UNIT- 8 FAMILY PLANNING

Methods of Family planning

Barrier Methods
IUCD (Copper T380 A)
General objective

At the end of this session, B.Sc. Nursing third

year students will be able to explain about
Intrauterine Contraceptive Device (IUCD).
Introduction
long-acting reversible contraception

Fitted inside the uterus

Most common types of IUCDs are copper

IUDs and hormonal IUDs

Copper T 380A available in Nepal

Introduction
The Copper T380A is

shaped like a "T' and

has copper on the

stem and the arms

Total exposed copper area of 380 square mm

Has a white string at its base

Effectiveness

 Effectiveness is 99.2%when used perfectly.

After insertion, the effective contraceptive

action lasts at least 12 years.
Types of IUCD
First generation IUCD
Second generation IUCD
Third generation IUCD
Mechanism of action
IUCD work by preventing fertilization and
implantation of fertilized egg in the uterus .

Not fully understood but it is believed to work

through several different mechanism;

Copper ion : interfere movement of sperm

Inflammatory response
Mechanism of action
 Prevention of implantation

Thickening of cervical mucus

Return of Fertility

• Fertility returns immediately after the removal of

IUCD
Indications
Prefer highly effective, long-term contraception

Prefer a method that does not require taking

contraceptive action daily

Have one or more children

Are breastfeeding and needs a contraceptive

Indications
Prefer not to use a hormonal contraceptive

Have successfully used an IUCD in the past

Are at low risk of contracting a STIs

Are post abortion clients who do not have evidence

of infection
Contraindications
Pregnancy
Anemia
Ectopic pregnancy
Unexplained vaginal bleeding
Pelvic Inflammatory Disease
History of recurrent PID
Within 6 weeks of CS
Timing of insertion of IUCD
 Interval insertion:

-Any time during the menstrual period

-if the woman is not pregnant Any time

during the menstrual cycle

 Soon after childbirth;

Any time within 48 hours

 Timing of insertion of IUCD
Postpartum insertion

Breastfeeding Non-breastfeeding
mothers mothers

Not using
Using LAM
LAM

Can be delayed Within 48 hours Within 48 hours of

Until her of delivery or delivery or after 4
mense after 4 weeks of weeks of delivery
return delivery
Timing of insertion of IUCD

After miscarriage or abortion

Immediately

Switching from another method

Immediately
Advantages of IUCD

Highly effective

Effective immediately

Immediate return to fertility upon removal.

Few side effects.

Advantages of IUCD

Convenient

No supplies needed by clients

Do not affect breastfeeding

Long term method(up to 12years protection

with copper T380 A)
Disadvantages
Pelvic examination and screening for genital
tract infection are required

May increase risk of PID

Require trained personnel to insert and

remove
Disadvantages
Increase menstrual bleeding and cramping
during the first few months.

May be spontaneously expelled

Women can not stop use whenever she wants

(provider dependent)
Side effects
Management of side effects

Cramping(abdominal pain)

Missing strings

Irregular or heavy vaginal bleeding

PID

Allergy skin reaction

Complications of IUCD

oExpulsion

oEctopic pregnancy

oPerforation

oAnemia
Warning signs for IUCD user
( Mnemonic @PAINS)

P=Period late (pregnancy), abnormal spotting

or bleeding.

A=Abdominal pain, pain with intercourse,

severe cramping.

I=Infection exposure (such as gonorrhea)

Warning signs for IUCD user
( Mnemonic @PAINS)

N=Not feeling well, fever, chills and

abdominal pain

S=String missing
 Advice during Inserting of the
IUD
Before procedure

During procedure

After procedure
Home assignment
Write short note on IUCD
Plan for next session
References
 Basavan Tappa, BT. (2008) .Community Health
Nursing (2nd ed) New Delhi, jaypee Brothers India
Publishers.

 Dahal, K. (2012). Community Health Nursing II (4th

edition) Kathmandu, Makalu ublication House.

 K, Park (2021). Park’s textbook of Preventive and

Social Medicine. (26th ed) India Prem Nagpur road
Jabalpur
References
 Shrestha ,k.(2017). A text book of Family and
Reproductive Health Nursing(1st ed)
Bhotahity,Kathmandu,Vidhyarthi Pustak Bhandar.

 Sthrestha ,D(2020). Reproductive Health National and

International Perspectives(3rd ed) dhulikhel Municipality

 WHO,USAID,JonsHopkins(2022).Family planning A
Global Hand Book for Providers(4th ed)