Time

Specific Objective

Content

AV aids

Teachers activity

Group Activity Group Listens

Evaluation

2 min

To introduce the topic

INTRODUCTION
Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility. A womans ability to space and limit her pregnancies has a direct impact on her health and well-being as well as on the outcome of each pregnancy.

Teacher introduces the lesson

1 min

To define the family planning

DEFINITION
A program to regulate the number and spacing of children in a family through the practice of contraception or other methods of birth control.

Flash cards

Teacher defines the topic

Group Listens

Define Family planning

2 min

Identifys the objectives of family planning

OBJECTIVES
To avoid unwanted births; To bring about wanted births; To regulate the intervals between pregnancies; To control the time at which births occur in relation to the ages of the parent, and To determine the number of children in the family.

Flash cards

Teacher list s out the objectives of family planning

Group Listens

List out any 2 objectives of family planning

2 min

Mentions the classificatio n of contraceptiv e methods

CLASSIFICATION OF CONTRACEPTIVE METHODS

Flash cards

Teacher explains

Group listens

Mention the types of contraceptiv e methods

classificatio and

Temporary

Permanent

n of contracepti ve methods

contribute s some

points

FOR MALES Vasectomy

FOR FEMALES Tubectomy

A] FOR MEN Condom Withdrawal

B]FOR WOMEN 1. Intrauterine devices Lippes loop Copper T 2. Hormonal contraceptives Oral pill Injectables [DMPA, NET-EN] Subdermal implants{Norplant] 3. Diaphgram 4. Foam tablets, jelly and cream 5. Rhythm method

2 min

Describes the temporary /spacing methods for men

TEMPORARY /SPACING METHODS

births. However the methods are also frequently used by the couples even though they have got strong desire for no more children.

Flash

Teacher

Group

Describe about one temporary any

These are the methods commonly used to postpone or to space cards

explains the listens temporary /spacing and contribute

methods for s

some method which can

FOR MEN
CONDOM [NIRODH] The condom is a thin rubber sheath used by men during sex . it is one of the oldest and widely used methods of contraception. Consistently used , condom is a safe and effective method of birth control. The condom is unrolled over erect penis before each act of sexual intercourse . the condom prevents the deposition of semen in the vagina.

men

points

be used by men

ADVANTAGES: Condoms are readily available and usually are low cost protect against sexually transmitted diseases such as AIDS and gonorrhea involves the male partner in the contraceptive choice easy to use protects from unwanted pregnancy requires no medical supervision

DISADVANTAGES: Condoms possibly decrease enjoyment of sex. Some users may have a latex allergy. Condom breakage and slippage makes them less effective. Oil-based lubricants may damage the condom failure rate is estimated to be about 14%

COITUS INTERRUPTUS/ WITHDRAWAL Coitus interruptus an ancient method of contraception. It involves withdrawal of the entire penis from the vagina before the man ejaculates (before sperm leaves the penis). Fertilization is prevented because sperm does not contact a womans egg. ADVANTAGES: This method can be used at any time, with no devices, no cost, Does not involve chemicals or hormones, May offer a lower risk for other problems.

DISADVANTAGES: There is a high risk for unintended pregnancy. Does not protect against sexually transmitted diseases (STDs).

4 min

Explains about the Intrauterine devices

FOR WOMEN 1. INTRAUTERINE DEVICES :

The IUDS currently used in India are: Copper-T Lippes Loop COPPER-T There are many types of copper-releasing IUDS (e.g., Copper-7, Copper-T, Multiload Copper T200). Copper-tT is made up of plastic material (polyethyelene) and the copper wire is wrapped around the stem of the device. Before insertion, the women are caqrefully selected after a through general and pelvic examination. When inside the uterus, the device does not interfere with the normal sex life of the wearer.

Flash cards

Teacher explains about the Intrauterine devices

Group contribute s listens attentivel y

Mention the types of and IUDS used in India List out the advantages of IUDS

Since Copper-T device may be replaced every 3-5 years. Copper IUDS have the following advantages over the Lippes Loop: Smaller in size and therefore easier insertion. Low expulsion rate Less pain and bleeding Greater effectiveness LIPPES LOOP: The LippesLoop is a S Shaped plastic device made of plastic. It hs attached threads or tails made of nylon. The loop contains a small amount of barium so that it could be seen on X-ray. The loop comes in differ ent sizes; the size most commonly used in India is 27.5mm. previously Lippes Loop was ebing widely used, but now Copper-T is replacing the Loop. Time of insertion: The best time for IUD insertion is between 3 and 7 days of the menstrual cycle. IUD can also be inserted 1-2 weeks after a normal delivery or

clean abortion or within a week after the first menses. Side effects: They include backache, lower abdominal pain intermenstrual bleeding, spotting and menorrhagia.

