Family Planning 3rd Stage Maternal & Neonatal Health Nursing Theory 2024-2025 PDF

Presented By: Dr. Zainab Neamat Al-Taee  Types of family planning methods.  Advantages & disadvantages of each method.  Objectives of family planning in Iraq.  Nursing care in family planning clinic. 2 At the end of this chapter, the student shoul...

Presented By: Dr. Zainab Neamat Al-Taee  Types of family planning methods.  Advantages & disadvantages of each method.  Objectives of family planning in Iraq.  Nursing care in family planning clinic. 2 At the end of this chapter, the student should be able to:  Describe the different methods of contraceptive.  Identify the more common factors influencing the choice of contraceptive method  Discuss the types of family planning  Describe the role of nurses in family planning  Mention the Advantages and disadvantages of each type of contraceptive methods. 3  The practice of controlling the number of children and intervals between their births, particularly by means of contraception's or other methods.  involves personal, social, economic, religious and cultural decisions about planning a pregnancy. 4  Cost in using the method.  Effectiveness of method in preventing pregnancy.  Availability of method.  Safety of method.  Convenience.  Desirability and personal preference.  Religious and moral factors.  Medical problems such as blood clotting disorder or cancer. 5 1. Natural method (Behavioral) 2. Hormonal methods 3. Mechanical method (Barriers) 4. Chemical method (Spermicides) 5. Surgical method (LongTerm /Permanent) 6 Natural family planning also called fertility awareness involve the sign and symptoms associated with ovulation the ovum is viable up to 24 hours after ovulation and sperm are viable for 48-72 hours in fallopian tube, although most die within 24 hours. (20% failure rate). Side effects of natural method  Lack of safety (Non safe 100%)  Pregnancy 7 1.Predicting fertility: Basal Body Temperature & Calendar method 2.Withdrawal/Pullout 3.Breastfeeding 4.Abstinence The only 100% effective way to prevent pregnancy, STIs 8 The basal body temperature method: a fertility awareness-based method and a type of natural family planning. Basal body temperature is body temperature When the person is fully at rest. 9  What? lowest temp of the body at rest  How? Ovulation raises body temp 0.5 degree Celsius, and temp will drop if fertilization does not occur  Basal body temperature may increase slightly — typically less than a 0.5 degree (0.3 C°) — when ovulate. Ovulation has likely occurred when the slightly higher temperature remains steady for three days or more Calendar  What? Predicting fertility based on menstrual cycles  How? Women chart previous menstrual cycles to predict the days they are fertile and infertile 10 11  This method based on calendar documentation of woman menstrual cycles and based on the assumption that ovulation occur approximately 14 days before the next menstrual period and the knowledge that sperm is viable for 48-72 hours (some references till 5days) and ovum only for 24hours. A woman is fertile 5 days before and 1 day after ovulation. 12 Breast feeding inhibits ovulation in many women as long the infant receive at least 10 feeding in 24 hours because prolactin secreted to stimulate milk production inhibit ovulation. When infant begin taking solid, milk intake (and thus prolactin secretion) falls ovulation is likely and pregnancy can occur. 13  how? The man takes his penis out of the vagina before he ejaculates Male needs to ejaculate away from female.  Notes: Depends on a male’s self knowledge and self control  Access: Free, available to anyone  Effectiveness: 78-96% 14  The Pill  The Patch  These methods add chemicals similar to  Vaginal Ring hormones to stop the  The Shot release of an egg and weaken the sperm.  Implant  The hormones change  IUD the cervical mucus  Emergency Contraception and uterine lining, slow sperm, and reduce ability of fertilized egg to implant into uterine wall. 15  What? A pill taken orally every day at about the same time  Notes: There are many different brands. The doctor prescribes the right pills for contraception. Menstrual period can occur monthly, every 3 months, or not at all.  