RESPONSIBLE PARENTHOOD
Presented by: Group 7 of II- CMA
What is
RESPONSIBLE
PARENTHOOD?
According to
DOH - POPCOM’s
Directional Plan
It is the will and ability of
parents to respond to the needs
and aspirations of the family
and children.
It is a shared
responsibility of the husband
and the wife to determine and
achieve
the
desired
number,
spacing, and timing of their
children according to their own
family life aspirations, taking
into
account
psychological
preparedness,
health
status,
socio-cultural,
and
economic
concerns.
REPUBLIC ACT 10354
The Responsible Parenthood and Reproductive Health Act of 2012
An act which guarantees universal access to methods on
contraception, fertility control, sexual education and maternal
care.
REPRODUCTIVE HEALTH (rh)
It refers to the state of complete physical,
mentak, and social well-being and not merely the
absence of disease or infirmity, in all matters
relating to the reproductive system and to its
functions and processes. This implies that people are
able to have a responsible, safe, consensual, and
satisfying sec life, that they have the capability to
reproduce and the freedom to decide if, when, and how
often to do so.
REPRODUCTIVE HEALTH CARE
It refers to the access to a full range of methods,
facilities, services and supplies that contribute to
reproductive health and well-being by addressing
reproductive health-related problems. It also includes
sexual health, the purpose of which is the enhancement
of life and personal relations.
Elements of Reproductive Health care
●
●
●
●
●
Family planning information and
services
Maternal, infant and child
health and nutrition
Proscription of abortion and
management of abortion
complications
Adolescent and youth
reproductive health guidance
and counseling
Prevention, treatment and
management of reproductive
tract infections (RTIs), HIV
and AIDS and other sexually
transmittable infections (STIs)
●
●
●
●
●
Elimination of violence against
women and children and other
forms of sexual and genderbased violence
Education and counseling on
sexuality and reproductive
health
Male responsibility and
involvement and men’s
reproductive health
Prevention, treatment and
management of infertility and
sexual dysfunction
Reproductive health education
for the adolescents
Terms to Consider:
➔ Abortifacient refers to any drug or device that induces
abortion or destruction of a fetus inside the mother’s
womb or the prevention of the fertility ovum to reach
and be implanted in the mother’s womb.
➔ FAMILY PLANNING
➔ Maternal Health refers to the health of a woman of
reproductive age including, but not limited to, during
pregnancy, childbirth, and postpartum period.
Terms to Consider:
➔ Gender equality refers to the principle of equality
between women and men and equal rights to enjoy
conditions in realizing their full human potentials to
contribute to, and benefit from, the results of
development, with the State recognizing that all human
beings are free and equal in dignity and rights.
➔ Gender equity refers to the policies, instruments,
programs and actions that address the disadvantaged
position of women in society by providing preferential
treatment and affirmative action.
All accredited public health
facilities shall provide full
range of modern family planning
methods,
which
shall
also
include medical consultations,
supplies
and
necessary
and
reasonable procedures for poor
and marginalized couples having
infertility issues who desire to
have children.
No person shall be denied
information and access to family
planning
services,
whether
natural or artificial: Provided,
That minors will not be allowed
access
to
modern
methods
of
family planning without written
consent from their parents or
guardian/s except when the minor
is already a parent or has had a
miscarriage.
The Department of Health (DOH) shall procure, distribute to LGUs
and monitor the usage of family planning supplies for the
whole country.
➢ No marriage license shall be issued by the Local
Civil Registrar unless the applicants present a
Certificate of Compliance issued for free by the
local Family Planning Office certifying that they
had duly received adequate instructions and
information on responsible parenthood, family
planning, breastfeeding and infant nutrition.
The supply and budget allotments shall be based on the current
1. Number of women of reproductive age and couples
levels of the ff: who want to space or limit their children
2. Contraceptive prevalence rate, by type of method
used
3. Cost of family planning supplies
DOH shall serve as the lead agency for the implementation of this Act and
shall integrate in their regular operations the following functions:
1. Fully and efficiently implement the reproductive health care
program
2. Ensure people’s access to medically safe, non-abortifacient,
legal, quality and affordable reproductive health goods and
services; and
3. Perform such other functions necessary to attain the purposes of
this Act.
What are the
QUALITIES of
Responsible
Parenthood?