Advantages: Low failure rate Inexpensive suitable for women who are breast feeding one time method, that is , it requires no attention of insertion reversible, i.e., IUD when pregnancy is desired it is aesthetic, i.e, does not in any way interfere with sexual intercourse no hospitalization is required reliable method for spacing child births

Disadvantages: may be painful when inserted or removed side effects: most IUDS are associated either with

intermenstrual bleeding or spotting in the first 3 months may be expelled spontaneously 3to 9 percent of pregnancies that occur with an IUD in uterus are ectopic. Contraindications: Cannot be used in the presence of certain gynecological conditions such as: Pregnancy Cervical or pelvic infection Sexually transmitted diseases

Abnormal vaginal bleeding or genital cancer

4min Enumerates about hormonal contraceptiv es These may be classified into three groups: Oral pills Injectables HORMONAL CONTRACEPTIVES: Flash cards Teacher describes about hormonal contracepti Group listens and Explain about mode

note of intake of

down the oral pills points

Subdermal implants

ves

A. Oral Pills:
Are popularly known as oral pills contain small amount of an oestrogen and preogesterone. They are one of the most effective and reversinble method of contraception, currently available. They are particularly suitable as a spacing of 30 years. Prevent pregnancy by inhibition of ovulation; if taken daily, according to prescription, they are almost 100% effective. Types of pills: Two types of low dose oral pills are supplied under the names of MalaN and Mala-D, both contain Norgestrel Ethinyl oestradiol -0.30 mg -0.30mg

Mala D is available to the consumer under the social marketing at a price of rupees 2 per packet. Mala-N is supplied free of cost through all PHCs, urban family welfare centers.

Mode of intake: A packet of oral pills contains 28 pills, of which 21 are contraceptive pills and the remaining 7 are iron tablets. The first course of the pills should be started strictly on the fifth day of the menstruation counting it as day No.1. then daily one tablet should be taken from the packet as indicated by the arrows on the pack till all the pills are consumed. After the pack is finished, a new packet should be started from the very next day. The instructions issued with each packet should be closely followed. The pill should be taken every day at a fixed time, preferasbly before going to bed at night. If a women forgets to take the pill on a particular day, she should take the missed pill as soon as possible, or two pills the next day one in the morning one in the evening. If the pill is not taken daily, it increases the chances of conception. Side-effects: Mild nausea Dizziness Headache Inter-menstrual bleeding

Spotting weight gain tender breasts in the first few weeks. In rare cases induces high blood pressure or cause cardiovascular complications.

Advantages: Almost 100 percent effective No interference with sexual intercourse Reversible method Disadvantages: Prior medical examinations necessary before starting the pills Side effects as stated above Requires strong motivation and self discipline to be able to take the pill daily All women are not fit for pill intake because of certain contraindications. Contraindications: Pregnancy

Women over 35 years of age Medical conditions such as high blood sugar, diabetes, chronic liver disease, or cancer of the breast or genitals Nursing mothers during the first 2 months.

B. Injectable contraceptives:
Currently there are two types Injectable contraceptives available: 1. Depo-provera [DMPA] 2. Net-EN Both contain only progesterone. DMPA has been much more widely used than Net- EN. Both are given by Intramuscular Injection. Net-EN every 2 months and DMPA every 3 months. Disadvantages: Side- effects like irregular bleeding and amenorrhea

Advantages: Most effective reversible method s of contraception currently available.

C. Subdermal implants:
Norplant is an highly effective, reversible, oestrogen -free, longacting contraceptive. It contains only progesterone (levonorgestrel). It is implanted subdermally. Follow- up studies at the end of 2 years showed that norplant is a safe and acceptable contraceptive, despite menstrual disturbances. 2 min

Illustrates about the vaginal diaphrag m

VAGINAL DIAPHRAGM

Flash cards

Teacher

Group listens

Mention the distadvanta

explains

The diaphragm is a shallow latex cup with a spring mechanism in its rim to hold it in place in the vagina. Diaphragms are manufactured in various sizes. You need a pelvic examination and measurement of the diagonal length of your vaginal canal so your health care provider can determine the correct diaphragm size.

of about the and note ges down the vaginal vaginal

diaphrag m

points

diaphragm

You insert the diaphragm with spermicide before sex. The spermicidal cream or jelly is applied to the inside of the dome, which then covers your cervix. Your doctor will show you how to insert it and how to know it is in place.

It prevents pregnancy by acting as a barrier to the passage of semen into the cervix. Once in position, the diaphragm provides

effective contraception for 6 hours. After that time, if you have not removed the diaphragm, you will add fresh spermicide with an applicator. After intercourse, the diaphragm must be left in place for at least 6 hours after sex but not more than 24 hours.

Advantages:

Does not interfere with sexual intercourse Comparatively cheap If properly used quite effective The diaphragm may be placed by the woman in anticipation of intercourse.

Disadvantages:

A doctor or nurse is required to determine the proper size and fit it initially

It is difficult to educate the illiterate women to use the diaphragm

Not quite suitable if the vaginal muscles do not have enough tone.

After use it must be washed, dried and stored carefully in between use.

