Introduction

http://www.youtube.com/watch?v=96Y
QdiMV-Jc&feature=related
Women’s Health
Family Planning and
Contraception
Developed by
D. Ann Currie , R.N., M.S.N.
2012
Goal of Family Planning

To assist the clients with reproductive
decision making, enabling the client to
have control of the number of
pregnancies, spacing the time between
children, and to prevent pregnancy if
desired
Decision to use a
contraceptive

May be made by the individual man or
woman or jointly as a couple
Legal Issues related to Family
Planning and Contraception



May vary from state to state concerning
minors,sterilization,and abortions.
Informed consent-need to document
information provided and understanding
of client -the nurse should use
(BRAIDED)when counseling client on
contraceptive methods
decision about contraception should be
made voluntarily with informed consent
BRAIDED







B- Benefits/Advantages
R-Risks/Disadvantages
A- Alternatives/Other methods available
I-Inquiries/ Allow time for questions
D-Decisions/opportunity to decide or
change mind
E-Explanation/about method/how to
use
D-Documentation /everything taught
What to teach about each
method








What it is, How it is used , or How it
works?
advantages
disadvantages
effectiveness
side effects
risks
contraindications
long term effects
Assessment





Obtain a history to identify the client’s
past and current health status and
potential risks factors.
Sexual history
Reproductive health
Future plans for childbearing
Psychosocial data- lifestyle, motivation,
religious beliefs,cultural influences,
Assessment




Financial factors
these factors may affect the
selection,access,and use of aparticular
method
Don’t assume anything….ask.
Knowledge of and concern about
contraceptive methods need to be
determined to identify deficits and need
Assessment



For accurate and additional information
Identify actual or potential problems
from the assessment.
Provide privacy for assessment and
discussion about contraceptive methods
Methods of Family Planning or
Contraception




Natural methodsabstinence
Coitus interruptus -(withdrawal)
Fertility awareness methods-calendar
method,basal body temperature (BBT),
cervical mucus method, symptothermal
method
Methods of Family Planning
and Contraception






Mechanical methodsBarrier methodsCondoms- Male/Female
Diaphragm
Spermicides
Intrauterine device(IUD)
Methods of Family Planning
and Contraception







Chemical MethodsOral Contraceptives(birth control pills)
Subdermal implants(Norplant)
Long-acting progestin injections
Postcoital contraception
Surgical Methods-Vasectomy
Tubal ligation
Natural methods




Safe
Situational methods requiring increased
self awareness
Self control
to be effective
Fertility Awareness Methods



Based on an understanding of the
woman’s ovulation cycle and the timing
of sexual intercourse
All methods attempt to identify the
female fertility and to avoid unprotected
intercourse during that time period
Free,safe,and acceptable to couple’s
religious beliefs prohibit other methods
Female Reproductive Cycle
Cont.







Increases awareness of the woman’s
body
encourages communication
can be used to prevent or plan a
pregnancy
Requires extensive counseling and
education
interfere with sexual spontaneity
difficult with irregular cycles
no protection for STI’s
Calendar method







Rhythm method
75-91 effective
6-8 months period
shortest and longest cycles
18days from shortest cycle
11days from longest cycle
avoid sex during fertile period
BBT





Based on the thermal shift in the
menstrual cycle
75-97% effective
drop prior to ovulation then raises .5-1
degree F with ovulation
Avoid intercourse when temperature
drops and for 3 days after.
Factors which could effect BBT
Cervical mucus





Ovulation or Billing’s Method
Based on the cervical mucus changes
that occur during the menstrual cycle
75-97% effective
Cervical mucus changes in response to
levels of estrogen and progesterone
Assess for amount, color,consistency,
and viscosity
Cervical Mucus Assessment
Factors to
assess
Vaginal
characteristic
Cervical
mucus amount
color
Infertile period Fertile period
dry
Wet,moist
scant
profuse
Cloudy,white- clear
yellow
Cervical Mucus Assessmentcont
viscosity
none
Microscopic
appearance
No ferning
Strectchable,
spinnbarkheit
present,
ferning
Dominant
hormone
progesterone
estrogen
Symptothermal Method


Incorporates the assessment of multiple
indicators of ovulation-BBT, and cervical
mucus,increased libido,abdominal
bloating,mittelschmerz ,breast
tenderness,pelvic tenderness,pelvic or
vulvar fullness,softer cervix located
higher in the vagina
75-97% effective
Mechanical Methods







Male condom-86-97 % effective
water based lubricants
proper technique to apply
protection from pregnancy and Std’s
Female condoms-79-95% effective
Proper technique to apply
no prescription is needed--OTC
Male Condom
Applying Male Condom
Female condom
Diaphragm






80-94% effective
Dome- shaped appliance made of
rubber with flexible rim that fits over
cervix
used with spermicidal jelly or cream
physician will assess for size
reassessment after birth of baby or
weight loss or gain.
Proper technique to apply
Diaphragm
Insertion of Diaphragm
Spermicides



Chemical barrier to prevent pregnancy
by killing sperm or neutralizing vaginal
secretions
74-94% effective
creams,jelly,melting suppositories,
foaming tablets,foam,and films
Intrauterine device-IUD




A device placed in the uterus to prevent
pregnancy
98.5-99.2 % effective
Placed and removed by health
professional
check for side effects
Oral Contraceptives-Birth
control pills




Act by inhibiting the release of an
ovum,blocking the cyclical release of
gonadotropin-releasing hormones and
changing cervical mucus
95099.5% effective
combined oral contraceptives-estrogen
and progestin
progestin-only pill-minipill
Subdermal implant(Norplant)




Consist of 6 silastic capsules containing
levonorgestrel-progestin
98.5-99.5% effective
placed and removed by health care
provider
5 years
Long-acting Progestin injection




Depo-Provera
long-acting progestin that blocks lh
surge,suppresses ovulation and thickens
cervical mucus
97.7% effective
Repeat every 80-90 days
Postcoital contraception





Emergency method-not to be used on a
frequent or regular basis
reduces pregnancy rates by 75-85%
oral contraceptives-MAP (morning after
pill)
insertion of IUD
abortions
Vasectomy





Male sterilization
the vas deferens is resected through
small incision in the scrotum resulting in
blockage of the passage of the sperm
Health care provider must do in
clinic,office or hospital
sperm count to check for sterility
99.5%effective
Tubal ligation


Surgical procedure done in hospital
cuts, tied ,or cauterized the fallopian
tubes preventing sperm from fertilizing
ovum
99.2-99.6% effective
OTHER
QUESTIONS
Thank you

http://www.youtube.com/watch?v=1_a
-pyUqwjc&feature=related