Qualities and
characteristics
1. MARRIAGE TO THE RIGHT
PARTNER
2. ABILITY TO PROVIDE
3. ADOPTION OF PEACEFUL
STRATEGIES
4. EMOTIONAL ADJUSTMENT
ABILITY
5. ADOPTION OF FAMILY
PLANNING, SOUND
KNOWLEDGE OF CHILD
BEARING AND REARING
What are the factors
to consider in
CHOOSING A PARTNER?
Factors to Consider:
1. Age
2. Religion
3. Personality and Character
4. Occupation
5. Economic Standing
What are the BASIC
CONCEPTS?
Basic Concepts
1. Family Size
2. Availability
3. Emotional Security
What are the
DUTIES of the
Parents?
FATHER’s Roles
1. Provision of Funds
2. Protection and
Defense
3. Assurance of Peace
4. Ensuring proper
upbringing
5. Overseer of basic
roles
6. Provision of Basic
Needs
MOTHER’s Roles
1. Love and Care
2. Training of Children
3. Neatness Role
4. Kitchen Role
5. Support
FAMILY PLANNING
Family Planning and
Population:
Uncontrolled
Fertility
What is UNCONTROLLED FERTILTY?
Uncontrolled fertility can be defined as when an individual
or couple fail to plan their future family size to match the
economic level of their family.
PSA: Birth in the Philippines, 2017
Based on the 2017 National Demographic and Health Survey
(NDHS), the total fertility rate declined steadily over time,
from 4.1 children per woman in 1993 to 2.7 children per woman in
2017. Currently, the average ideal family size is 2.7 children.
Resources needed for supporting families may cause many couple
to think twice about having kids. The use of any method of
family planning among married women has increased from 40% in
1993 to 54% in 2017.
cont.
What are some contributing factors for having too many
children?
Some of the factors that contribute to high fertility are
early marriage, low literacy, limited use of family planning
methods, religious and cultural influences.
POPULATION SIZE AND GROWTH
Population size is a measurement of existing population at
any point in time, while the population growth rate tells us
what is happening to the population in terms of whether it is
growing, getting smaller, or remaining constant.
cont.
1.What will happen to
population size if a country
experiences a high birth rate
with a corresponding high
death rate?
3. What will happen to
population size if a country
experiences both a low birth
rate and a low death rate?
The population size will be
This results in a slow increase well controlled and increase
in population size.
only slowly.
2. What will happen to population size if a country experiences
a high birth rate with disproportionally low death rates?
High birth rate sand disproportionally low death rates result
in rapid population growth.
Global unmet need for Contraception
214 million women of reproductive age in developing countries
who want to avoid pregnancy are not using a modern
contraceptive method. Reasons for this include:
● limited choice of methods;
● limited access to contraception, particularly among young
people, poorer segments of populations, or unmarried
people;
● fear or experience of side-effects;
● cultural or religious opposition;
● poor quality of available services;
● users and providers bias
● gender-based barriers.
What is Family
Planning or
Contraceptives? Who
provides it?
FAMILY PLANNING
➔ It is the decisionmaking process by
couples, together or
individually, on the
number of children that
they would like to have
in their lifetime, and
the age interval
between children.
➔ It is one of the leading
strategies to improve
family life and welfare,
control unwanted
population growth,and
aid the development of
the nation.
FAMILY PLANNING
➔ Family planning is the term given for pre-pregnancy
planning and action to delay, prevent or actualize
a pregnancy.
➔ “Family planning is a way of thinking and
living that is adopted voluntarily, upon
the bases of knowledge, attitude and
responsible decision by individuals and
couples in order to promote the health and
welfare of family group and thus contribute
effectively to the social development of
country.” -B T BASVANTHAPPA
OBJECTIVES:
( WHO ) “the use of a range of methods of a
fertility regulation to help individuals or
couples attain certain objectives:
➔
➔
➔
➔
➔
Avoid unwanted birth.
Bring about wanted birth.
Regulate the intervals between pregnancies.
Produce a change in the no. of children
born.
Control time at which birth occur.”
KEY FACTS
World Health Organization (2018):
● 214 million women of reproductive
age in developing countries who want
to avoid pregnancy are not using a
modern contraceptive method.
● Some family planning methods, such
as condoms, help prevent the
transmission of HIV and other
sexually transmitted infections.
● Family planning / contraception
reduces the need for abortion,
especially unsafe abortion.
