Week 7.1 FAMILY PLANNING

FAMILY
PLANNING
BY: PROF. JACKIELYN L. DELA CRUZ RN, LPT
PHILIPPINE FAMILY PROGRAM
 Principal recipients of information, education, communication, and motivation in

family planning:
 - married couples of reproductive age
 It requires all couples who want to receive a marriage license first to undergo a
seminar in family planning and responsible parenthood.
 - PD 965
ADVANTAGES:
1. FP helps families improve their standard of living
2. FP reduces/eliminates fears of unwanted pregnancy
3. FP affords family members time to study or pursue occupational interests
MAJOR TARGET (HIGH-RISK WOMEN)
 Women under 20 years old Women over 35 years old

 Women that suffering from certain medical conditions that contradict
pregnancy Women who have had at least 4 deliveries
 THE FAMILY CODE OF THE PHILIPPINES?

- Executive Order No. 209
REPRODUCTIVE LIFE PALNNING
 It includes all the decisions an individual or couple make

about whether and when to have children, how many
children to have, and how they are spaced.
 Intentional pregnancies are important for the health of
children because when a pregnancy is unintended or
mistimed, both short term and long term consequences
can result.
TYPES OF CONTRACEPTION
NATURAL FAMILY PLANNING
 Methods that involve no introduction of chemicals or foreign material into
the body
 ABSTINENCE
 LAM
 BBT
 OVULATION METHOD
 SYMPTOTHERMAL
 WITHDRAWAL
ABSTINENCE
 Refraining from sexual relations

 Theoretical 0% failure rate
 Most effective way to prevent STIs
 Difficult for many couples to adhere and with high failure rate
 Acceptable to all religions group
 Requires high motivation and periods of abstinence
Periodic abstinence
--is a method to avoid pregnancy by avoiding sex on the days a woman may
conceive.
LACTATION AMENORRHEA METHOD
 temporary introductory postpartum method of postponing pregnancy based on

physiological infertility experienced by Breast Feeding women.
 Criteria:
1) Amenorrhea- menses is not returned
2) Infant is less than 6 months
3) Being totally breastfed at least every 4 hours during the day and every 6hrs at night
4) Receives no supplementary feedings
A-EFFECTIVE WHILE INFANT IS TOTALLY BREASTFED
- NOCOST
D-TEMPORARY MEASURE, NOT RELIABLE IF INFANT TAKES SUPPLEMENTAL FEEDINGS
BASAL BAODY TEMPERATURE
 used to be sure changes of in temperature during ovulation.

 woman's takes orally or tympanic thermometer
 Temp. slightly decreases before ovulation and increases during ovulation
day.
 It must be measured on the same time of the day, before rising, with the
same thermometer.
 A woman notices a slight dip temperature followed by an increase she
knows she was ovulated and refrain from having coitus for the next 3 days
 With 25% ideal failure rate
OVULATION METHODS
Cervical mucus method(billing’s method)

 Change in cervical mucus
 Copious, thin, watery and transparent
 Feels slippery and stretchy (spinnbarkeit) with 25% failure rate
 Requires motivation and cooperation by male partner
Marquette model
 Combination of cervical mucus, BBT, cervix position and softness
 Develop on 1990 by nurses and doctors at Marquette University in Wisconsin
STANDARD METHOD
 A new method of natural family planning in which all users with menstrual
cycles between 26 and 32 days are counseled to abstain from sexual
intercourse on days 8-19 to avoid pregnancy.
 The couples use color-coded cycle beads to mark the fertile and infertile
days of the menstrual cycle.
SYMPTOTHERMAL
 It is a combination of cervical mucus and BBT methods

 Women takes daily temperature and watching for rise that marks for
ovulation also monitoring her cervical mucus.
 Couple abstain from coitus fro 3 days if positive sign
 25% failure rate
 Requires motivation and cooperation by male partner
WITHDARWAL
 COITUS INTERRUPTUS
 OLDEST METHOD
 A male controlled method
 The couple proceeds with coitus until the moment of ejaculation
 The man withdraws and spermatozoa are emitted outside the vagina
 82% effective but needs caution in using this method
 Disadvantage- sperm may be present in pre ejaculatory fluid
BARRIER METHODS
 Forms of birth control that place a chemical or latex barrier between the
cervix and advancing sperm as sperm cannot reach and fertilize an ovum
 SPERMICIDE
 MALE CONDOM
 FEMALE SPONGE CONDOM
 DIAPHRAGM
 CERVICAL CAP
SPERMICIDE
 An agent that causes the death of spermatozoa before they can enter
the cervix
 Kills sperm and change vaginal ph to a strong acid level to not conducive
to sperm survival
 Can be purchased without prescription
 Various preparation are available including gels, creams, sponges, films,
foams, and vaginal suppositories
 Contraindicated with acute cervicitis
MALE CONDOM
 A latex rubber or synthetic sheath that is placed over the erect penis
before coitus to trap sperm.
 Male responsibility
 Protects against STIs
 Disadvantage- requires interruption of sexual activity
FEMALE CONDOM
 Sheaths made of latex or polyurethane, prelubricated with a spermicide

