Family Planning New

Family planning
- conscious process by which a

couple decides on:
1. the number
2. spacing of children and
3. the timing of births.
 …Means deciding when is

the right time to have
children, and what is the
appropriate number of
children for a couple to have.
Contraception- is the
voluntary prevention of
pregnancy.
• The best contraceptive

method
is:
1. most comfortable and
natural for partners, and
2. they will use correctly
and consistently.
Credit:
https://www.google.com/search?q=contraception&tbm=isch&ved=2ahUKEwj6hMPcy6TsAhVixosBHZzkB7IQ2
Nursing responsibilities:
1. Assist the couple to select and

use an effective contraceptive
method.
2. Understand one’s own

philosophy, beliefs and
standards.
Picture credit: https://www.google.com/search?q=nursing+responsibilities&tbm=isch&ved=2ahUKEwi-
mYbfzKTsAhWIAqYKHVDSDMgQ2
3. Educating couple or individual

about the complete range of
contraceptive possibilities is a
key factor in helping the client to
make an informed and
satisfactory contraceptive choice.
Credit:
https://www.google.com/search?q=health+education&tbm=isch&ved=2ahUKEwik853DzaTsAhVEeZQKHc8tCrEQ2
4. Teach about available contraceptive

methods and their use, effectiveness,
advantages, disadvantages and side
effects.
5. Provide a comfortable, factual,

nonjudgmental attitude when
discussing contraception and sexuality.
6. Compiling a thorough health history

and assessment data.
Credit:
https://www.google.com/search?q=healthassessment&tbm=isch&ved=2ahUKEw
ivgOeXz6TsAhXhGKYKHfdpA1wQ2
Elements of Counseling:
GATHER (acronym)
Greet clients.
- give full attention, be
polite, greet them,
introduce yourself, offer
them seats
Credit:
https://www.google.com/search?q=counseling&tbm=isch&ved=2ahUKEwixq6vJz6TsAhVD15QKHRGZBjIQ2
 Tell clients that you will not
tell others what they say
 In clinics, explain what will
happen during the visit.
 Describe physical
examination and laboratory
tests if any
 Conduct counseling where
no one can hear
Credit:
https://www.google.com/search?q=family+planninf+counseling&tbm=isch&ved=2
ahUKEwj1x-bt0KTsAhX8zIsBHaUpAXgQ2
Ask clients about themselves
 Help clients talk about their

needs, wants and any doubts,
concerns, or questions
 If the client is new, obtain a

history
 Keep questions simple and

brief
 Eye contact
https://www.google.com/search?q=asking+a+client+during+counselling&tbm=isch&v
ed=2ahUKEwjxsovZyv7sAhXRAaYKHX4eBskQ2
Tell clients about family planning
methods
 Available family planning

methods
 Tell:which methods are

available and where
https://www.google.com/search?q=tell+a+client+during+counselling&tbm=isch&ved
=2ahUKEwjR0JHoyv7sAhVDAaYKHa59AtoQ2
 Ask : which method interest
them
 Ask: what they know about

the method that interests
them
 Briefly describe each

method: how it works,
advantages and benefits,
disadvantages and possible
side effects
https://www.google.com/search?q=family+planning+counselling&tbm=isch&ved=2ah
UKEwiWrezFy_7sAhUJTZQKHW3FDnkQ2
Help client choose a method
 Listening
and questioning
are important here
 Ask:what their sexual

partners wants
https://www.google.com/search?q=help+choose+a+family+planning+method&tbm=isch&ved=2
ahUKEwiPn82O0f7sAhUUxosBHd_hCaIQ2
Explain how to use chosen
method
 Giveher/him supplies if
available
 Explain how to use and ask

client to repeat the
instructions (listen
carefully)
https://www.google.com/search?q=explain+a+family+planning+method&tbm=isch&ved=2ahUK
EwibxKma0f7sAhVQTZQKHexzD_wQ2
 If
possible provide printed
materials about the
method
 Tell the client when to

