Family Planning Flashcards
Family planning definition
Conscious decision of when to conceive or avoid pregnancy
Contraception
intentional prevention of pregnancy
Birth Control
Device or method used to decrease risk of pregnancy
Effectiveness and safety considerations of contraception
Cost?
Religion?
You want the most effective method possible but you also want it to be safe.
Want it to be easily available and affordable to make sure will they use it.
Does BC/contraception go against one’s religion? Catholicism for instance
Age considerations of contraception
Is the age they are appropriate for complications?
Parity
Can you use an IUD if your parity is none (or you’re nulliparious)?
Is the amount of times pregnant.
Yes, now you can.
Why do you need to ask about how many partners someone has?
Some contraception works better than others
T/F
Diabetics can use whichever contraception they want
False.
Diabetes can limit your options of contraception
Can motivation affect contraception effectiveness?
Cooperation too?
Yes. If someone doesn’t comply, then it won’t work as well.
Sometimes you may even have to abstain from intercourse.
BRAIDED acronym of informed consent
Benefits risks alternatives inquiries decision explanation/education ; make sure they know how to use it document
What do fertility awareness methods do?
When does it require abstinence?
They’re a method of contraception which focuses on knowing the fertile periods during the menstrual cycle.
Abstinence is needed during fertile days of the cycle.
This is also the method with the least amount of side effects.
What is the calendar method?
How long do you have to record for the calendar rhythm method of contraception?
How many days do you need to count back to know ovulation?
The calendar method uses the dates of your menstrual flow to calculate when you are fertile (so no checking mucus or anything. Just math).
Method that requires recorded cycles for 6+ months
Know when you started your menses & count back 14 days to know how far back you were ovulating.
How many days for the calendar method do you need to count back to know when you should practice abstinence?
What is the risk in using the calendar method?
Subtract 18 days from shortest cycle
Subtract 11 days from longest cycle
The days in between are when you should abstain.
You’re relying on old data to calculate the future events. Lots of things can throw you off.
What does the Basal Body Temp method detect?
Drop hormone?
Rise hormone?
It detects ovulation based off temp changes in your cycle.
The drop is from estrogen around start of ovulation.
The progesterone causes the rise (only tenth of degree)
But this only happens in regular cycle so if yours is irregular, this method is not for you.
How long do you need to record temp before BBT is effective?
3-4 months to learn your body
What type of things can affect your temp? (4)
Illness
Stress or anxiety
Lack of sleep
Alcohol
What does the Billings method measure and look at?
What does fertile mucus look like?
pH level of mucus?
Pattern in mucus?
It looks for physical changes in the mucus.
Fertile:
thin, watery
spinnbarkheit (clear and stretchy)
high pH making it more sperm friendly
ferning
Using the Billing method, you notice your mucus looks fertile. How long should you abstain from sex?
Abstain from sex until 4 days after the last day you detect fertile “wet” mucus.
You use the Billing method and your mucus looks infertile (key word here). What does it look like? What hormone is involved in this?
Thick
Sticky
Less of it
Progesterone
What do antihistamines do to your mucus levels?
Other factors that can affect your mucus?
Will dry you up
Presence of semen
Infections that can affect discharge
Douching
What does the sympothothermal method combine?
Is this more accurate?
Combines Basal temp with the observation of mucus (billilngs)
Yes, it is more accurate than them being seperate
Fertile indicators that you should look for with the Sympothermal method.
Libido? Any spotting? Mittelschmerz present? How does the cervix feel? What mucus changes? Pelvic and vulvar feeling? BBT?
Effective or not?
Main uses?
Increased libido
Mid cycle spotting can be present.
Mittelschmerz = mid cycle pain associated w ovulation due to free blood & yes.
Cervix feels soft
Mucus becomes much thinner & watery. Also stretchy.
Pelvic and vulvar fullness
BBT drops then rises (bc you combine mucus & temp fo this method).
Again, it is more effective than the two seperate methods.
Can be used to achieve or avoid pregnancy
What do Ovulation predictors do?
How reliable is this?
How many hours is the ovum able to be fertilized?
How long is sperm capable of fertilization?
Method that predicts ovulation by checking the LH levels related to ovulation 24 hrs beforehand. After this, fertility is greatest the next 3 days.
Pretty reliable.