 Offer protection against conception and STIs
 Sheath may be inserted any time before sexual activity begins and then
removed after ejaculation occurs
DIAPHRAGM
 A circular rubber disk that is placed over the cervix before intercourse to
mechanically halt the passage of sperm
 Diaphragm is prescribe and fitted initially by a health care provider to
ensure a correct fit.
 Placed before coitus and should remain in place for at least 6hrs after
coitus may be left for as long as 24hrs
 After use washed with mild soap and water, dried gently and stored in its
protective case
 Last for 2 yrs
CERVICAL CAP
 Made of soft rubber shaped like a thimble

 Precautions of use is same as diaphragm
 Can leave in place for several days if desired 48hrs
 Disadvantage- difficult to insert, can irritate cervix
 Contraindicated to women with abnormally short or long cervix, allergy to
latex or spermicide
HORMONAL METHODS
 Hormones that can be taken orally, transdermally, intravaginally or intramuscularly
cause such fluctuations in a normal menstrual cycle that ovulation or sperm transport
does not occur.
 TRANSDERMAL PATCH
 VAGINAL RING
 COC’S
 PROGISTIN ONLY PILLS
 INJECTABLES PROGESTERONE(DMPA)
 INTRADERMAL IMPLANT
 IUD
TRANSDERMAL PATCH
 Patches that slowly but continuously release a combination of estrogen

and progesterone
 Applied each week for 3weeks, on the week 4 no patches need and
menstrual flow will occur
 Easy to apply
 Can irritate skin at local site
VAGINAL RING
 An etonogestrel/ethinyl estradiol vaginal ring (NUVA RING)

 a flexible silicone vaginal ring that placed in the vagina, continually
releases a combination of estrogen and progesterone.
 EASY TO INSERT
ORAL CONTRACEPTIVE
 contains hormones estrogen and progesterone taken daily to prevent

contraception. Advised for women who are anemic because of the
reduced menstrual flow.
 taken some time every day preferably at night.
COMBINATION ORAL CONTRACEPTIVES
 IMPORTANT TO REMEMBER ABOUT PILL

 Pills are advised for women who are anemic because of the reduced menstrual flow
 Take pills same time every day
 A packet of pills contains 28 tablets; 21 pills are “active pills”,7 contain no hormones, only
iron
 Follow the direction of the arrows of the pill. When empty, start a new pack the next day
without missing a day
 For 1 missed pill: take the pill as soon as possible; take the regular pill at night
 For 2 missed pill:take 2 pills next day,then take 2 pills the next day again
 For 3 missed pills: discard and substitute method, start on next pack on next menstrual
period.
PROGESTIN ONLY PILLS
 OC containing only progestins

 Must taken conscientiously every day
 Without estrogen content ovulation may occur but because the progestin
have not allowed the endometrium to develop fully or sperm to freely
access the cervix, fertilization and implantation will not take place.
INJECTABLES PROGESTERONE
 DMPA- DEPOT MEDROXY PROGESTERONE ACETATE

 Depo-Provera
 IM administration on major muscle buttocks, deltoid or thigh
 a progesterone given every 12 weeks
 Inhibits ovulation, alters the endometrium and thickens the cervical mucus
so sperm progress is difficult.
 Can be used during breast feeding, long term effect
 Common side effects include headache, weight gain, depression,
irregular or heavy menstrual cycle for 1 year
INTRADERMAL IMPLANT
IUD( COPPER T)
 Intra uteine device- small plastic device that is inserted into the uterus
through the vagina.
 Either hormonal or non hormonal
 No memory motivation needed
 changes the nature of internal secretions of a woman’s body., disturbs
transport, and decreases the number of viable sperms.
SURGICAL METHODS
 FEMALE STERILIZATION (BTL)
 MALE STERILIZATION (VASECTOMY)

FEMALE STERILIZATION
 a safe and simple surgical procedure that provides permanent

contraception for women who do not want more children.
 Also known as BTL that involves cutting or blocking the two fallopian tubes.
performed during the first 2 weeks of her menstrual cycle OR
 within the first 3 days after delivery.
MALE STERILIZATION
 the permanent method wherein the vas deferens (passage of sperm) is

tied and cut or blocked through a small opening on the scrotal skin. It is
also known as vasectomy.

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FAMILY

 Principal recipients of information, education, communication, and motivation in

 Women under 20 years old Women over 35 years old

 THE FAMILY CODE OF THE PHILIPPINES?

 It includes all the decisions an individual or couple make

 Refraining from sexual relations

 temporary introductory postpartum method of postponing pregnancy based on

 used to be sure changes of in temperature during ovulation.

Cervical mucus method(billing’s method)

 It is a combination of cervical mucus and BBT methods

 Sheaths made of latex or polyurethane, prelubricated with a spermicide

 Made of soft rubber shaped like a thimble

 Patches that slowly but continuously release a combination of estrogen

 An etonogestrel/ethinyl estradiol vaginal ring (NUVA RING)

 contains hormones estrogen and progesterone taken daily to prevent

 IMPORTANT TO REMEMBER ABOUT PILL

 OC containing only progestins

 DMPA- DEPOT MEDROXY PROGESTERONE ACETATE

 MALE STERILIZATION (VASECTOMY)

 a safe and simple surgical procedure that provides permanent

 the permanent method wherein the vas deferens (passage of sperm) is

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