passes along with the tube.
CONTRACEPTION

it is the voluntary prevention of pregnancy, a

process with individual and social implications.

Contraception (birth control) prevents pregnancy

by interfering with the normal process of ovulation,
fertilization, and implantation. There are different
kinds of birth control that act at different points in
the process.
 Emergency contraception

Emergency contraception refers to back up

method for contraceptive emergencies which
woman can use within the first few days after
unprotected intercourse to prevent an unwanted
pregnancy. Emergency contraceptive is not
suitable for regular use.
(WHO, 2005)
 INDICATIONS OF EMERGENCY
CONTRACEPTIVES

•After voluntary sexual act without contraceptive protection.

•Incorrect or inconsistent use of regular contraceptive
methods. Failure to take oral contraceptive for more than
three days.
•In case of contraceptive failure or mishap, miscalculation of
infertile period, expulsion of an intrauterine device and
failed coitus interruptus or in case of leakage of condom.
•In the case of sexual assault.
•Emergency contraception should not be used as regular
birth control. Other birth control methods are much better
at keeping women from becoming pregnant.
 METHODS OF EMERGENCY CONTRACEPTION

Emergency contraceptive pills (ECPs) emergency

contraceptive pills; ECPs
Medication containing synthetic hormones for preventing pregnancy after
unprotected vaginal intercourse.
All the hormonal oral contraceptive pills (combined as well as single) in
varying doses and IUD can be used for EC. The method currently used in
india are :
High dose of progesterone only pill containing
levonorgestrel (LNG).
high doses of combined oral contraceptive containing ethylestradiol
and levonorgestrol (yuzpe regimen).
Cont…..

•Copper releasing intrauterine devices (IUCD) such

as CuT 380A.

•Under the national family welfare programme, the

drug controller of india has only approved
levonorgestrel (LNG) 0.75mg tablet for use as ECP.
LNG is the specially packaged at the correct doses
for use as ECP.
MODE OF ACTION OF ECPs

➢ Inhibition or delay of ovulation.

➢ Thickening of cervical mucus.

➢ Direct inhibition of fertilization.

➢ Alteration in endometrium leading to impaired
endometrium receptivity to implantation of the
fertilized egg..
MODE OF ACTION OF ECPs

➢Alteration in transport of egg, sperm and

embryo.

➢Interference with corpus luteum and luteolysis

 Effectiveness of ECPs

❑The probability of conception after single act of intercourse

is approximately 8%.
❑A normally fertile sexually active couple not using contraception
has an average monthly chance of conceiving of 20-25% (counting
on pregnancies that result in live births.
❑ECPs taken within 72 hours of unprotected vaginal
intercourse are 85% effective .
❑ECPs are more effective if used within 12-24 hours of
unprotected intercourse any delay in taking the pills decrease the
efficiency of ECPs.
ADVANTAGES OF ECPs

❑ Effective if taken correctly as prescribed.

❑Safe for all woman including those who have conditions, that
are listed as precautions in case of other hormonal
contraceptives.
❑ Does not affect lactation.
❑Can be taken at any time during the monthly cycle.
❑It is available without a prescription (over the counter
medicine)
❑Use not associated with foetal malformation or congenital
defects.
DISADVANTAGES

•Has to be used within 72 hours of the first act of sexual

intercourse as use of ECP beyond this period increases the
risk of pregnancy.
•Effectiveness decreases with frequent use.
•Does not protect from STIs/HIV.
•Side effects: nausea, vomiting, irregular bleeding per vagina,
breast tenderness, headache, dizziness, fatigue.
 MODE OF INTAKE
❖ECPs must be taken 72 hours of an
unprotected act of intercourse best to be taken
as soon as possible after the unprotected act
and as a single dose of 2 tabs of 0.75 mg each.
❖ There is an option of taking 2 doses of 1 tablet
0.75 mg each, 12 hours apart.
❖However no woman should be denied the pills
in case she comes later than 3 days (maximum
120 hours) but should be counseled regarding
the decreased efficacy).
 EMERGENCY CONTRACEPTION PILLS

Calculation of 72 hours (three days interval)

Calculation of 72 hours or three days should
start from the first unprotected penetrative
vaginal intercourse the woman has had
during the particular menstrual cycle.
Side effects of ECPS

➢ Nausea and vomiting

➢. Headache,
➢dizziness,
➢irregular bleeding,
➢breast tenderness,
➢ fatigue
 ROLE OF NURSE IN FAMILY PLANNING

❑ Administrative role -
❑ Supervisory role.
❑ Functional role
❑ Educational role-
❑ Role in research
❑ Role in evaluation -
 BIBLIOGRAPH
•Basawanthappa Y ” Community Health Nursing”,
B. T, (2008), Pp
600- 6001.
•Kamalam S. (2005), Essential In Community Health Nursing Practice, Pp
319-321
•Lowdermilk Leonard Deitra, Perry Phinon E. (1997), “Maternity And Woman
Health Care”, New York, PP 1192-1195.
•Mahajan B. K, Gupta M.C. (1972),“ Textbook Of Preventive And Social
Medicin”, Second Edition, pp- 608.
•May Antley Katharyan, Laura Mahlmeister, “Comprehensive
Maternity Nursing” Pp-192.
• Jacob annamma, (2005), a comprehensive textbook of midwifery”, pp
– 242-245.
• Myles Margret f.,(1975), “text book for midwifes” pp 421.
• Park K. Preventive And Social Medicine , 20th Edition, Pp
• Gulani K. K, Community Health Nursing” First Edition, Pp 318-321.
• .wikipedia.com.