| 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. | Reproductive Life Planning |
| Unintended or mistimed pregnancy may result in women less likely to: | Seek prenatal care
breastfeed
protect fetus from harmful substances |
| Types of Reproductive Life Planning: | 1. Natural Family Planning
2. Artificial Family Planning |
| Types of Reproductive Life Planning: 1:
Also called periodic abstinence methods
Involves no introduction of chemical or foreign material into the body or sustaining from sexual intercourse during a fertile period. | Natural Family Planning |
| Types of Reproductive Life Planning: 2:
Any unnatural technique to prevent pregnancy from occurring.
It may be using barrier devices, chemicals, hormonal or surgical | Artificial Family Planning |
| Types of Natural Family Planning: | 1. Abstinence
2. Coitus Interruptus
3. Lactation Amenorrhea method
4. Post coital douching
5. Fertility Awareness Method |
| Types of Natural Family Planning: 1:
Refraining from sexual relations
Many sex education classes advocate abstinence as the only contraceptive measure
Provide information not only on the method but suggestions of ways to comply with this method
Advantage: No Cost. Has a theoretical 0% failure rate and is also the most effective way to prevent STIs
Disadvantage: High motivation needed; highly unreliable | Abstinence |
| Types of Natural Family Planning: 2:
Also known as withdrawal or the pull-out method, is a method of birth control in which a man, during sexual intercourse, withdraws his penis from a woman's vagina prior to orgasm ( and ejaculation) and then directs his ejaculate (semen) away from the vagina in an effort to avoid insemination
Advantage(s): No Cost
Disadvantage(s): Less effective and ineffective in the prevention of STDs | Coitus interruptus |
| Types of Natural Family Planning: 3:
As long as a woman is breastfeeding an infant, there is some natural suppression of ovulation.
Advantage(s): Effective for short term, 6 mos at most
Disadvantage(s): Temporary measure; not reliable if infant takes supplemental feedings, ineffective in the prevention of STDs | Lactation Amenorrhea Method |
| Types of Natural Family Planning: 3: Lactation Amenorrhea Method: Requirements: | 1. Menstruation since delivery has not yet returned
2. baby less than six months
3. Exclusive breast feeding |
| Types of Natural Family Planning: 4:
Washing or cleaning out the inside of the vagina with water or other mixtures of fluids after coitus
Disadvantage(s): ineffective in preventing pregnancy, interferes with normal flora. | Post coital douching |
| Types of Natural Family Planning: The 5th type of Natural Family Planning: | Fertility Awareness Methods |
| Types of Natural Family Planning: The 8 types of Fertility Awareness Methods: | 1. Calendar (Rhythm) Method
2. Cervical Mucus Method (Billing's Method)
3. Basal Body Temperature Method
4. Symptothermal Method
5. Two-Day Method
6. Standard Days Method: Cycle Beads
7. Ovulation Detection
8. Marquette Model |
| Types of Natural Family Planning: Fertility Awareness Methods: 1:
This method requires a couple to abstain from coitus (sexual relations) on the days of a menstrual cycle when the woman is most likely to conceive (3 or 4 days before until 3 or 4 days after ovulation).
Advantage(s): no cost
-Disadvantage(s):
-Ineffective in the prevention of STDs
-Women must monitor the length of their menstrual cycle in order to use
them effectively;
-Suitable only for women who have regular menstrual cycles;
-Constant menstrual cycle length monitoring required
-Additional contraceptive methods or abstinence are required for a significant portion of the menstrual cycle | Calendar (Rhythm) Method |
| Types of Natural Family Planning: Fertility Awareness Methods: 1: Calendar (Rhythm) Method:
To plan for this, the women keeps a diary of how many menstrual cycles? | six (6) menstrual cycles |
| Types of Natural Family Planning: Fertility Awareness Methods: 1: Calendar (Rhythm) Method:
To calculate "safe" days, she subtracts ___ from the ___ cycle documented
This number represents her FIRST FERTILE DAY | ... She subtracts 18 from the shortest cycle documented |
| Types of Natural Family Planning: Fertility Awareness Methods: 1: Calendar (Rhythm) Method:
To calculate "safe" days, she subtracts ____ from her ____ cycle.