come back for follow-up
visit
https://www.google.com/search?q=explain+a+family+planning+method&tbm=isch&ved
Return for follow-up
-Ask the client if he/she is still using the
method
-Ask: how the client is using the method,
problem encountered, side effects
https://www.google.com/search?q=follow+up+++family+planning+method&tbm=isch&ved
Natural family planning
method
 Is a technique of determining the fertile
period of a woman by observing the
physiologic signs and symptoms of the
fertile and infertile phases of the
menstrual cycle to avoid or achieve
pregnancy.
https://www.google.com/search?q=natural++family+planning+method&tbm=isch&ved
Natural methods are sometimes
called…..
FertilityAwareness-
Based methods
https://www.google.com/search?q=fertility+awareness+based+method&tbm=isch&ved
Effectiveness:
 Successfuluse of natural
methods to prevent
pregnancy depends upon:
1. the accuracy of the
method in identifying the
woman’s actual fertile days
2. a couple’s ability to correctly

identify the fertile time
3. the couple’s ability to follow
the rules of the method they are
using
Actual failure rate: 10-30%

Types:
https://www.google.com/search?q=basal+body+temperature+method&tbm=isch&ved
1. Basal body temperature

Basal body temperature
BBT is measured by taking

and recording the
temperature orally or rectally
- each morning before
arising after at least 3
hours of sleep.
•BBT drops before ovulation and
rises 0.4 to 0.8 degrees
Fahrenheit with ovulation (in
response to progesterone
production)
•Progesterone is a heat producing
hormone that causes the BBT to
rise
•The temperature rise above the
highest of the previous low
temperature is called THERMAL
SHIFT
https://www.google.com/search?q=thermal+shift+in+BBT&tbm=isch&ved
•The thermal shift does not
enable a woman to know that
ovulation has occurred.
Ovulation most commonly occurs
1 to 2 days before the thermal
shift
Important points to
remember: https://www.google.com/search?q=thermal+shift+in+BBT&tbm=isch&ved
 The safest way to use BBT

charting for contraceptive
purpose is to avoid
intercourse all through the
first half of the cycle.
 Resume intercourse on the 4th
day of the thermal shift
Observing and recording BBT
1. Use BBT thermometer- a fever
thermometer may also be used
2. Take temperature every morning at the
time upon waking up and before any
activity such as eating, drinking, and
urinating
- If it is not possible, a woman may take
her temperature between 8pm and
midnight
3. Take temperature about the same
time everyday after at least 3 hours of
undisturbed rest
4. Take the temperature by placing the
silver bulb under the tongue, in the
vagina or rectum
- rectal and vaginal temp is higher
than oral temp
5. Leave the thermometer in
place for 5 minutes
How to determine the coverline?
https://www.google.com/search?q=coverline+in+BBT&tbm=isch&ved
1. Identify first 10 temperatures
of the cycle
2. Disregard temperature day
1-5
3. Find the highest temperature
from day 6-10
4. Disregard any temperature
that is abnormally high due to
illness
https://www.google.com/search?q=ctemperature&tbm=isch&ved
5. Draw a horizontal line on the
highest of the temperatures from
day 6-10, This is the coverline.
What is coverline?
 … is the point of reference to determine the

