Family Planning

Dr. Barkat A Khan

 Family planning

Family planning is "the ability of individuals and couples to anticipate

and attain their desired number of children and the spacing and timing of

their births OR

Family planning is the term given for pre-pregnancy planning and action

to delay, prevent or actualize a pregnancy

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 Finance

⋆ Family planning is among the most cost-

effective of all health interventions.

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 OBJECTIVES ( WHO )

“The use of a range of methods of a fertility regulation to help

individuals or couples :
 avoid unwanted birth.
 bring about wanted birth.
 Produce a change in the no. of children born.
 Regulate the intervals between pregnancies.
 Control time at which birth occur.”
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 Benefits
Benefits to Mother 
1. Reduce the health risk. Below 20y, And above 35 y.
At risk of developing complications during
pregnancy.
2. Physical strain of child bearing. 
3. Reduce number of maternal death. 
4. Reduce the risk of ovarian cysts.
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 Health Benefits to Children:
1. Ensures better chance of survival at birth. 
2. Promote better childhood nutrition.  Promote
physical growth and development. 
3. Prevent birth defects

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⋆ Health Benefits to Father 
⋆ Allows father to keep a constant balance between
their physical, mental, social well –being. 
⋆ Increase father sense of respect because he is able
to provide the type of education and home
environment.

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Benefits to Whole Family Health 
Benefits to Whole Family Health - help the
family enjoy the better kind of life.

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Methods

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 ⋆ NATURAL FAMILY PLANNING

No introduction of chemical of foreign material into the

body.
Types
a) Rhythm (Calendar) method
b) Basal Body Temperature (BBT)
c) Ovulation or Cervical Mucus Method
d) Symptothermal method
e) Coitus Interruptus
f) Lactation amennorhea
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 Rhythm (Calendar) method
The rhythm method, also called the fertility awareness method, is a form
of pregnancy prevention where couples calculate a woman's fertile time
using a calendar .
➢ Woman keeps a diary of 6 menstrual cycles.
➢ This method is used by women whose menstrual cycles are always
between 26 and 32 days in length.
➢ To calculate: 18 from shortest cycle documented –11 from longest
cycle = represents her last fertile day.
➢ Example: If she has 6 menstrual cycles ranging from 25 to 29 days,
fertile period would be from 7th day (25- 18) to the 18th day (29-11). To
avoid pregnancy, avoid coitus/use contraceptive during those days.
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 ⋆ Risks benefits
1: The rhythm method is an inexpensive and safe way to help
you chart your fertility
2: Doesn't pose any direct risks

1: It's considered one of the least effective forms of birth control.

How well the rhythm method works varies between couples. In
general, as many as 24 out of 100 women who use natural family
planning for birth control become pregnant the first year.
2: The rhythm method doesn't protect you from sexually
transmitted infections.
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 b)Basal Body Temperature (BBT):

⋆ Identifying fertile and infertile period of a woman’s cycle by

daily taking and recording of the rise in body temperature
during and after ovulation.

⋆ ❖ Just before ovulation, a woman’s BBT falls about 0.5ºF

At time of ovulation, her BBT rises a full degree (influence
of progesterone). This higher level is maintained the rest of
menstrual cycle.
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⋆ The WHO placed fertility awareness methods in the third

tier of effectiveness, after "most effective" methods such

as IUDs and "very effective" methods such as combined

oral contraceptive pills

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Disadvantages:
NOT reliable method: of birth control, especially for women
with irregular cycles. Plus, outside factors, such as a lack of
sleep, can cause a woman’s temperature to vary.

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 Cervical Mucus/Ovulation
Cervical mucus is a fluid produced by small glands near the
cervix
➢ This fluid changes throughout her cycle, from scant and
sticky, to cloudy and thick, to slick and stringy.
➢ Each of these types of mucus is related to the hormonal
shifts that naturally occur during the menstrual cycle as her
body prepares for and achieves ovulation.