● Family planning reinforces people’s
rights to determine the number and
spacing of their children.
● By preventing unintended
pregnancy, family planning
/contraception prevents deaths of
mothers and children.
What are the health
benefits of Family
Planning?
TO the MOTHER:
TO the CHILDREN:
❏ Reduce the health risk
❏
(Below 20y, And above 35 y.
At risk of developing
❏
complications during
pregnancy.)
❏
❏ Physical strain of child
bearing.
❏
❏ Reduce number of maternal
death.
❏ Reduce the risk of ovarian
cysts.
Ensures better chance
of survival at birth.
Promote better
childhood nutrition.
Promote physical growth
and development.
Prevent birth defects.
TO the FATHER:
❏
Allows father to keep a
constant balance between
their physical, mental,
social well –being.
❏ Increase father sense of
respect because he is
able to provide the type
of education and home
environment.
TO the WHOLE FAMILY:
❏ Help the family enjoy
the better kind of
life.
What are the TYPES
AND corresponding
METHODS available
for Family Planning?
TYPES:
1. Natural Planning
2. Barrier Family Planning
3. Permanent/ Surgical Planning
1. Natural Planning
● No introduction of chemical
or foreign material into
the body.
● Practice may be due to
religious belief, “natural”
way is best for them.
● Effectiveness varies
greatly, depends on couples
ability to refrain from
having intercourse on
fertile days.
● Failure Rates: about 25%
Poses no risk to fetus
Rhythm
(Calendar)
Method
Basal Body
Temperature
(BBT)
Ovulation or
Cervical Mucus
Method
Symptothermal
Method
Coitus
Interruptus
Lactation
Amenorhea
Rhythm (Calendar) Method
❖ Also called the fertility awareness method, is a form of
pregnancy prevention where couples calculate a woman's
fertile time using a calendar .
❖ This method may be used by women whose menstrual cycles
are always between 26 and 32 days in length .
❖ To calculate:
18 from shortest cycle documented - 11 from longest cycle
= represents her last fertile day.
Example: If she has 6 menstrual cycles ranging from 25 to 29
days, fertile period would be from 7th day (25- 18) to the 18
th day (29-11). To avoid pregnancy, avoid coitus/use
contraceptive during those days.
Basal Body Temperature (BBT)
❖ Identifying fertile and infertile period of a woman’s
cycle by daily taking and recording of the rise in
body temperature during and after ovulation.
❖ Just before ovulation, a woman’s BBT falls about
0.5ºF At time of ovulation, her BBT rises a full
degree (influence of progesterone). This higher level
is maintained the rest of menstrual cycle.
Ovulation or Cervical Mucus Method
❖ Cervical mucus is a fluid produced by small glands near the
cervix This fluid changes throughout her cycle, from scant
and sticky, to cloudy and thick, to slick and stringy.
❖ Each of these types of mucus is related to the hormonal
shifts that naturally occur during the
menstrual cycle as her body
prepares for and achieves
ovulation.
❖ Ideal Failure rate: 3%
Symptothermal Method
❖ Combines the cervical mucus and BBT methods:
Watches temperature daily and analyzes cervical mucus
daily. And watch for mid cycle abdominal pain.
❖ Couple must abstain from intercourse until 3 days after
rise in temp. or 4 th day after peak of mucus change.
❖ More effective than BBT
or CM method alone
❖ Ideal Failure rate: 2%
Coitus Interruptus
❖ One of oldest known methods of contraception
Couple proceeds with coitus until the
moment of ejaculation which offers little
protection.
Lactation Amenorrhea
❖ The lactation amenorrhea method (LAM) is
a natural birth control technique based
on the fact that lactation causes
amenorrhea (lack of menstruation).
❖ How it works: Breastfeeding interferes
with the release of the hormones needed
to trigger ovulation.
Classification of contraceptive method
Barrier Method
Spacing Method
Intrauterine
Method
CLASSIFICATION
Hormonal
Method
Terminal Method
Post Coital
Method
2. Barrier Family Planning
➔
➔
➔
➔
➔
Condoms (male and female)
Spermicidal
Sponge
Diaphragm
Cervical cap
Condom Male
➢ These are made up of polyurethane or latex.
➢ Silicon used now a days to produce semi dry prelubricated forms.Spermicidal – coated with nonoxynol
on inner and outer surfaces.
