Reproductive Life Planning (NCM 107A) PDF

06/09/2024 Saint Louis University School of Nursing, Allied Health & Biological Sciences NURSING DEPART...

06/09/2024 Saint Louis University School of Nursing, Allied Health & Biological Sciences NURSING DEPARTMENT REPRODUCTIVE LIFE PLANNING (NCM 107A) Prepared by: John Lopez Balignasay, RN, LPT Level II Clinical Instructor Barrier Methods BILATERAL TUBAL LIGATION PERMANANENT METHODS FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP ✓ works by the placement of a chemical or mechanical barrier SPERMICIDES VASECTOMY DIAPHRAGM between the cervix and advancing sperm so that sperm cannot enter the uterus or fallopian tubes and fertilize the ovum. ✓ A major advantage of barrier methods is that they lack the hormonal side effects associated with COCs. ✓ compared with COCs, their failure rates are higher and sexual enjoyment may be lessened. 1  06/09/2024 Male Condom BILATERAL TUBAL LIGATION PERMANANENT METHODS FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP ✓ AKA rubbers, “raincoats,” and “umbrellas,” SPERMICIDES VASECTOMY DIAPHRAGM ✓ Made from latex rubber, plastic or natural membranes ✓ prevent the passage of sperm cells by forming a barrier that prevents pregnancy. ✓ keep infections in semen, on the penis, or in the vagina from infecting the other partner. Male Condom DOs DONTs ✓ DO use a condom every time you  DON’T store condoms in your have sex. wallet as heat and friction can BILATERAL TUBAL LIGATION ✓ DO put on a condom before PERMANANENT METHODS damage them. FEMALE CONDOMS having sex. BARRIER METHODS  DON’T use nonoxynol-9 (a MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM ✓ DO read the package and check spermicide), as this can cause the expiration date. irritation. ✓ DO make sure there are no tears  DON’T use oil-based products like or defects. baby oil, lotion, petroleum jelly, ✓ DO store condoms in a cool, dry or cooking oil because they will place. cause the condom to break. ✓ DO use latex or polyurethane  DON’T use more than one condom condoms. at a time. ✓ DO use water-based or silicone-  DON’T reuse a condom. based lubricant to prevent breakage. 2  06/09/2024 BILATERAL TUBAL LIGATION PERMANANENT METHODS FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM Male Condom BILATERAL TUBAL LIGATION PERMANANENT METHODS WHAT TO DO IF SEVERE ALLERGIC REACTION TO LATEX OCCURS: FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM ✓ Tell the client to stop using latex condoms. ✓ Refer, if necessary. ✓ Severe allergic reaction to latex could lead to life-threatening anaphylactic shock. Help the client choose another method unless the client is at risk for STIs. ✓ If itching continues, the client and partner should be assessed for infection. ✓ Suggest the use of female condoms or plastic male condoms for clients or partners who cannot avoid the risk of STIs. 3  06/09/2024 BILATERAL TUBAL LIGATION PERMANANENT METHODS Female Condom FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP ✓ thin sheath of soft transparent, soft film made from latex, SPERMICIDES VASECTOMY DIAPHRAGM polyurethane plastic or nitrile about 7 cm to 8 cm in diameter and 17 cm long. ✓ A female condom works by forming a barrier that keeps sperms out of the vagina, thus preventing pregnancy ✓ it also keeps infections in semen, on the penis, or in the vagina from infecting the other partner. Female Condom DOs DONTs ✓ DO use a female condom from start to finish, every time you have vaginal sex (can also be used for BILATERAL TUBAL LIGATION PERMANANENT METHODS anal sex).  DON’T use a male condom with a FEMALE CONDOMS BARRIER METHODS female condom, as this can cause MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY ✓ DO read the condom package DIAPHRAGM tearing. insert and check the expiration date.  DON’T reuse a female condom. ✓ DO make sure there are no tears  DON’T flush female condoms as or defects. they may clog the toilet. ✓ DO use lubricant to help prevent the condom from slipping and tearing. ✓ DO store female condoms in a cool, dry place. 4  06/09/2024 BILATERAL TUBAL LIGATION PERMANANENT METHODS FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM Spermicides BILATERAL TUBAL LIGATION PERMANANENT METHODS ✓ are chemical substances that kill the sperms and are available in different forms, such as gel, aerosol foam, foam tablet, film tablet, sponge and FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM cream. ✓ Vaginal spermicides are sperm-killing substances, such as nonoxynol-9, benzalkonium chloride, chlorhexidine, menfegol, octoxynol-9, and sodium docusate ✓ It works by causing the membrane of sperm cells to break, killing them or slowing their movement. ✓ Spermicide as a contraceptive is NOT currently used in the Philippines because spermicides are not readily available in drug stores. 