thermal shift due to ovulation.
- to identify the rise in temperature due to
ovulation, wait for 3 consecutive temperatures
above the coverline. Intercourse is allowed from
the 4th day of the thermal shift until the end of
the cycle. This is known as the absolute infertile
phase days.
•Typical user
pregnancy rate is
about 20%.
https://www.google.com/search?q=BBT+pregnancy+rate&tbm=isch&ved
Advantages:
1. inexpensive,
2. has no side affects,
3. encourages communication,
4. ethically and morally non controversial and
5. is appropriate for sexual education programs
https://www.google.com/search?q=BBT+method+advantages&tbm=isch&ved
Disadvantages:
1. requires regular and accurate record
keeping
2. and it calls for partners to have only
intercourse only in the postovulatory
period
https://www.google.com/search?q=BBT+method+disadvantages&tbm=isch&ved
2. Cervical mucus method or Billings
Ovulation method (Ovulation
method)
- This method uses the appearance,
characteristics and amount of cervical mucus
to identify ovulation.
- The activity of estrogen and progesterone in the
ovulatory period, cervical mucus is clear and
slippery and more abundant.
https://www.google.com/search?q=cervical+mucus+method&tbm=isch&ved
https://www.google.com/search?q=cervical+mucus+method&tbm=isch&ved
In the preovulatory periods, cervical mucus
is
1. yellowish,
2. less abundant and
3. thick and sticky
thereby inhibiting sperm motility.
https://www.google.com/search?q=cervical+mucus&tbm=isch&ved
Probability of pregnancy is about 20%
Advantages: inexpensive, no side effects and not

controversial.
Disadvantage: not effective as other methods
https://www.google.com/search?q=cervical+mucus&tbm=isch&ved
3. Symptothermal method
Couple uses combination of

the above- mentioned
techniques to determine the
fertile period(BBT and cervical
mucus)
https://www.google.com/search?q=symptothermal+method&tbm=isch&ved
- Probability of pregnancy can be as high
as 13 to 20%
- Advantages: inexpensive, no side effects,
and not controversial
- Disadvantage: not as effective as other
methods
https://www.wikihow.com/images/thumb/9/91/Get-Pregnant-Using-the-Sympto-Thermal-
Method-Step-1-Version
4. Standard Days Method
 Relies on “standard rule” or “fixed

window” of fertility that makes it easy
for women to know when they are
likely to become pregnant
- to avoid pregnancy, the woman
should not have unprotected
intercourse during the fertile window
 WHO study reveals that the fertile
window is on days 8 to 19 for women
whose cycle lengths range from 26-32
days
A woman can use this method if her

cycles are between 26-32 days
https://www.google.com/search?q=WHO&tbm=isch&ved
Use of color-coded
string of beads, called
CYCLE BEADS
https://www.google.com/search?q=standard+days+method+beads&tbm=isch&ved
The cycle beads
 Represent the woman’s menstrual cycle.
 Each bead represents a day of her cycle
 The red bead marks the first day of menstruation
 The white beads represent the days when a woman can
get pregnant (abstain from intercourse)
 The brown beads are the days when
a woman cannot get pregnant (you
can have intercourse)
 The marked bead and the black bead
determine if the woman is within the
required cycle range
Effectiveness?
With correct use of

method: 95% or a
pregnancy rate of
4.7%
5. The TwoDay method
Relies on a simple
algorithm to help women
identify when they are
fertile, based upon
presence or absence of
cervical secretions
https://www.google.com/search?q=cervical+secretions&tbm=isch&ved
Ifthe woman notices any
secretions on the current or
previous day, then she is
probably fertile and should not
have unprotected intercourse
to avoid pregnancy
https://www.google.com/search?q=no+sexual+intercourse&tbm=isch&ved
Ifshe notices no
secretions on either day,
then she is not fertile
https://www.google.com/search?q=not+fertile&tbm=isch&ved
6. Lactational Amenorrhea Method (LAM)
 isa modern, short-term family

planning method based on the
natural effect of breastfeeding on
fertility.
https://www.google.com/search?q=breatfeeding+clipart&tbm=isch&ved
The act of breastfeeding,
particularly exclusive
breastfeeding, suppresses the
release of hormones that are
necessary for ovulation.
Ifcertain conditions are met,
the method provides protection
from pregnancy for a woman
immediately following birth
until the child is 6 months old.
Simplified criteria for the method,
developed by the Interagency LAM
Working Group, are:
1. The baby is exclusively breastfed and is
fed often, day and night, AND
2. The mother’s monthly bleeding has not
returned, AND
3.The baby is less than 6 months old.
https://www.google.com/search?q=breastfeeding%20clipart&tbm=isch&hl=en&tbs
 When any one of these conditions
is no longer met, the mother must
begin using another family
planning method immediately to
ensure that she does not get
pregnant right away
How does the method work?
1. The woman starts breastfeeding
as soon as possible after the
baby is born.
2. The baby is exclusively
breastfed - which means that no
supplementary foods are offered
to the baby.
3. The baby is breastfed day and night, as
often as the baby wants.
4. If and when any one of the three