Condom Female
➢ It is a pouch made up of polyurethane which lines the
vagina and also external genitalia.
➢ It is 17 cm in length with one flexible polyurethane
ring at each end.
Spermicidal
❖ Available as vaginal foams, gels, creams, tablets and
suppositories.
❖ Contain
surfactant
like
nonoxynol-9,benzalkonium
chloride.
❖ Alter the sperm surface membrane permeability resulting
in killing of sperm.
Sponge
❖ Vaginal contraceptive sponge (TODAY)
❖ The sponge is a doughnut-shaped device made
of soft foam coated with spermicide.
❖ Made
up
of
polyurethane
with
1gm
of
nonoxynol-9 as a spermicide.
❖ It releases spermicide during coitus, absorbs
ejaculate and blocks the entrance of cervical
canal.
❖ To use the sponge, it must be moistened with
water. Once inserted in the vagina, it covers
the cervix and blocks sperm from entering the
uterus.
Diagphragm
❖ Most common and easiest to fit and use. It’s thin,
nearly hemispherical dome made of rubber or latex
material, with circular, covered metal spring at
periphery (flat type and coil type.) The device is
introduced up to 3 hrs. before intercourse and is
to be kept for at least 6 hrs after intercourse.
❖ External diameter of rim is size of diaphragm – 45
mm diameter rising in steps of 5 mm to 105mm (most
common 60,65,70,75,80)
ADVANTAGES: cheap No gross medical side
effects Control of pregnancy in hands
of woman Reasonably safe when properly
used Prevent spread of STDs though less
effective than condom
DISADVANTAGES May get broken difficult
removal High pregnancy rate Allergic
reactions Vaginal dryness, soreness
May damage vaginal epithelium increase
risk of HIV transmission
Cervical Cap
Intrauterine Devices
➔ The IUD is a small, T-shaped, plastic device that is
inserted and left inside the uterus to prevent
pregnancy.
Nonmedicated
Intrauterine
Device
First
Generation
Second
Generation
Medicated
Third
Generation
First Generation
● Non-medicated
made
up
of
polyethylene.
● Different shapes and sizes
● LIPPE’S LOOP
Double ‘s’ shaped
device , made up of polyethylene
material.
● Non- toxic, non-tissue reactive
and extremely durable.
● Small amount of barium sulphate
is also added for radiological
examination
● Available in 4 sizes A,B,C,D
Second Generation
● Made up of metal Cu
● Earlier devices Cu-7 , Cu-T
200
● Newer devices: T copper 220
C, T copper 380 C, nova T
● multiload devices:
ML-Cu
250 ML-Cu 375
Third Generation
● Hormones releasing IUD
● PROGESTASERT
○ Most commonly used T shaped device
filled with 38 mg progesterone
○ Effective for 1 year
● LNG-mirena Mirena (levonorgestrel releasing intrauterine device) is a
form
of
birth
control
that
is
indicated
for
intrauterine
contraception for up to 5 years and
Releases 20 µg of levonorgestrel.
○ Effective for 5 years.
Side Effects:
❏ Amenorrhea
❏ Intermenstrual bleeding
and spotting
❏ Abdominal/pelvic pain
❏ Ovarian cysts
❏ Headache/migraine
❏ Acne
❏ depressed/altered mood.
ADVANTAGES OF IUD
❏ Safe effective,
Reversible, Long action,
Inexpensive
DISADVANTAGES
❏ Heavy bleeding and pain
Pelvic inflammatory
diseases Ectopic
pregnancy May come out
accidently if not
properly inserted.
Hormonal Contraceptives
➔ With hormonal birth control , a women takes hormones
similar to those her body makes naturally .
➔ Hormonal contraceptives are mostly for female sex
steroids.
Combined
Prep.
Oral
SIngle Prep.
Hormonal
Contraceptive
Injectables
Parenteral
Implants
Oral Contraceptives
❖ Combined oral contraceptive pills
❖ Commonly used progestin are either levonorgestrel or
norethisterone and estrogens are ethinyl estradiol
or mestranol
❖ COMMERCIAL NAMES
NO. OF
TABLETS
➢ Mala –N
21+7 iron tab.
➢ Mala –D
21+7 iron tab.
➢ Loette(desogestrel 0.15)
21 tab.