5  06/09/2024 HOW TO USE IT Check first the expiration date, and avoid using spermicides that are past their expiration date. For foam or cream: shake can of foam; squeeze spermicide from the can or tube into a plastic applicator. Insert the applicator deep into the vagina, near the cervix, and push the plunger. BILATERAL TUBAL LIGATION PERMANANENT METHODS For tablets, suppositories, jellies: insert the spermicide deep into the vagina, FEMALE CONDOMS near the cervix, with an applicator or with fingers. BARRIER METHODS MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM Time of insertion of spermicide into the vagina: a. Foam or cream can be inserted any time less than one hour before sex. b. Tablets, suppositories, jellies, and film can be inserted between 10 minutes and 1 hour before sex, depending on type. Do not douche after sex because it will wash away the spermicide and increases the risk of STIs. If the client must douche, wait for at least six hours before doing so. POSSIBLE SIDE EFFECTS: ✓ Irritation in or around the vagina or penis ✓ Vaginal lesions Diaphragm BILATERAL TUBAL LIGATION PERMANANENT METHODS ✓ A soft latex cup that covers the cervix. FEMALE CONDOMS BARRIER METHODS ✓ Plastic and silicone diaphragms may also be available. MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM ✓ The rim contains a firm, flexible spring that keeps the diaphragm in place. ✓ Used with spermicidal cream, jelly, or foam to improve effectiveness. ✓ Most diaphragms come in different sizes and require fitting by a specifically trained provider. ✓ A one-size-fits-all diaphragm is becoming available. It does not require seeing a provider for fitting. ✓ Works by blocking sperm from entering the cervix; spermicide kills or disables sperm. Both keep sperm from meeting an egg. 6  06/09/2024 HOW TO USE IT Initial fitting is done by a health care provider to determine appropriate diaphragm size. Positions for insertion of diaphragm: 1. Squatting 2.Chair Method 3. Reclining 4.Leg-up method Check the diaphragm for any damage, including the expiration date of the spermicide. Insert the diaphragm less than six hours before having sex. BILATERAL TUBAL LIGATION PERMANANENT METHODS After hand washing with soap and water, squeeze a spoonful of spermicidal cream, FEMALE CONDOMS BARRIER METHODS jelly, or foam into the diaphragm and around the rim. MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM Press the rim together to ease the insertion of the device into the vagina. Assume a position that is comfortable for insertion. While holding the diaphragm with the fingers pressing on the rim, insert the diaphragm into the vagina until the cervix is felt, and then apply it to cover the cervix. Feel the diaphragm and the rim to make sure that it covers the entire cervix, fits properly, and does not come out easily. Keep the diaphragm in place for at least 6 hours after having sex but no longer than 24 hours. To remove the diaphragm, wash hands with soap and water, insert finger to feel for the rim, then gently slide a finger under the rim of the diaphragm to pull it down and out. Wash the diaphragm with mild soap and water and dry it after each use. NOTE: For multiple sexual intercourse, make sure that the diaphragm is in the correct position, and insert additional spermicide in front of the cap before each sexual intercourse. BILATERAL TUBAL LIGATION PERMANANENT METHODS WARNING SIGNS AND SYMPTOMS: ✓ Toxic Shock Syndrome (TSS) FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES o Temperature > 38.5OC DIAPHRAGM o Diarrhea and vomiting o Muscle Aches o Sore throat o Sunburn-type rash ✓ Difficult or painful urination ✓ Abdominal or pelvic fullness ✓ Foul smelling vaginal discharge 7  06/09/2024 BILATERAL TUBAL LIGATION PERMANANENT METHODS Cervical Cap ✓ A cervical cap is a cup-shaped device made of soft rubber that fits FEMALE CONDOMS BARRIER METHODS over the cervix and is held in place at least partially by suction MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM ✓ It is one of the least effective methods of FP. HOW TO USE IT Initial fitting is done by a health care provider to determine appropriate diaphragm size. Positions for insertion of cervical cap: 1. Squatting 2.Chair Method 3. Reclining 4.Leg-up method Check the cervical cap for any