Family Planning Methods: BTL & Vasectomy PDF

BILATERAL TUBAL LIGATION ❑ A safe and simple surgical procedure that provides permanent contraception for women who do not want any more children ❑ Involves cutting or blocking the two fallopian tubes BT L Minilaparotomy using local anesthesia and light sedation is the DOH-...

BILATERAL TUBAL LIGATION ❑ A safe and simple surgical procedure that provides permanent contraception for women who do not want any more children ❑ Involves cutting or blocking the two fallopian tubes BT L Minilaparotomy using local anesthesia and light sedation is the DOH-approved standard procedure for BTL MECHANISM OF ACTION ▪ No fertilization occurs ▪ The fallopian tubes that carry the eggs from the ovaries are cut off and blocked ▪ Eggs released from the ovaries cannot move down the fallopian tubes to meet the sperm EFFECTIVENESS ▪ 99.5% effective ▪ Varies slightly depending on how the tubes are blocked, but pregnancy rates are still low with all techniques  ADVANTAGES ❑ Permanent method of contraception ❑ Nothing to remember, no supplies needed, and no repeated clinic visits required ❑ Does not interfere with sex ❑ Does not affect a woman’s ability to have sex ❑ Results in increased sexual enjoyment - no need to worry about pregnancy ❑ No effect on breastfeeding ❑ No known long-term side effects or health risks ❑ Can be performed immediately after delivery  DISADVANTAGES ❑ Requires minor surgery by a specially trained physician ❑ Requires an operating room set-up ❑ Considered to be permanent ❑ Does not protect against STIs and HIV ❑ Limitation of physical activities for about one week  POSSIBLE SIDE EFFECTS Related to surgical procedure: Pain and swelling over the operative site (diminishes in a day or two) Superficial bleeding  TIMING OF BTL Postpartum Immediately or within seven days after giving birth  TIMING OF BTL Interval From six weeks after childbirth if it is reasonably certain that the woman is not pregnant Within seven days after the start of the woman’s menstrual cycle At any time if it is reasonably certain that the woman is not pregnant Post Abortion Within 48 hours after an uncomplicated abortion  Warning Signs ▪ Bleeding, pain, pus, heat, swelling or redness of the wound that becomes worse or does not heal/resolve ▪ High grade fever ▪ Fainting, persistent light-headedness, or extreme dizziness in the first week ▪ Missed period  Key Messages ▪ Safe for all women, has no long-term side effects ▪ No need to worry about contraception again ▪ Is easy to use, nothing to do or remember ▪ The procedure is intended to be permanent VASECTOMY ❑ Works by closing off each vas deferens, keeping sperm out of semen ❑ Semen without sperm is ejaculated, but it cannot cause pregnancy  EFFECTIVENESS ❑ Use of a reliable method ❑ Correctly used: of contraception for 99.9% three months after the ❑ Commonly used: procedure 99.8% ❑ Semen is checked after ❑ More effective when three months to ensure used correctly that it does not have any more sperm  DISADVANTAGES ▪ Requires minor surgery by ▪ Must be considered as a specially trained health permanent care provider ▪ Does not protect against ▪ Not immediately effective STIs, including HIV/AIDS  POSSIBLE SIDE EFFECTS ▪ Discomfort for two to three days ▪ Pain in the scrotum, swelling, and bruising which decreases in about two to three days ▪ Brief feeling of faintness after the procedure  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  ADOLESCENTS ❑ Adolescence is the period between the ages 10 to 19 years (WHO) ❑ Due to lack of knowledge on sexual and reproductive health, adolescents are exposed to: ✓ Unplanned pregnancy, that may result in unsafe abortion ✓ Pregnancy risks due to “too young” pregnancy ✓ High risk of STIs as a result of unprotected sexual intercourse  WOMEN OVER 40 ❑ Delayed pregnancy after age 35 is associated with an increased risk for maternal morbidity and mortality ✓ Spontaneous abortion ✓ Ectopic pregnancy ✓ Hyperemesis ✓ Diabetes ✓ Hemorrhage and infection  OBESE WOMEN ❑ Obese women are those who have a body mass index of more than 30kg/m3 ❑ Obese women are at risk for medical illnesses like cardiovascular disease, diabetes, gallbladder disease, some forms of arthritis, and certain cancers, which puts them at high risk for pregnancy  SMOKERS ❑ Women who smoke during PREGNANCY have increased risks of: ✓ delivering low-birth weight infants ✓ miscarriages ✓ stillbirths ✓ infant deaths  POSTPARTUM AND BREASTFEEDING WOMEN ❑ Postpartum women are strongly encouraged to breastfeed their infant ❑ FP method choice and practice must be compatible with breastfeeding ✓ Estrogen affects the quantity and quality of breastmilk adversely ✓ Estrogen-containing contraceptives are not the best choice for breastfeeding women  POSTPARTUM AND BREASTFEEDING WOMEN ❑ Pregnancy is a hypercoagulable state ✓ Estrogen increases the risk for venous thrombosis and embolism ✓ Estrogen-containing preparations must be avoided until one month postpartum  SUMMARY Special populations have particular family planning needs that should be considered when providing them with services  SUMMARY Adolescents are primarily advised to practice ABSTINENCE, but once they become sexually active, the following methods are recommended for them namely: fertility awareness-based methods, condoms and low- dose COCs  SUMMARY Women over 40 years of age have an increased risk of pregnancy-related morbidity and mortality Taking into consideration the related risks, the recommended methods for family planning are low- dose COCs, POPs, progestin injectables, IUDs or sterilization (if limiting family size is desired)  SUMMARY Obese women are at risk for other diseases that may be affected by some family planning methods. The recommended FP methods for this group are POPs, POIs and IUDs  SUMMARY Smokers must be encouraged to quit smoking For three to 12 months after quitting, the risks will be similar to nonsmokers in terms of selecting a method best for them However, low-dose estrogen contraceptives may be provided to smokers who are less than 35 years old