This represents her LAST FERTILE DAY. | She subtracts 11 from her longest cycle. |
| Types of Natural Family Planning: Fertility Awareness Methods: 2:
another method to predict ovulation using the changes in cervical mucus that occur naturally with ovulation
Before ovulation each month, the cervical mucus is thick and does not stretch when pulled between the thumb and finger.
Just before ovulation, mucus secretion increases.
With ovulation ( the peak day), cervical mucus becomes copious, thin, watery, and transparent.
It feels slippery and stretches at least 1 inch before the strand breaks
All the days on which cervical mucus is copious, and for at least 1 day afterward, are considered to be fertile days, or days on which the woman should abstain from coitus to avoid conception.
In addition, breast tenderness and an anterior tilt to the cervix occur. | Cervical Mucus Method (Billing's Method) |
| Types of Natural Family Planning: Fertility Awareness Methods: 2: Cervical Mucus Method (Billing's Method):
The cervical mucus feeling slippery and stretches at least 1 inch before the strand breaks is a property known as? | spinnbarkeit |
| Types of Natural Family Planning: Fertility Awareness Methods: 2: Cervical Mucus Method (Billing's Method):
The typical failure rate is about: | 25% |
| Types of Natural Family Planning: Fertility Awareness Methods: 3:
To use this method, the woman takes her temperature each morning immediately after waking either orally or with an ear thermometer before she undertakes any activity
As soon as she notices a slight dip in temp followed by an increase, she knows that she has ovulated.
She refrains from having coitus for the next 3 days (the life of the discharged ovum).
Because sperm can survive for at least 4 days in the female reproductive tract, it is usually recommended that the couple combine this method with a calendar method, so that they abstain for a few days before ovulation as well.
Advantage(s): No Cost
Disadvantage(s): Less effective due limitation the the temperature can also rise caused by illness, starting an aerobic program
-Ineffective in the prevention of STDs | Basal Body Temperature Method |
| Types of Natural Family Planning: Fertility Awareness Methods: 3: Basal Body Temperature Method:
Just before the day of ovulation, a woman's basal body temperature (BBT), or the temperature of her body at rest, falls about ____
At the time of ovulation, her BBT rises a full degree because of the influence of progesterone
This higher level is then maintained for the rest of her menstrual cycle | O.5 degree Fahrenheit |
| Types of Natural Family Planning: Fertility Awareness Methods: 4:
The symptothermal Method of birth control combines the ____ and _____ methods | ... combines the cervical mucus and BBT methods |
| Types of Natural Family Planning: Fertility Awareness Methods: 4: Symptothermal Method:
She also analyses her cervical mucus every day and observes for other signs of ovulation such as _____ (midcycle abdominal pain). | mittelschmertz |
| Types of Natural Family Planning: Fertility Awareness Methods: 5:
A woman assesses for vaginal secretions daily.
If she feels secretions for 2 days in a row she avoids coitus that day and the day following as the presence of secretions suggests fertility.
Requires conscientious daily assessment and results in about 12 days per month in which she should avoid coitus, the same as a calendar method
Advantage(s): No cost
Disadvantage(s): Requires motivation, cooperation; ineffective in the prevention of STD | Two-Day Method |
| Types of Natural Family Planning: Fertility Awareness Methods: 6:
A woman purchases a circle of beads that helps her predict fertile days
The first bead on the ring is red and marks the first day of her menstrual flow; this is followed by six brown beads which indicate "safe" days.
The woman advances one bead per day during the month. If she reaches a dark brown bead (appears on the 27th day) before she begins her next menses, her cycle is too short for the method to be reliable.
If she reaches the end of the string of beads (32 days) before menses, she knows her cycle is too long for the method to be reliable.