damage, including the expiration date of the spermicide. Insert the diaphragm less than 42 hours before having sex. BILATERAL TUBAL LIGATION PERMANANENT METHODS After hand washing with soap and water, squeeze a spoonful of spermicidal cream, FEMALE CONDOMS BARRIER METHODS jelly, or foam into the diaphragm and around the rim. MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM Press the rim together to ease the insertion of the device into the vagina. Assume a position that is comfortable for insertion. While holding the diaphragm with the fingers pressing on the rim, insert the diaphragm into the vagina until the cervix is felt, and then apply it to cover the cervix. Feel the cervical cap and the rim to make sure that it covers the entire cervix, fits properly, and does not come out easily. Leave the cervical cap for at least 6 hours after the sexual intercourse but not more than 48 hours from the time it was inserted. To remove the diaphragm, wash hands with soap and water, insert finger to feel for the rim, then gently slide a finger under the rim of the diaphragm to pull it down and out. Wash the cervical cap with mild soap and water and dry it after each use. NOTE: For multiple sexual intercourse, make sure that the cap is in the correct position and insert additional spermicide in front of the cervical cap before each sexual intercourse. 8  06/09/2024 BILATERAL TUBAL LIGATION Permanent Methods PERMANANENT METHODS ✓ methods of sterilization that prevent pregnancy permanently FEMALE CONDOMS BARRIER METHODS MALE CONDOMS o Bilateral tubal ligation CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM o Vasectomy Bilateral Tubal Ligation (BTL) ✓ AKA FEMALE STERILIZATION ✓ It is a safe and simple surgical procedure that involves cutting or blocking the two fallopian tubes. BILATERAL TUBAL LIGATION PERMANANENT METHODS ✓ With the tubes blocked, the woman’s egg cannot meet the FEMALE CONDOMS BARRIER METHODS man’s sperm MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM ✓ The woman continues to have menstrual periods after BTL 9  06/09/2024 Bilateral Tubal Ligation (BTL) POSSIBLE SIDE EFFECTS ✓ There are no long-term side effects of BTL ✓ Most common S/E is pain over the operative site which BILATERAL TUBAL LIGATION PERMANANENT METHODS diminishes in a day or two FEMALE CONDOMS BARRIER METHODS ✓ Complications of surgery which is uncommon include: MALE CONDOMS CERVICAL CAP VASECTOMY SPERMICIDES DIAPHRAGM o Infection or bleeding at the incision o Internal infection or bleeding o Injury to internal organs o Anesthesia risk: ▪ With local anesthesia alone or with sedation, rare risk of allergic reaction or overdose ▪ With general anesthesia, occasional delayed recovery and side effects. Bilateral Tubal Ligation (BTL) WARNING SIGNS & SYMPTOMS: ✓ Bleeding, pain, pus, heat, swelling or redness of the wound that becomes worse or is BILATERAL TUBAL LIGATION PERMANANENT METHODS ✓ High grade fever FEMALE CONDOMS BARRIER METHODS ✓ Fainting, persistent light-headedness, or extreme dizziness MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM ✓ Missed period 10  06/09/2024 Bilateral Tubal Ligation (BTL) ✓Any time as long as the client is not pregnant. BILATERAL TUBAL LIGATION PERMANANENT METHODS POSTPARTUM ✓Between day 1 and day 7 of the menstrual cycle, preferably on day 1. FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM ✓When not associated with a recent pregnancy, BTL can be performed: a. From 6 weeks after childbirth if sure that the woman is not pregnant. INTERVAL b. Within 7 days after the start of the woman’s menstrual cycle c. At any time convenient for the woman if it is reasonably certain that she is not pregnant POST ✓ Within 48 hours after uncomplicated abortion. ABORTION Vasectomy ✓ AKA MALE STERILIZATION ✓ Safe, simple and quick surgical procedure. ✓ It can be done in a clinic or office with proper infection BILATERAL TUBAL LIGATION PERMANANENT METHODS prevention practices FEMALE CONDOMS BARRIER METHODS ✓ Traditional/incisional vasectomy MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM ✓ No-scalpel vasectomy (NSV) 11  06/09/2024 Vasectomy POSSIBLE SIDE EFFECTS: ✓ Discomfort for 2-3 days ✓ Pain in the scrotum, swelling and bruising which decreases for BILATERAL TUBAL LIGATION PERMANANENT METHODS about 2-3 days FEMALE CONDOMS BARRIER METHODS MALE CONDOMS CERVICAL CAP SPERMICIDES VASECTOMY DIAPHRAGM WARNING SIGNS: ✓ Severe bleeding or blood clots after the procedure ✓ Redness, heat, swelling, pain at the incision site ✓ Pus at the incision site ✓ Pain lasting for months 12