24 hrs
48 hrs for sperm to penetrate the ovum
Marquette Model does what?
accuracy?
Combines cervical mucus with urinary metabolites of estrogen & LH using test strips to test for fertility periods.
88-90% accurate
Describe the two day method
What if you have no secretions and are dry for 2 whole days?
Highly recommended method by ascension where you check mucus every-time you go to the bathroom. The presence of fertile like mucus yesterday or today means you are currently fertile
If you’re completely dry than you’re not fertile
So, if you want to avoid getting pregnant, make sure to abstain from sex until mucus is dry for at least 2 days. And the next time you check your mucus and it is fertile, do it again.
What is Coitus Interruptus?
Failure rate?
Does this protect against infections?
Oldest method where male withdrawals before ejaculation.
Failure rate is 22% due to pre-ejaculate containing sperm.
No protection
Barrier method
Barrier method is a method where there is some sort of condom involved.
What are condoms made out of?
Latex
Silicone
Polyurethane (sti infection protection)
If a condom has nonoxynol-9 what does that mean?
What should the wearer leave at the end of a condom?
It means there is a spermicide - which kills sperm to increase prevention from pregnancy
Leave space at the end so semen can accumulate.
What type of lubrication should you use with a condom?
Can you use condoms more than once?
Water or silicone based.
NOT petroleum - this leaves holes.
Use condoms only once.
What are female condoms? Which method do they go with?
Can you use this with spermicide?
Female condoms are like a reverse condom with a more flexible ring that is considered a barrier method.
Yes the female condom can be used with a spermicide.
Why should you be cautious about removing a female condom?
The female condom is more risky to remove and can cause pregnancy if spilled.
How many times can you use a female condom?
Once
What is a vaginal diaphragm made out of?
How do you get one?
Flexible silicone or latex dome with a wire rim that you have to be prescribed and fitted for to use.
How long can you use a vaginal diaphragm before needing a new one?
What should you reapply to the vaginal diaphragm?
Can use the vaginal diaphragm for about 2 years.
You’ll need to reapply spermicides
How long must you wear the vaginal diaphragm before removing?
Need to wear for at least 6 hrs after last act so it can kill all the sperm before removal but don’t wear longer than 24 hrs
Why do you need to see a GYN when using a vaginal diaphragm?
What are reasons you’d have to refit the vaginal dipahragm?
Exam makes sure it fits well.
Refit for 20% weight gain or loss && pregnancy
What can a vaginal diaphragm increase risk of?
Cystitis or urethritis due to an increase in pressure against bladder and urethra
A main complaint
How to clean a vaginal diaphragm?
Clean with soap and water
How to check for holes in the vaginal diaphragm?
Hold up to the light & do so periodically
Reasons why someone may not be ok to use a vaginal diaphragm?
Toxic shock syndrome history
Abnormal discharge
Cervical cap method?
How to get one?
Other names?
Reusable silicone barrier that works by covering the cervix and is held by walls of the vagina but also requires a prescription
Other names are Lea’s shield or FernCap
What does the central valve of a cervical cap allow for?
Is spermicide used?
The central valve allows for flow of cervical secretions and mucus
Yes, a cervical cap can use spermicide
How long can a cervical cap be left in place?
How long is too much & why?
Need to leave in for 6 hours at least
But don’t wait any longer than 48 hrs bc of Toxic shock syndrome
What is a vaginal sponge?
How can someone get a sponge?
Known as “Today’s Sponge”
Single use soft polyurethane device that contains a spermicide (N-9)
They are OTC
How long can you wear a a vaginal sponge for?
Leave in for at least 6 hrs but not more than 24 hrs
Your patient is wearing a vaginal sponge & they develop a rash. Why might this be happening?
Can it move tho?
This can happen due to allergic rxn
Yes it can move but it is better than nothing
Nulliparous meaning & how it relates to the vaginal sponge
Nulliparous means never having a baby before
Sponge method works best for Nulliparous women
What are long acting contraceptives ? (LARC)
Used for an extended period of time but they are reversible - meaning you will ovulate again if you stop..
Could be an IUD or IUC
How does an IUD work?
Why is it a good thing this is radiopaque?
Device inserted into uterus to cause inflammatory response that inhibits ability to conceive
Bc if you’re afraid it fell out you can find it with an xray