conditions mentioned above is no
longer met, the mother should begin
using another family planning method
immediately. The mother is encouraged
to continue breastfeeding.
Quick Facts
1. 98% effective during the six months following

childbirth
2. No health side effects
3. Does not require the purchase of supplies
4. Encourages good breastfeeding patterns which benefit
the health of the mother and baby
5. It can be initiated immediately after child birth
SPERMICIDES
Vaginal jelly, cream, suppository, or foam
preparations interfere with sperm
viability and prevent sperm from entering
the cervix.
Pregnancy rate ranges from 5% to 50%
Advantages: available without prescription,

useful when other methods are
inappropriate, provide moderate
protection against STD’s
Disadvantages: lower effectiveness than

other methods, may irritate tissues, and
are aesthetically unpleasant.
Spermicides
AMERICAN DREAM REVIEW INSTITUTE

BARRIER METHODS
FEMALE CONDOM
 This is along polyurethane sheath

that inserts manually into the vagina
with a flexible internal ring forming
the cervical barrier
 Itcan be inserted up to 8 hours

before intercourse and is available
over the counter
Advantages:
1. protects against STD’s and
conception,
2. inexpensive,
3. for single use, and
disposable
Disadvantages:
1. esthetically unappealing,
2. requires dexterity,
3. expensive for frequent use,
4. may cause sensitivity to sheath
material, and
5. decrease spontaneity
https://www.google.com/search?q=how+to+insert+the+female+condom&tbm=isch&ved
MALE CONDOM
 this is a rubber sheath that fits

over the erect penis and
prevents sperm from entering
the vagina
 is about 86% effective
https://www.google.com/search?q=male+condom&tbm=isch&ve
advantages:
1. helps prevent conception and

transmission of STD’s ,
2. available OTC,
3. no side effects,
4. helps men maintain erection
longer,
5. prevents premature
ejaculation, and
6. prevents sperm allergies
disadvantages:
1. decrease sensation,
2. vaginal jelly is used if

condom or vagina is dry
How to Safely Store
Condoms
1. you need to make certain
that you store the condoms
in their original package
until you are ready to use
them.

2. you need to store your condoms in a
dry and cool place.
- Condoms need to be stored out of

direct sunlight.
- Condoms can degrade and become
damaged very easily if they are not
stored in this manner.
- Condoms should last through their
expiration date when properly
stored in this manner.

3. do not store condoms in the glove
compartment of your automobile or
in any other place in which the heat
can rise.
- Heat significantly increases the

chance that condoms will be
damaged or will break when being
used.

4. do not store condoms in
wallets or billfolds.
-This type of storage regularly
results in the condoms being
damaged even before they are
used.
-also weakens condoms

rendering them more likely to
break during use.

5. do not use condoms that
are in packages that look
damaged.
- A damaged package is an
indication that the condom
itself has been damaged.
6. do not use condoms that have past
their expiration date.
- Keeping in mind that condoms do

not last forever, you do not want to
over buy when you go to the store.

7. do not use condoms
that show obvious
signs of :
- deterioration
- appear brittle
- are sticky
- are discolored

Cervical Cap
 a small rubber or plastic dome that fits snugly over
the cervix
 advantage: provides continuous protection for 48

hours
 disadvantages: may dislodge, must be filled with

spermicidal, must be fitted individually by a health
care provider
 side effects: trauma to the cervix, pelvic infection,

cervicitis and odor problems may occur if prolong use
INSERTING A CERVICAL CAP
1. Wash your hands with soap

and water.
https://www.google.com/search?q=wash+hands+with+soap+and+water&tbm=isch&ved
2. Put one-quarter
teaspoon of
spermicide in the
dome of the cervical
cap and spread a thin
layer on the brim.