Advantage(s): Easy to use
Disadvantage(s): Needs funds for the beads, Requires motivation, cooperation, ineffective in the prevention of STDs | Standard Days Method: Cycle Beads |
| Types of Natural Family Planning: Fertility Awareness Methods: 6: Standard Days Method: Cycle Beads:
This method is designed for women who have menstrual cycles between ____ and _____ days. | ... between 26 and 32 days. |
| Types of Natural Family Planning: Fertility Awareness Methods: 6: Standard Days Method: Cycle Beads:
_____ glow-in-the-dark _____ beads, which mark fertile days (during which she needs to abstain form coitus), and ____ additional _____ "safe" days follow. | Twelve (12) glow-in-the-dark- white beads, which mark fertile days (during which she needs to abstain from coitus), and 13 additional brown "safe" days follow |
| Types of Natural Family Planning: Fertility Awareness Methods: 7:
Use of an over-the-counter ovulation detection kit
98 to 100% accurate in predicting ovulation.
Can be used in the future to help conception when the couple is ready to have children.
Advantage(s): Easy to use
Disadvantage(s): Needs funds for monthly Kit, Requires motivation, cooperation, ineffective in the prevention of STDs | Ovulation Detection |
| Types of Natural Family Planning: Fertility Awareness Methods: 7: Ovulation Detection:
These kits detect the midcycle surge of LH that can be detected in urine ____ before ovulation | ... in urine 12 to 24 hours before ovulation |
| Types of Natural Family Planning: Fertility Awareness Methods: 8:
This method combines the use of ovulation detection with other signs of ovulation (cervical mucus, BBT, cervix position and softness) to avoid pregnancy during a woman's fertile period.
Advantage(s): Teaches couples to understand their fertility and work with their bodies.
Disadvantage(s): Needs funds for monthly Kit, Requires motivation, cooperation, ineffective in the prevention of STDs | Marquette Model |
| Types of Artificial Family Planning: | 1. Barrier Methods
2. Hormonal Methods
3. Intrauterine devices
4. Surgical Methods |
| Types of Artificial Family Planning: 1:
Are forms of birth control that work by the placement of a chemical or other barrier between the cervix and advancing sperm so that sperm cannot enter the uterus or fallopian tubes and fertilize the ovum | Barrier Methods |
| Types of Artificial Family Planning: 2: Are, as the name implies, hormones that cause such fluctuations in a normal menstrual cycle the ovulation does not occur. | Hormonal Methods |
| Types of Artificial Family Planning: 2: Hormonal Methods:
Hormonal contraceptives may be administered: ____, _____, _____, by _____, or through _____ | Hormonal contraceptives may be administered orally, transdermally, vaginally, by implatation, or through injection. |
| Types of Artificial Family Planning: 3:
Is a small plastic device that is inserted into the uterus through the vagina. IUDs can be either hormonal or nonhormonal.
-almost 100% effective and _____
-prevent fertilization as well as to create a local sterile inflammatory reaction that prevents implantation.
-device must be fitted by a healthcare provider
-inserted before a woman has had coitus after a menstrual
side effects: spotting or uterine cramping the first 2 or 3 weeks after IUD insertion - intervention: ibuprofen
-Nulliparous women may have a higher percentage of spontaneous expulsion than others.
-Contraindicated: distorted uterus, sever dysmenorrhea, menorrhagia, anemia
-Common problem: | Intrauterine Devices |
| Types of Artificial Family Planning: 4:
include tubal ligation for women and vasectomy for men | Surgical Methods |
| Types of Artificial Family Planning: 4: Surgical Methods
Of reproductive life planning, often called _____ | sterilization |
| Barrier Methods: | 1. Spermicides
2. Male condom
3. Female condom
4. Diaphragm
5. Cervical cap |
| Barrier Methods: 1:
Chemical barrier
an agent that causes "death of spermatozoa" before they can enter the cervix.
Change the vaginal pH to a strong acid level, a condition not conducive to sperm survival.
Advantage(s): May be purchased without a prescription
-When used in conjunction with another contraceptive, they increase other method's effectiveness.
