Temporary Family Planning Methods

Presented by Mamata Manandhar M Sc Nursing 2011 Batch

Oral Pills
Oral contraceptive widely known as "pill" has become the most popular spacing method since early sixties. Oral pills are the most effective reversible, safe and convenient form of contraceptives.

Oral Pills contd..

It is estimated that over 200 million women from the developed and developing countries are using" pills" . Combined pills are the most popular oral contraceptives pills containing two synthetic hormones an estrogen and progesterone.

Oral Pills contd..

In Nepal, two brands of low-dose combined pills are marketed by Nepal CRS Company under the brand name of Sunaulo Gulf and Nilocon White.

Health benefits and advantages

Highly effective reversible contraception Menstrual cycle regulation Reduce menstrual cramps Decreases risk of iron deficiency (anemia)

Contd..
Decreases risk of ovarian, endometrial cancers and ovarian cysts Protection against PID

Disadvantages/risks
Requires regular and dependable supply. Client dependent Offers no protection against STDs/HIV.

Not most appropriate choice for lactating women

Precautions
Has a suspected pregnancy by history, symptoms, or signs Six weeks to 6 months postpartum Taking anti-seizure drugs for epilepsy or rifampin for tuberculosis

Contraindications
Current or past history of venous thrombo embolic disorders
Breastfeeding Breast cancer Active liver disease

Contd..
Smoking over 15 cigarettes a day and over age 35 High blood pressure Headaches

Women with ischemic or valvular heart disease.

Timing of initiation
If pills are begun within 5 days of the start of menses, no backup method is needed. If pills are begun after the fifth day of the menstrual cycle, a backup method must be used for 7 days.

Contd..
Postpartum Breastfeeding mothers

Non-breastfeeding mothers (after 3 weeks postpartum) Within 7 days following spontaneous or induced first trimester abortion

Instructions for missed pills

If she forgets to take a pill, she should take that pill as soon as she remembers and then take the next pill as usual. If she forgets to take two pills, she should two pills on each of the next two days and use a condom along with the pills for the rest of the cycle.

Contd
If the woman misses three pills, another form of contraception should be taken immediately If two menstrual periods are missed completely, the woman should be examined for pregnancy.

IUCDs
The copper-bearing intrauterine device (IUD) is a small, flexible plastic frame with copper sleeves or wire around it. A specifically trained health care provider inserts it into a womans uterus.

Contd..
IUDs are a form of long-acting reversible contraception, which is the most effective type of reversible birth control. Types of IUDs Copper-releasing (Copper T 380A) Progestin-releasing

Effectiveness of IUCD
There is less than 1 pregnancy per 100 women using an IUD over the first year Studies have found that the TCu-380A is effective for 12 years.

Return of fertility after IUD is removed.

Mechanisms of Action

Benefits
Highly effective (0.6B0.81 pregnancies per 100 women during the first year of use)

Effective immediately
Long-term method Do not interfere with intercourse

Benefits contd..
Immediate return to fertility upon removal Do not affect breastfeeding

Few side effects

After follow-up visit, client needs to return to clinic only if problems

Benefits contd..
Decrease ectopic pregnancy also used as an emergency contraception

Limitations
Pelvic examination required screening for STDs recommended before insertion Require trained provider for insertion and removal

Increase menstrual bleeding and cramping during the first few months

Contd..
May be spontaneously expelled Rarely (< 1/1000 cases), perforation of the uterus may occur during insertion May increase risk of PID and subsequent infertility in women at risk for STIs.

Side Effects and Complications

Most women have some bleeding following insertion of an IUD, and menstrual cramps. Menstrual bleeding may be heavier and longer than usual, and spotting can occur.

These side effects decrease over time.

References
1. Park K.Park K. Parks Textbook of Preventive & Social Medicine.

21st edition. Bhanot publishers. 2011.

2. 3. 4. 5. 6. 7. SBA MODULE 24 http://www.crs.org.np/nilocon-white http://www.nlm.nih.gov/medlineplus/ency/article/001946.htm http://www.crs.org.np/iud http://www2.pathfinder.org/pf/pubs/module4.pdf http://en.wikipedia.org/wiki/Intrauterine_device

Any Questions??

THANK YOU..