3. Put one-half teaspoon
in the folded area
between the brim and the
dome.

4. Find a comfortable position —
stand with one foot on a chair, sit on
the edge of a chair, lie down, or
squat.
https://www.google.com/search?q=putting+the+midle+and+index+finger+for+cervical+cap+ins
ertion&tbm=isch&ved
5. Put your index and middle fingers
in your vagina to locate your cervix.
That way, you will know where to
place the cap.
https://www.google.com/search?q=inserting+a+finger+cervical+cap+insertion&tbm=isch&ved
6. Separate the labia with one
hand and squeeze the rim of the
cap together with the other
hand. Slide the cervical cap
dome-side down into the vagina,
with the long brim entering first.

7. Push down toward the anus
and then up and onto the
cervix. Make sure the cervix is
completely covered. (It is
easier to insert before you are
sexually aroused.)

How long do I leave the cervical cap in?
What if I have sex again?
- With each act of intercourse, check
that the cervical cap is still covering
the cervix.
- You can leave the cap in place and
insert more spermicide deep into
your vagina.
- The cervical cap must stay in place
six hours after the last intercourse.
- Do not leave the cervical cap in
place for more than 48 hours.
REMOVING A CERVICAL CAP
1. Wash your hands

with soap and water.
2. Squat down. Grip the
removal strap and rotate
the cervical cap. Push
on the dome with your
finger to break the
suction.

3. Hook your finger under
the removal strap and pull
the cap out.

How do I take care of my cervical cap?
If you take good care of your cervical

cap it may last about two years. Taking
care of the cap is simple.
1. After you remove the cervical cap,

wash it with mild soap and warm water.
2. Allow it to air dry.
3. Do not use any powder on the

cervical cap — it can cause infections.
•Be sure to examine the cervical
cap regularly.
- You can look for small holes or

weak spots by holding it up to
the light.
- If there is a hole or weak spot,
light will shine through the
cervical cap.
- You can also fill the cup of the
cervical cap with water and
look for leaks.
FemCap is available in three
sizes:
1. small, for women who have

never been pregnant
2. medium, for women who have
had an abortion or a
cesarean delivery
3. large, for women who have
given birth vaginally

Diaphragm
this is a flexible ring covered with rubber cap hat
inserts into the vagina and covers the cervix
effectiveness is 80%
advantages: reusable and inexpensive
disadvantages: requires dexterity to insert, must be

fitted individually, refitted after childbirth and
should not be used longer than 24 hours due to
the risk of toxic shock syndrome
https://www.google.com/search?q=diaphragm+inside+the+vagina&tbm=isch&ved
INTRAUTERINE DEVICE
 This is flexible device inserted into the uterine cavity
 Effectiveness vary between 93% to 97%
 Advantages: inexpensive, reversible, has no systemic side

effects, may be used in lactating women
 Disadvantages: can not be used to a woman who has an active

pelvic infection, postpartum infection or uterine abnormalities
 Side effects: dysmenorrhea, increased menstrual flow, spotting

between periods
PHARMACOLOGICAL METHODS
oral contraceptives
combined estrogen and progesterone preparation in tablet form

inhibits the release of FSH, LH and ovum.
97% effective
Advantages: convenient to use, protects against ovarian cancer,

benign breast cancer, ectopic pregnancy, pelvic inflammatory
disease and anemia
Disadvantages: should not be used in women who smoke,

circulatory disease, history of thromphlebitis, diabetes,
varicosities
Side effects: breakthrough bleeding, nausea, vomiting, edema,