Types:
1. Monophasic
➢ fixed doses of both estrogen and progesterone
throughout 21 day cycle.
1. Biphasic
➢ constant amount of estrogen throughout cycle BUT
increased amount of progestin during the last 11
days
1. Triphasic
➢ Varies level of estrogen and progesterone.
Closely mimic natural cycle, reducing
breakthrough bleeding (bleeding outside the
normal menstrual flow)
Contraindications:
ABSOLUTE:
➢
➢
➢
➢
➢
Circulatory diseases
Severe HTN Angina or ischemic heart disease
Liver disease
Tumors
Pregnancy breast cancer or breast feeding
RELATIVE
➢ Age>40 yrs.
➢ Smoker,
➢ history of jaundice
Diabetes
BENEFITS
●
●
●
●
●
Protection against unwanted
pregnancy
Convenient to use.
Regulation of menstrual cycle
Reduction of dysmenorrhea
Protection against PID,
fibroids, ovarian cysts,
chances of cancer.
SIDE EFFECTS:
●
●
●
●
●
●
●
●
●
Dizziness
Nausea
Weight gain
Headache
Breast tenderness
vaginal infection
Mild HPN
Depression
Increase blood clotting
Progesterone Only Pills
❖ Also known as “Mini Pill” and it contains
progesterone or progesterone hormone.
❖ Causing plug of mucus in the neck of
cervix block the entry of the sperm.
Example:levonorgestrel 75 µg
❖ Advantages: No side effect on breastfeeding or
lactation, t may be prescribed in patient having
diabetes, HTN , smoking etc. and it reduce risk of
PID
❖ Disadvantages: Acne, mastalgia, headache
CONTRACEPTIVE INJECTIONS
(DEPOPROVERA & NORISTERET)
➢ Contain progesterone hormone .
➢ Prevents ovulation.
➢ Commonly used as Depo Medroxyprogesterone Acetate
(DMPA) administered on deltoid
muscle within 5 days of cycle.
➢ DOSE: 150 mg
➢ Provide protection for 3 months .
CONTRACEPTIVE IMPLANTS
It is a small device placed under the skin Contains
progesterone hormone. Works in a similar way to injection
but it’s implanted instead.
● Contains 3 Keto Desogestrel that
releases hormone about 60 mcg,
gradually reduced to 30 mcg
per day over year.
● Inhibits ovulation.
● Lasts for 3 years.
➔ NORPLANT – II
◆ Two rods of 4cm long. Each rod containing 75 mg
of levonorgestrel releases 50 mcg per day.
3. Permanent/ Surgical Planning
STERILIZATION
It is most effective method its failure rate is 1/2000
so in this there is permanent termination.
VASECTOMY
● Small incision made on each side of scrotum vas deferens
is then cut and tied , cauterized or plugged. Blocking
the passage of spermatozoa. Does not interfere with
production of sperms but does not pass beyond vas
deferens.
❏ Very effective after 3 months.
❏ Permanent and safe
No apparent long term risks.
❏ Slightly uncomfortable due pain
and swelling after 2-3 days of
the of the procedure.
❏ Bleeding may result in the
hematoma in scrotum .
TUBECTOMY
● It is one of the operative procedure where resection
of a both segment of both fallopian tubes is done to
achieve permanent sterilization.
The approach may be :
1. Abdominal
a. Conventional - In which a loop is made by holding the
tube by Allis forceps in such a way that the major part
of loop consists mainly of isthmus and ampullary part of
tube. The loop is ligated with catgut and is cut.
i. Minilantrophy - When the tubectomy is done through
small abdominal incision along with some device
1. Vaginal Ligation - Tubectomy through vaginal
route may be done along with vaginal plastic
operation or on isolation.
➢ Complication:
○ Ectopic pregnancy
○ Menstrual irregularities
○ Loss of libido Infection
EMERGENCY CONTRACEPTIVES
Used within 72 hrs, the point is to either prevented or
delayed the ovulation. It may be in form of : hormones, IUD,
antiprogesterone
INDICATIONS:
● Unprotected intercourse
● Condom rupture
● Sexual assault
HORMONES:
1.
MORNING AFTER PILLS:
It prevents conception in case of
accidental intercourse. Drugs used: ethinyl oestradiol
2.5mg, premarin(conjugated oestrogen) 15 mg. Drug is
taken orally twice daily for 5 days.