Disadvantage(s): They do not protect against STIs. | Spermicides |
| Barrier Methods: 1: Spermicides: Different Preparations: | 1. Gels or creams
2. Film of glycerin
3. Cocoa butter and glycerine based vaginal suppositories
4. Foam-impregnated synthetic sponges |
| Barrier Methods: 1: Spermicides: Different Preparations: 1:
Are inserted into the vagina before coitus with an applicator no more than 1 hour before coitus | Gels or creams |
| Barrier Methods: 1: Spermicides: Different Preparations: 2:
Folded and inserted vaginally
On contact with vaginal secretions or precoital penile emissions, the film dissolves and a carbon dioxide foam forms | film of glycerin |
| Barrier Methods: 1: Spermicides: Different Preparations: 3:
Inserted vaginally, these dissolve and release the spermicidal ingredients
Must be inserted 15 minutes before coitus for the suppository to dissolve. | Cocoa butter and glycerine based vaginal suppositories |
| Barrier Methods: 1: Spermicides: Different Preparations: 4:
moistened and then inserted vaginally
feminine hygiene products are for vaginal cleanliness and are not spermicidal; therefore, are not effective contraceptives. | Foam-impregnated synthetic drugs |
| Barrier Methods: 1: Spermicides: Side Effects and Contradictions:
Vaginal leakage after use are bothersome;
Vaginally inserted spermicidal products are contraindicated in women with ____ because they might further irritate the cervix | Acute cervicitis |
| Barrier Methods: 2: A latex rubber or synthetic sheath that is placed over "erect penis before coitus to trap sperm
They have an ideal failure rate of 2% and a typical failure rate of about 15%, because breakage or spillage occurs in up to 15% of uses.
Advantage(s): One of the few "male responsibility" birth control measures available, no prescription
Disadvantage(s): if latex, cannot be used if there is sensitivity or allergy to latex | Male condom |
| Barrier Methods: 2: Male condom: Must be applied ______ | I ask unya |
| Barrier Methods: 2: Male condom: Must be _____ after evacuation to prevent leakage | ask lang gihapon |
| Barrier Methods: 3:
Condoms for females are latex sheaths made of polyurethane and prelubricated with a spermicide
The sheath may be inserted any time before sexual activity begins and then removed after ejaculation occurs
Like male condoms, they are intended for one-time use and offer protection against both conception and STIs
advantage(s): no prescription needed; protects against STIs
Disadvantage(s): bulk and difficult to use | Female condoms |
| Barrier Methods: 3: Female condom:
The _____ (closed end) covers the cervix, and the ____ (open end) rests against the vaginal opening. | The inner ring (closed end) covers the cervix, and the outer ring (open end) rest against the vaginal opening |
| Barrier Methods: 4:
Is a circular rubber disk that is placed over the cervix before intercourse to mechanically halt the sperm.
Usually, but not required, coated with using a spermicidal gel.
With the use of a spermicide, the failure rate of the diaphragm is as low as 6% (ideal) to 18% (typical use)
Is prescribed and fitted initially by a health-care provider to ensure a correct fit.
Refitting after pregnancy, miscarriage, cervical surgery (dilatation and curettage), gains or loses greater than 15 lb.
Disadvantage(s): Prescription and initial fitting needed | Diaphragm |
| Barrier Methods: 4: Diaphragm: Side effects and contraindications: | may not be effective if the uterus is prolapsed, retroflexed, or anteflexed
cystocele or rectocele
a higher number of UTIs than nonusers
should not be used in the presence of acute cervicitis or a papillomavirus infection |
| Barrier Methods: 4: Diaphragm: Other contraindications include: | History of "toxic shock syndrome (staphylococcal infection through vagina)"
Allergy to rubber or spermicides
History of recurrent UTIs |
| Barrier Methods: 4: Diaphragm: To prevent TSS while using a diaphragm, advise women to: | -Wash their hands thoroughly with soap and water before insertion or removal.
-Do not use a diaphragm during a menstrual period.
-Do not leave a diaphragm in place longer than 24 hours
-Be aware of the symptoms of TSS, such as elevated temperature, diarrhea, vomiting, muscle aches, and a sunburn-like rash.
-If symptoms of TSS should occur, immediately remove the diaphragm and call a health care provider. |
| Barrier Methods: 5:
Made of soft "rubber, shaped like a thimble," which fits snugly over cervix
With small strap for easy removal
Advantage(s): caps can be kept in place longer (than diaphragms) because they do not put pressure on the vaginal walls or urethra with a spermicidal jelly the same as a diaphragm.