weight gain, missed periods
Minipills
 contain progestin but no estrogen

 do not suppress ovulation consistently
 Advantages: may be used immediately

postpartum if the client is not breast feeding
and 6 weeks postpartum if she is exclusively
breast feeding. Highly effective when
combined with breast feeding.
 Disadvantages: irregular bleeding, increased
risk of functional ovarian cysts, increased risk
of ectopic pregnancy
Subdermal implants
Six,soft, silastic rods filled with synthetic
progesterone are implanted into the woman’s
arm.
Advantages: long acting ( effective up to five

years), not coitus dependent, reversible,
inexpensive over the life of the drug
Disadvantages: require surgical insertion through

a half- inch incision on the inside surface of the
nondominant arm. They may be difficult to
remove and should not be used by a woman who
has active thromboplebitis, unexplained bleeding
https://www.google.com/search?q=subdrmal+implants+contraception+&tbm=isch&ved
DMPA(Depo medroxyprogesterone acetate) is an
intramuscular injection given every 3 months that
works like subdermal implants
advantages: highly effective and requires a little

attention except for returning to the health care
provider for injection every 3 months.
disadvantages: increased risk for breast cancer and

osteoporosis
https://www.google.com/search?q=dmpa+contraception&tbm=isch&ved
STERILIZATION
 Vasectomy - surgical ligation of the vas

deferens terminates sperm passage
through the vas completely after
residual sperm clear.
 advantages: highly effective
and usually permanent
 disadvantages: requires surgery
and may be irreversible
https://www.google.com/search?q=vasectomy&tbm=isch&ved
https://www.google.com/search?q=vasectomy+vas+deferens&tbm=isch&ved
Tubal ligation - the fallopian tubes
are surgically ligated
advantages: highly effective and

usually permanent
disadvantages: invasive procedure
and may be irreversible
https://www.google.com/search?q=tubal+ligation&tbm=isch&ved

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Family Planning New

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Family planning

- conscious process by which a

 …Means deciding when is

• The best contraceptive

1. Assist the couple to select and

2. Understand one’s own

3. Educating couple or individual

4. Teach about available contraceptive

5. Provide a comfortable, factual,

6. Compiling a thorough health history

 Help clients talk about their

 If the client is new, obtain a

 Keep questions simple and

 Available family planning

 Tell:which methods are

 Ask: what they know about

 Briefly describe each

 Ask:what their sexual

 Explain how to use and ask

 Tell the client when to

2. a couple’s ability to correctly

Actual failure rate: 10-30%

1. Basal body temperature

BBT is measured by taking

 The safest way to use BBT

How to determine the coverline?

 … is the point of reference to determine the

thereby inhibiting sperm motility.

Advantages: inexpensive, no side effects and not

Disadvantage: not effective as other methods

Couple uses combination of

 Relies on “standard rule” or “fixed

A woman can use this method if her

With correct use of

 isa modern, short-term family

4. If and when any one of the three

1. 98% effective during the six months following

Pregnancy rate ranges from 5% to 50%

Advantages: available without prescription,

Disadvantages: lower effectiveness than

AMERICAN DREAM REVIEW INSTITUTE

 This is along polyurethane sheath

 Itcan be inserted up to 8 hours

 this is a rubber sheath that fits

 is about 86% effective

1. helps prevent conception and

2. vaginal jelly is used if

AMERICAN DREAM REVIEW INSTITUTE

- Condoms need to be stored out of

AMERICAN DREAM REVIEW INSTITUTE

- Heat significantly increases the

AMERICAN DREAM REVIEW INSTITUTE

-also weakens condoms

AMERICAN DREAM REVIEW INSTITUTE

- Keeping in mind that condoms do

AMERICAN DREAM REVIEW INSTITUTE

AMERICAN DREAM REVIEW INSTITUTE

 advantage: provides continuous protection for 48

 disadvantages: may dislodge, must be filled with

 side effects: trauma to the cervix, pelvic infection,

1. Wash your hands with soap

AMERICAN DREAM REVIEW INSTITUTE

AMERICAN DREAM REVIEW INSTITUTE