Access: Prescription needed  Effectiveness: 91-99.7% 16  Are the most popular hormonal contraception.  Oral contraceptives prevent pregnancy by suppressing ovulation through the combined action synthetic estrogen and progestin  Action: the hormones thicken the cervical mucus and alter the decidua of uterus to prevent pregnancy oral contraceptive effectiveness rate of 99% 17  What? A bandage-like patch that sticks to woman skin  How? Changed weekly, no patch on 4th week. Hormones are absorbed through the skin  Notes: Less effective if woman weigh over 90 Kg. May cause skin irritation.  Access: Prescription needed  Effectiveness: 91-99.7% 18  What? A clear, soft, flexible 2 inch circle worn in the vagina  How? The body absorbs hormones from the ring through vaginal wall. The ring is worn in the vagina for 3weeks and removed for 1 week to allow withdrawal bleeding.  Notes: One size fits all.  Access: Prescription needed  Effectiveness: 91-99.7% Side effect: Hormonal disturbance and pregnancy. 19  Depo-Provera along acting injectable progestin it alters the cervical mucus so that become hostile to sperm which impairs ovulation and implantation. Actions: a single injection is given every 3 months giving IM, should not be massaged coz reduce effectiveness. it's giving 1-5 days of menstrual cycle. Side effect of hormonal contraceptives:  Weight gain.  Risk osteoporosis.  Menstrual spotting. 20 21  What? A long acting hormone injection  How? Female is given a shot one time every 3 months  Notes: Not reversible- once the injection occurs, the hormones are in the woman body for at least 3 months. It may take a long time to get pregnant after the shot.  More chance of weight gain than any other method  Access: Clinic / doctor visit needed every 3 months  Effectiveness: 94-99.8% 22  Implanon ,a single silicon rod implant that use etonogestrel (progesterone) is inserted sub dermally and provide contraceptive for up to 3 years.the rod can be removed in the outpatient clinic under local anesthesia  Sid effect: (headache, vertigo, nervousness) 23  What? A soft rod 3.8 Cm long placed under the skin in woman upper arm  How? Slowly releases hormones into system  Notes: Prevents pregnancy for 3 years, but can be taken out at any time  Access: Clinic / doctor visit needed every 3 years  Effectiveness: 99.95% 24 Is a small T shaped flexible device inserted by health care provider into the uterine cavity through the cervix to provide continues pregnancy prevention. more popular than the traditional copper IUD a smaller progestin only IUD (mirena) is also available for long term contraception contain tow lien remain 2 cm for checking and removing. Cupper IUD 25 Hormonal IUD 26  What? A small plastic “T” with a string inserted into the uterus  How? Releases synthetic progestin hormone that changes cervical mucus, fallopian tubes and the uterine lining. Stops or slows sperm and egg  Notes: Lasts 5 years. IUD Copper (10 years). Insertion can cause discomfort and pain, but removal is fast and easy  Access: Clinic / doctor visit needed for insertion & removal  Effectiveness: 99.8% 27  Liver disease. Cooper allergy. Breast cancer. Immunodeficiency. Uterine abnormally. Pelvic infection or disorder. Abnormal uterine bleeding. 28 1. Lower abdominal pain. 2. Heavy Menstrual bleeding. 3. Uterine Perforation &collapse. 4. Expulsion of device. 5. Infection (Endometritis) 6. Fail and unwanted pregnancy. 29 30  What? A pill or combination of pills taken after sex to prevent pregnancy  How? Contains a higher dosage of the same hormones found in regular birth control  Notes: Won’t stop an existing pregnancy  Access: Available at pharmacy  Effectiveness: Approx 95% if taken within first 24 hours of unprotected sex 31  The emergency contraceptive pills – Levonelle or EllaOne (the "morning after" pills)  The intrauterine device (IUD) the emergency contraceptive pill need to be taken within 3 days after unprotected sex for it to be effective – the sooner the more effective it'll be. The IUD can be fitted up to 5 days after unprotected sex, for it to be effective. The cooper IUD is more effective than the contraceptive pill at preventing pregnancy 32 33 Male condom: Male condoms are sheaths of thin latex or natural membrane worn on the penis during intercourse.  