Reproductive Life Planning Flashcards
family planning
REPRODUCTIVE LIFE PLANNING
Includes all the decisions an individual or couple make about:
Whether and when to have children
✅How many children to have
✅How they are spaced
3 elements or responsibilities of family planning
- Responsibility of parents to themselves and to each other
- Responsibility to their present and future children
- Responsibility to their community and country
Purposes of Family Planning
✅improvement of health
✅promotion of human right to determine reproductive performance
✅relation of demographic change to economic development
give 7 Important things to consider when helping a couple choose a method that will be right for them include:
- Personal values
- Ability to use a method correctly
- How the method will affect sexual enjoyment
- Financial factors
- If a couple’s relationship is short term or long term.
- Prior experiences with contraception.
- Future plans.
An ideal contraceptive should be:
Safe
100% effective
Compatible with religious and cultural beliefs and personal preferences of both the user and sexual partner.
Free of side effects.
Convenient to use and easily obtainable
Affordable and needing few instructions for effective use.
Free of effects after discontinuation on future pregnancies.
give 4 types of contraceptives
- Natural Family planning
- Hormonal contraception
- barrier methods
- terminal methods
types of natural family planning
- abstinence
- calendar “rhythm” method
- basal body temperature method
- cervical mucous method
5 symptothermal method - lactation ammonrhea method
- coitus interruptus
periodic abstinence methods.
NATURAL FAMILY PLANNING
natural family planning involves?
no introduction of foreign material into the body nor sustaining from sexual intercourse during a fertile period.
degree of effectiveness? and what does it depend on?
25% to 85%, depending mainly on the couple’s ability to refrain from having sexual relations on fertile days.
involves detecting when a woman is fertile so she can use periods of abstinence during that time.
Fertility Awareness
what is fertility awareness?
involves detecting when a woman is fertile so she can use periods of abstinence during that time.
describe abstinence
refraining from sexual relations
failure rate of abstinence?
Has a theoretical 0% failure rate
most effective way to prevent STIs.
➜most effective method
abstinence
who finds it difficult to adhere? what would happened if they break their pledge?
adolescents, may find it difficult to adhere
break their pledge (about 50% do)= more vulnerable to STI’s and pregnancy
Requires a couple to abstain from coitus (sexual relations) on the days of a menstrual cycle when the woman is most likely to conceive or iis fertile
B.CALENDAR (“RHYTHM”) METHOD
how do you do calendar “rhythm” method
➜entails keeping a day-by-day record of your cycle for 6 consecutive months
➜noting the onset of bleeding as day 1 and the last day before your next menstrual bleeding as the final day of your cycle
➜6 month record will show you your longest and shortest cycles from which you can calculate your FERTILE days
First unsafe day: subtract 18 from the number of days in your shortest cycle Last unsafe day: subtract 11 from the number of days in your longest cycle
do not forget to count day one of menstrual bleeding (circle)
example:
shortest: 26
longest: 31
shortest: 26-18= day 8
Longest: 31- 11= day 20
Unsafe period: Day 8 to day 20 = avoid coitus or use contraceptive
describe basal body temp of a woman before and during ovulation
24 hours before ovulation: a woman’s basal body temperature (BBT), or the temperature of her body at rest, decreases about 0.5°F.
during ovulation causes an increase of 0.5 – 1 °F in basal body temperature
how to do BBT method?
taking the temperature every morning BEFORE the woman gets out of bed and recording it
why is their change in basal body temperature?
because of the influence of progesterone.
how many days will the rise in temperature last?
3 days
Billing’s method
CERVICAL MUCUS METHOD
what is the CERVICAL MUCUS METHOD based on?
changes that occurs on the cervical mucus during the menstrual cycle.
how to to do CERVICAL MUCUS METHOD
inserting the forefinger into the vagina first thing in the morning
qualities of cervical mucous as ovulation approaches
copious, clear, thin, less viscous, more liquid, slippery, stringy and becomes increasingly elastic and transparent
when is the unsafe period for CERVICAL MUCUS METHOD
as soon as changes begin and after 3 days later
property that makes the mucus feel slippery and stretches at least 1 inch before the strand breaks.
-cervical mucus is thin, watery and can be stretched into long strands
Spinnbarkeit test
why is there change in cervical mucuos?
High levels of estrogen: ovulation is about to occur
Combines the cervical mucus and BBT methods
SYMPTOTHERMAL METHOD
more effective than either BBT or the cervical mucus method alone
SYMPTOTHERMAL METHOD
what to do in SYMPTOTHERMAL METHOD
- takes her temperature daily, watching for the rise in temperature that marks ovulation.
- analyzes her cervical mucus every day
- observes for other signs of ovulation such as: Mittelschmerz
Mittelschmerz
midcycle abdominal pain.
OVULATION DETECTION uses?
over-the-counter ovulation detection kit.
OVULATION DETECTION kit detects?
midcycle surge of LH that can be detected in urine 12 – 24 hours before ovulation.
OVULATION DETECTION kit accurate percentage?
98% to 100% accurate in predicting ovulation.
describe lactation amenorrhea method
As long as a woman is breastfeeding an infant, there is some natural suppression of ovulation.
contraindications of lactation amenorrhea method
women can still be fertile and ovulate even if she does not menstruate
what is the rule for lactation amenorrhea method
woman should be advised to choose another method of contraception.
One of the oldest known methods of contraception.
COITUS INTERRUPTUS
give 3 contraindications for COITUS INTERRUPTUS
- offers little protection
- ejaculation can still occur before withdrawal is complete
- some spermatozoa may be deposited in the vagina
effectivity of
COITUS INTERRUPTUS
75% effective.