Disadvantage(s): Must be fitted individually by a healthcare provider.; not be as effective in parous women because cervix does not conform as well to a thimble shape after childbirth; sometimes caps tend to dislodge during coitus. | Cervical Caps |
| Barrier Methods: 5: Cervical caps: Contraindications: | an abnormally short or long cervix
A current abnormal Pap smear
A history of TSS, an allergy to latex or spermicide
A history of cervicitis or cervical infection
A history of cervical cancer
Undiagnosed vaginal bleeding |
| Hormonal Methods: | 1. Oral contraceptives
2. Estrogen/Progesterone Transdermal Patch
3. Vaginal estrogen/progestin rings (Nuvaring)
4. Subdermal hormone implants
5. Intramuscular Injections |
| Hormonal Methods: 1:
Commonly known as the "pill, and contraceptives (OCs), or (COCs) Combination Oral Contraceptives," are composed of varying amounts synthetic estrogen combined with a small amount of synthetic progesterone (progestin).
Estrogen suppress follicle stimulating hormone (FSH) or Luteinizing Hormone (LH)
Progesterone decreases permeability of cervical mucus and interferes with tubal transport and endometrial proliferation = no implantation | Oral Contraceptives |
| Hormonal Methods: 1: Oral Contraceptives:
Take pills in the order designated by the dispense
When used correctly, they are 99.7% effective in preventing conception.
Women can set a start date for a cycle of pills in On four ways
Not effective for the first 7 days, advise women to use a second form of contraception | Combination Oral contraceptives |
| Hormonal Methods: 1: Oral Contraceptives: Women can set a start date for a cycle of pills in On four ways: | 1. First pill: Take the first pill on the first Sunday after the beginning of mens
2. Quick Start system: Begins as soon as prescribed
3. Placebo tablets: Begin on first day of menses.
4. After childbirth, a woman should start on a day (or Sunday) closest to 2 wks after birth: after an elective termination of pregnancy, begin on chosen day or first Sunday after procedure. |
| Hormonal Methods: 1: Oral Contraceptives:
Containing only progestins | Progestin-Only Pills (Mini-Pills) |
| Hormonal Methods: 2:
Patches that slowly but continuously release a combination of estrogen and progesterone.
After the patch-free week, a new cycle of 3 weeks on, 1 week off begins again.
Less effective in women who are obese
not be placed on any area where makeup, lotions, or creams will be applied; at the waist where bending might loosen the patch; or anywhere the skin is red, irritated, or has an open lesion.
can be worn in shower, while bathing, or swimming.
If a patch does come loose, the woman should remove it and immediately replace it with a new patch.
Mild breast discomfort and irritation at site may occur. | Estrogen/Progesterone Transdermal Patch |
| Hormonal Methods: 2: Estrogen/ Progesterone Transdermal Patch:
Are applied in each week for _____. | 3 weeks |
| Hormonal Methods: 2: Estrogen/ Progesterone Transdermal Patch:
_______. During the week on which the woman is patch free, a menses will occur. | No patch is applied on the 4th week. |
| Hormonal Methods: 2: Estrogen/ Progesterone Transdermal Patch:
Patches may be applied to one of four areas: | Upper outer arm, upper torso (front or back, excluding the breasts), abdomen, or buttocks |
| No additional contraception is needed if patch has been loose not longer than 24 hours. If not sure how long patch has been loose, ____ and _____ to start a _____ then use a backup contraception. | ... been loose, remove and apply a new patch to start a new 4-week cycle with a new day 1 and a new day to change the patch then use a backup contraception. |
| Hormonal Methods: 3:
Flexible "silicone ring" that, when placed in the vagina, continually releases a combination of estrogen and progesterone.
- left in place for 3 weeks and then removed for 1 week with menstrual bleeding occurring during the ring-free week.
-Advantage for women with liver disease because it is absorbed in mucous membrane of vagina therefore avoiding a "first pass" through the liver
-Need to be removed for intercourse
-The effectiveness is equal to COCs.
-Women may experience vaginal discomfort or infection.
-If they should take out the ring for more than 4 hours for any purpose, they should replace it with a new ring and use a form of barrier protection for the next 7 days. | Vaginal estrogen/progestin rings (Nuvaring) |
| Hormonal Methods: 4:
A progestin-filled "rod" no bigger than a "size of a pencil lead," etonogestrel implant (Nexplanon) can be embedded just under the skin on the inside of the upper arm where it will slowly release progestin over a period of 3 years.
