Chapter 6: Nursing Care for the Family in Need of Reproductive Life Planning
Reproductive Life Planning
 Includes all decision an individual or a couple
make about having children including
o If and when to have children
o How many children to have
o Length of time between children
 Counselling may include the topics of avoiding
conception, increasing fertility and what to do
if contraception has failed
Contraceptives
 An ideal contraceptive should be
 Safe and effective
 Compatible with religious and cultural
beliefs, personal preferences of user
and partner
 Free of bothersome side effects
 Affordable and needing few
instructions for use
 Free of effects on future pregnancy
after discontinuation
Categories of Commonly used Birth Control Methods:
I. Natural Family Planning
 Also called “periodic abstinence
methods”
o No chemical or foreign material
into the body
o Failure rate: 2% to 25%
o Need for couple to be
conscious of time period when
woman is most likely to be
fertile
 Abstinence
o 0% failure rate
o Most effective method to
prevent STIs
 Lactation Amenorrhea Method (LAM)
o Safe method
o Failure rate: 1% to 5% if
1. Infant under 6 mos of
age
2. Breastfeeding with no
supplements
3. Menses had not
returned
2. Coitus Interruptus
o 82% effective
o Does not prevent STIs
3. Postcoital douching
o Ineffective
 Fertility Awareness Methods
Calendar (rhythm) method
1. Gather data for 6 months
2. Minus 18 from shortest = 1st
fertile day
3. Minus 11 from longest = last
fertile day
Basal Body Temperature (BBT) method
1. Before rising bed in the
morning
2. Working at night: longest sleep
3. Same time
4. 0.2 degree Celsius
Cervical mucus (Billing’s) method
o The cervical mucus method is
based on careful observation
of mucus patterns during the
course of your menstrual cycle
Two – day method
o Two days in a row observe
vaginal secretions
o Fertile: stretch 10 to 12 cm
Symptothermal method
o Combination of CERVICAL
MUCUSA AND BBT
o Observe for puson pain; left or
right side
o Cervix
Standard days method: CycleBeads
o It identifies a fixed fertile
window in a woman's menstrual
cycle when pregnancy is most
likely. CycleBeads®, a visual
tool, helps women track their
cycles to know when they are
fertile.
Ovulation detection
o helps determine the time in the
menstrual cycle when getting
pregnant is most likely.
The test detects a rise in
luteinizing hormone (LH) in the
urine. A rise in this hormone
signals the ovary to release the
egg.
Marquette model
o using urine fertility biomarkers
collected at home that measure
hormone levels. These
biomarkers can be used in
conjunction with cervical mucus
or basal body temperature and
an algorithm to confidently
determine the woman's fertile
window
II. Barrier Methods
 Place a chemical or latex barrier between the
cervix and advancing sperm
1. Spermicides
2. Male and Female condoms
3. Diaphragm
4. Cervical cap
Side effects and Contraindications
o Not effective if uterus is prolapsed,
retroflexed or anteflexed
o Cystocele or rectocele
o Higher number of UTIs, herpes virus
infection or papillomavirus infection
o History of toxic shock syndrome (TSS)
a staphylococcal infection introduced
through the vagina
o Allergy to rubber or spermicides
o History of recurrent UTIs
To prevent TSS
o Wash hands
o Do not use a diaphragm during
menstrual period
o Do not leave a diaphragm in place
longer than 24 hours
o Be aware of S&S
III. Hormonal Contraceptives
1. Oral
2. Transdermal
3. Intravaginal
4. Intramuscular
5. Subdermal hormone implants
IV. Intrauterine Devices (IUDs)
1. Copper T380
2. Levonorgestrel – releasing intrauterine
system (Mirena or liletta)
3. Levonorgestrel – releasing intrauterine
system 13.5 mg Skyla
4. Levonorgestrel – releasing intrauterine
system 19.5 mg Kyleena
V. Surgical Methods
1. Tubal Ligation
2. Vasectomy
VI. Emergency Postcoital Contraception
1. High – dose progestin – based pills
2. Insertion of copper IUD
3. Ulipristal acetate (known as ella)
VII. Termination of Pregnancy
1. Class IV heart disease
2. Chromosomal defect
3. Unwanted as result of rape or incest
4. Unwanted due to financial, age and
not wanting to be single parent,
wanting no more children