4 types of hormonal contraception
- Oral contraceptives
- Transdermal route
- Injection
- Intrauterine route
ORAL CONTRACEPTIVES Commonly known as
pill,
OCs ( oral contraceptives)
COCs (combination oral contraceptives).
2 components of ORAL CONTRACEPTIVES and its functions
✨ Estrogen-acts to suppress FSH and LH, thereby suppressing ovulation.
✨Progesterone- decrease in the permeability of cervical mucus, thereby limiting sperm motility and access to ova.
give 6 benefits of ORAL CONTRACEPTIVES
✅Dysmenorrhea –– due to lack of ovulation
✅Premenstrual dysphoric syndrome and acne –– due to increased progesterone levels.
✅Iron deficiency anemia –– due to reduced amount of menstrual flow
✅Acute pelvic inflammatory disease (PID)
✅Endometrial and ovarian cancer, ovarian cysts, and ectopic pregnancies.
✅Fibrocystic breast disease
Side Effects of Oral Contraceptives
oNausea oWeight gain oHeadache oBreast tenderness oBreakthrough bleeding oMonilial Vaginal Infections oMild Hypertension oDepression
Absolute Contraindications
oBreastfeeding oFamily History of CVA or CAD o H/O thromboembolic disease oHistory of Liver Disease oUndiagnosed Vaginal Bleeding
Possible Contraindications
oAge 40+ oBreast or reproductive tract malignancy oDiabetes Mellitus oElevated Cholesterol or Triglycerides oHigh blood pressure oUse of drug with interaction effect oMigraine or other vascular type headaches oObesity oPregnancy oSeizure disorders oMental Depression oSmoking oSickle cell or other hemoglobinopathies
3 types of transdermal routes
- Estrogen/Progesterone Transdermal Patch
- Emergency Postcoital Contraceptives
- 1.Subcutaneous implants (Norplant)
what is Transdermal contraception?
patches that slowly but continuously release a combination of estrogen and progesterone.
when do you apply patches? for how long?
-Patches are applied each week for 3 weeks.
No patch is applied on the fourth week.
explain the mechanism of patches
oDuring the week on which the woman is patch free, a menstrual flow will occur.
oAfter the patch free week, a new cycle of 3 weeks on/1 week off begins again.
efficiency rate of Estrogen/Progesterone Transdermal Patch
-Efficiency is equal to that of COCs.
contraindication of Estrogen/Progesterone Transdermal Patch
- May be less effective in women who weigh more than 90kg (198 lbs.)
- have the same risk for thromboembolitic symptoms as COCs.
4 places to apply Estrogen/Progesterone Transdermal Patch
oAbdomen oButtocks oUpper outer arm oUpper torso (front or back, excluding the breasts)
where not to apply Estrogen/Progesterone Transdermal Patch
They should 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 or irritated or has an open lesion.
describe Emergency Postcoital Contraceptives
✅Morning after pills
✅High level of estrogen
✅Must be initiated within 72 hours of unprotected intercourse
3 forms of Emergency Postcoital Contraceptives
✅Morning after pills
✅High level of estrogen
✅Must be initiated within 72 hours of unprotected intercourse
description of Subcutaneous implants (Norplant)
progestin-filled miniature rod
Subcutaneous implants (Norplant)
where is it embedded?
embedded just under the skin on the inside of the upper arm
what does Subcutaneous implants (Norplant) do?
slowly release progestin over a period of 3 years.
Subcutaneous implants (Norplant)
how is it inserted? when is it inserted? why?
-The implants are inserted with the use of a local anesthetic, during the menses or no later than day 7 of the menstrual cycle, to be certain that the woman is not pregnant at the time of insertion
Subcutaneous implants (Norplant)
characteristics of mechanism
It effectively suppresses ovulation,
thicken cervical mucus and
change the endometrium lining, making implantation difficult.
Subcutaneous implants (Norplant)
when can it be inserted
inserted immediately after an elective termination of pregnancy or
6 weeks after the birth of a baby.
Subcutaneous implants (Norplant)
failure rate?
less than 1%.
Subcutaneous implants (Norplant)
when and how can it be removed?
At the end of 3 to 5 years, the implants are removed under local anesthesia (a quick minutes-only procedure).
describe an Intramuscular Injection contraceptive
tuwing kailan binibigay?
single muscular injection of depot medroxyprogesterone acetate or DMPA (Depo-Provera), a progesterone, given every 12 weeks.
what is DMPA
depot medroxyprogesterone acetate or DMPA (Depo-Provera)
where and when is DMPA administered
deep into a major muscle (buttocks, deltoid, or thigh) before the 5th day after the beginning of a menstrual flow.
DMPA effectiveness rate
almost 100%.
what is small plastic object that is inserted into the uterus through the vagina.
Intrauterine Device (IUD)
what does Intrauterine Device (IUD) do?
- Triggers a spermicidal type reaction in the body, thereby preventing fertilization.
- Also produces local inflammatory effect on the endometrium.
advantages of Intrauterine Device (IUD)
Effective for up to 5 years without removal
disadvantages of Intrauterine Device (IUD) (6)
-risk for infection ✅Ectopic Pregnancy ✅PID ✅Dysmenorrhea ✅Spotting or uterine cramping ✅Heavier menstrual flow
give 5 types of barrier methods
- spermicide
- diaphragm
- cervical cap
- male condom
- female condom
-Agent that causes the death of spermatozoa before they can enter the cervix.
Spermicide
6 variety forms of Spermicide
oMelting suppositories oFoaming tablets oVaginal contraceptive film oCream oGels oAerosol foams