-inserted as an in-office procedure with the use of a local anesthetic during menses or no later than 'day 7 of a menstrual cycle.
-can be used during breastfeeding without an effect on milk production.
-Side Effects: Weight gain, irregular menstrual cycle (heavy bleeding, spotting, breakthrough bleeding, and amenorrhea), depression, scarring at the insertion site, and need for removal.
-contraindications: pregnancy, desire to be pregnant within 1 year, and undiagnosed uterine bleeding.
-Complication: infection at the insertion site, although this is very rare. | Subdermal hormone Implants |
| Hormonal Methods: 5:
A single intramuscular injection of depot medroxyprogesterone acetate or DMPA (DepoProvera), a progesterone given every 12 weeks, inhibits ovulation, alters the endometrium, and thickens the cervical mucus so sperm progress is difficult.
-effectiveness rate of this method is almost 100%
-made deep into a major muscle (buttocks, deltoid, or thigh) before the fifth day after the beginning of a menstrual flow.
-do not massage the injection site after administration
-can be used during breastfeeding, although women should wait 6 weeks after birth for for first injection.
Advantages:
-decreases in ectopic pregnancy, endometrial cancer, endometriosis, and, for unknown reasons, the frequency of sickle cell crises
-must return to a healthcare provider for a new injection every 12 wks to remain stable. | Intramuscular injections |
| Hormonal Methods: 5: Intramuscular injections: Side Effects and Contraindications: | -Common side effects include headache, weight gain, depression, irregular or heavy menstrual cycles for 1 menstrual bleeding after the first year.
-may impair glucose tolerance in women at risk for DM
-may increase risk for osteoporosis from a loss of bone mineral density- calcium and weight-bearing exercise
-not to use the method long term (not over 2 years) to protect against bone loss.
-prescribed with caution to adolescents |
| Four types of Intrauterine devices that are commonly approved in US: | 1. Copper T380
2. Levonorgestrel-releasing intrauterine system 52 mg (Mirena or Liletta)
3. Levonorgestrel-releasing intrauterine system 13.5 mg (Skyla)
4. Levonorgestrel-releasing intrauterine system 19.5 mg (Kyleena) |
| Surgical methods:
Minor surgery to block sperm from reaching the semen that is ejaculated from the penis. Semen still exists, but it has no sperm in it.
After a vasectomy the testes still make sperm, but they are soaked up by the body.
Men who feel a need to have their sperm available for the future can have it stored in a sperm bank before vasectomy.
Important to discuss:
-It requires at least 10 to 20 ejaculations to clear the tract of sperm | Vasectomy |
| Surgical method:
Fallopian tubes are "occluded by cautery, crushing, clamping, or blocking.
-99.5% effectiveness rate
-most common to achieve tubal ligation= laparoscopy
-After a menstrual flow and before ovulation, an incision as small as 1 cm is made just under the woman's umbilicus with the woman under general or local anesthesia.
-A lighted laparoscope is inserted through the incision.
-Carbon dioxide is then pumped into the incision
-An electrical current to coagulate tissue is then passed through the instrument for 3 to 5 seconds, or the tubes are clamped by plastic, metal, or rubber rings, then cut or filled with a silicone gel to seal them.
-A new system, essure, consists of a spring-loaded mechanism that, when inserted through the vagina and uterus into the outer end of a fallopian tube ( a hysteroscopy procedure), releases a soft micro-insert into the tube that effectively seals the tube.
-may return coitus 2 to 3 days after the procedure.
-will still have a monthly menstrual flow
-If a silicone gel has been instilled into the tubes as a blocking agent, it can be removed at a later date to reverse the procedure.
-May go home on the same day of the procedure | Tubal Ligation |
| Surgical Method: Tubal Ligation: Side effect: | bowel proliferation, hemorrhage, or umbilical hernia (spotting intermittent vaginal bleeding, and even severe lower abdominal cramping after tubal ligation) |
| Surgical Method: Tubal Ligation: Contraindications: | Umbilical hernia, extensive obesity |