Condom action by collect the semen before during and after ejaculation they come in various style such as ribbed, lubricated, and colors& with or without spermicidal agents Sid effect and contraindication:  Partners may be allergic to latex  Less sensation 34 Two flexible rings, one side into the vagina and one that remain outside. essentially used for same purpose as male condom to prevent pregnancy and protect women from STIs such as (HIV) human immunodeficiency virus. There are two types of female condoms: Sid effect and contraindication:  Spermicidal can cause local irritation in the vagina or on the penis.  The irritation can cause cracks that provide a portal of entry for infection including HIV. 35  What? A thin covering that open over an erect penis. Made of latex, polyurethane, or animal membrane (protect against STIs).  How? Put on before any genital contact.  Notes: May decrease the sensation for men. Access: Easy to buy in a store or online. Inexpensive. Usually offered for free at a community health centers.  Effectiveness: 82-98% 36  What? A soft, loose pouch that is inserted in the vagina. Flexible rings at each end hold it in place. Can be put in up to 8 hours before sex.  How? Insert the small ring in vagina, large ring stays outside partially covering external genital labia.  Notes: Can be used if woman is allergic to latex (made of nitrile). Men usually feel no reduction in sensation.  Access: Available at many pharmacies, clinics, and online  Effectiveness: 79-95% 37 38 Sponge is a one size, single use, non- prescription. Barrier sponge contraceptive that work by absorbing the semen and providing a barrier to the cervix and spermicidal.  Sid effect: movement leading to entrance of sperm and lead to pregnancy. 39 40 Diaphragm and cap is rubber domes that fit over the cervix and are use spermicidal agent to kill sperm that pass.  The diaphragm and cervical cap are fitted by health care provider the women must learn how it insert and remove.  It may be inserted several hours before intercourse remain in place at least for 6 hours after intercourse But not more than 24 hours to prevent pressure on local tissue. Sid effect  Women who have allergy to rubber or spermicidal agents.  Pressure on the bladder may be increased risk of urinary tract infection. 41 42 43 44 a. Fuming tablets. b. Vaginal contraceptive film. c. Suppositories.  Action: change the uterus and cervical (PH) that sperm can’t live in it (Spermicides). 45 46  Female- Tubal ligation  Male- Vasectomy ◦ These procedures are permanent, and are usually done by people 35+ years ◦ Both procedures are done in hospital operation theater 47 Tubal Ligation (Female) A small incision is made in the abdomen to access the fallopian tubes. Fallopian tubes are blocked, burned, or clipped shut to prevent the egg from traveling through the tubes. Recovery usually takes 4-6 days. 48 Damage to the bowel, bladder or major blood vessels.  Reaction to anesthesia.  Improper wound healing or infection.  Continued pelvic or abdominal pain.  Failure of the procedure, resulting in a future unwanted pregnancy.  Ectopic Pregnancy 49  A small incision is made to access the vas deferens, the tube the sperm travels from the testicle to the penis, and is sealed, tied, or cut. After a vasectomy, a male will still ejaculate semen (seminal fluid), but there won’t be any sperm (the reproductive cells) present once client has ejaculated about 15-20 times. A vasectomy blocks the sperm made by the testes from reaching the semen. Instead, the body absorbs the sperm, which is harmless 50  Bleeding or a blood clot (hematoma) inside the scrotum  Blood in semen  Bruising of scrotum  Infection of the surgery site  Mild pain or discomfort  Swelling 51 1. Space pregnancy: child spacing. 2. Reduce incidence of induce abortion. 3. Keep woman healthy and fit. 4. To control the unwanted (unplanned) pregnancy which is burden on the mother and family. 5. Make balance between economic resources & increasing population. 52 1. Explain the aims of family planning. 2. Encourage the mother to get access to the center of family planning. 3. Providing family planning services for mothers in far areas. 4. Educate the mother about the aims, types, complication of each family planning methods. 53 54