2 min

Explains about Foam tablets, jelly and cream

FOAM TABLETS: These are vaginal tablets containg a spermicidal agent (nonoxynol-9). In contact with water or moisture, the foam tablets generate a thick foam. A women pita a tablet moistened with water deep into her vagina near to the external opening of the cervix 5 to 10 minutews before sexual intercourse. The foam enmeshes the sperm an dreduces its mobility; the spermicidal agent kills the sperm. Thus the action of the foam tablet is both physical and chemical. Foam tablets are most effective when used with condoms at the same time. Advantages: Easy to use God for a woman who has sex only once in a while Usually no side-effects Does not interfere with sex.

Flash cards

Teacher explain

Group listens

What the

are

about Foam and tablets, jelly cream contribute and s

advantages of use of

foam tablets

Disadvantages: Occasional side effects include irritation or burning in the vagina Not an effective contraceptive deteriorates under conditions of improper storage

CREAMS AND JELLIES

These are chemical contraceptives containing the spermicide nonoxynol-9. A measured quantity of the cream or jelly is introduced into the vagina by a special applicator just before sexual intercourse. At body temperature, they melt and spread in the vagina and provide a thin film of a chemical barrier. The sperm is destroyed by chemical action. In ombination with mechanical contraceptives (e.g., condom or diaphragm) cream and jelly are highly effective. Used alone they will provide relatively less protection. Of all the chemical barriers, the aerosol foam is by far effective.

4min

Reviews the RHYTHM METHOD: natural method family of A week before and a week after menses is considered as the safe period. During this period the woman is not fertile because she cannot

Flash cards

Teacher

Group

Explain about rhythm method of the

explains the listens natural method of

planning

ovulate. As a general rule, if the day of menstruation for a woman is a Monday, the next Monday will be her first risky day, the Monday following the first most risky day will be her last risky day. The period between the firwt risky Monday and last risky Monday will be the unsafe period. If the menstrual cycles are regular , calculation of the safe period is simple, but often they are irregular. In such cases calculations are difficult. Currently there is no technique that can predict the fertile period precisely. The failure rate with the rhythm method is almost 24 percent. BREAST-FEEDING: Breast-feeding has a natural contraceptive effect, and in many societies it is main factor regulating fertility. The mother should be encouraged to breast-feed their babies for more than one year. This will help in spacing the birth of their children more widely

family planning

family planning

2min

To conclude the topic

Conclusion
Family planning is an important health and development issues as well as a human rights issue.People have consciously or unconsciously engaged in family planning throughout history.

Teacher concludes the topic

Ideal family planning includes consideration of the timing of marriage, number and spacing of children, and when the first and last births will occur. It requires that couples discuss sexuality, contraception, and other long-range plans such as schooling or work plans that affect births.

3min

To summarize the topic

Summary
As far as we discussed about the what is family planning, its objectives, classification and in detail we saw about the temporary methods for men and women their advantages and disadvantages. REFERENCE D.C Dutta, the text book of obstetrics, by new center book, page no: 531- 546. K.Park ,Text book of preventive and social medicine,18 th edition,Bhanot Publishers, page no 389 401 6th edition,Published

Teacher summarize the topic

 Robert A. Hatcher, THE ESSENTIALS OF CONTRACEPTIVE TECHNOLOGY, Population Information Programmes, USA, 1997, Page No: 5 13. A Classified International Bibliography of Family Planning Research, 1955-68, by Reuben Hill 1968 Population Association of America Alvarez F, Brache V, Fernandez E, et al. New insights on the mode of action of intrauterine contraceptive devices in women. Fertil Steril 1988;49:768-73. http://family.jrank.org/pages/565/Family-Planning.html#

KEMPEGOWDA INSTITUTE OF NURSING

K.R ROAD, V. V PURAM, BENGALURU-4.

HEALTH EDUCATION:

POSTNATAL EXCERCISES
SUBMITTED TO: Mrs. Kamala .J HOD of OBG department Kempegowda College of Nursing Banglore-4 SUBMITTED BY: Ms. Mamatha B.V 1st Msc Nursing, OBG Kempegowda College Of Nursing Banglore-4

GENERAL OBJECTIVE: At the end of health education the group should be able to explore various aspects of temporary family planning methods. SPECIFIC OBJECTIVE: At the end of health education group will be able to:
1. define family planning 2. identify the objectives of family planning 3. mention the classification of contraceptive methods 4. describe the temporary /spacing methods for men 5. explain about the intrauterine devices 6. enumerate about hormonal contraceptives 7. illustrate about the vaginal diaphragm 8. explain about foam tablets, jelly and cream
9. reviews the natural method of family planning

Name of the Student Teacher Name of the Supervisor Topic Date and Time Duration Venue AV Aids Method of Teaching

: : : : : : : :

Mamatha B.V Mrs. Kamala J. Temporary Family Planning 17/8 /11 30 minutes Postnatal Ward Flash Cards Lecture and Discussion