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➢ Right before ovulation, the mucus from the cervix changes
from being cloudy and scanty to being clear and slippery.
➢ The consistency of ovulation mucus is like that of an egg
white and it can be stretched between the fingers. It is the peak
of her fertility.
➢ After the ovulation, the mucus tends to dry up again. These
are also safe days.
➢ Ideal Failure rate: 3%

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 Disadvantages:

➢ It is not a particularly reliable method of birth control, especially

for women with irregular cycles.
➢ Remember that cervical mucus does not let you know when you
will soon be ovulating, but sperm can live up to seven days inside
the vagina. Any sperm deposited ahead of time can still impregnate
the woman.

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COITUS INTERRUPTUS/pull-out/withdrawal:

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ADVANTAGES:
➢ Breastfeeding on demand improves health for mother and
baby.
➢ Convenient and effective (98%).

DISADVANTAGES
▪ This method can be used only for the first six months after
birth or until the first menstrual period.
▪ LAM does not provide protection against SEXUALLY
TRANSMITTED INFECTIONS.

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 ⋆ BARRIER METHODS OF FAMILY PLANNING

BARRIER METHODS WORK BY PREVENTING THE

PASSAGE OF SPERM INTO THE FEMALE GENITAL TRACT.

1. Physical

2. Chemical

3. Hormonal
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Condoms (male and female)

Diaphragm

Sponge

Cervical cap

IUD

Spermicidal
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Ethinyl oestradiol/norgesterel
 1. (i) MALE CONDOM

Most widely used. • Made up of fine latex sheath.

Instructions:

• Should be worn on erect penis before intercourse.

• Air must be expelled

• Held carefully when withdrawing from vagina.

• A new condom should be used for each sexual act.

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 1. (ii) Female condoms

It is a pouch made up of polyurethane which lines the

vagina and also external genitalia. It is 17cm in length

with one flexible polyurethane ring at each end.

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ADVANTAGES:
➢ Prevents STDs including HIV/AIDs
➢ Not damaged by oils and other chemicals.

DISADVANTAGES:
➢ High motivation
➢ Only women who can use diaphragms can use female
condom
➢ Slippage occurs
➢ Expensive
➢ Failure rate 21% with typical use and 5% with
correct and consistent use.
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 2. Diaphragm

Thin, nearly hemispherical dome made of rubber or latex

material, with circular, covered metal spring at periphery

(flat type and coil type)

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 Advantages of the Diaphragm

Compared with OCPs and IUDs, the diaphragm provides moderate protection
against sexually transmitted diseases. 1,7–9

Diaphragm use allows greater sexual spontaneity and more sexual sensation
than male condom use.1

Compared with OCPs, the diaphragm is safer for use in women with medical
conditions and in women older than 35 years who smoke.

The diaphragm is less expensive than OCPs, IUDs, or sterilization.

The diaphragm is an easily reversible method of contraception

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DISADVANTAGES:
✓ Requires help of doctor to measure the size required.
✓ Need high motivation
✓ Allergic reaction to rubber
✓ Erosion
✓ UTI’s

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 ⋆ (3) SPERMICIDES

➢ Available as vaginal foams, gels, creams, tablets and

suppositories.
➢ Contain surfactant like nonoxynol-9, benzalkonium
chloride.
➢ Alter the sperm surface membrane permeability
resulting in killing of sperm.

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ADVANTAGES:
➢ No instructions by doctors or nurses
➢ Easily available and easy to use
➢ No gross medical side effects
DISADVANTAGES
➢ Can increase spread of HIV infection by irritating vaginal and cervical
mucosa
➢ Failure rate – 21% with typical use and 6% with proper use

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 Cervical Cap

The cervical cap is made of soft re-usable rubber and is designed

to fit completely over the cervix. Spermicide is placed on the outer
rim of the cap and in the portion of the cap facing the vagina. The
cervical cap prevents pregnancy by blocking the sperm from
entering the uterus.

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INTRAUTERINEDEVICES:

Intrauterine Device The IUD is a small, T-shaped, plastic/metal

device that is inserted and left inside the uterus to prevent

pregnancy.

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ADVANTAGES OF IUD :
✓ Safe
✓ effective , Reversible
✓ Long action ,Inexpensive

DISADVANTAGESOF IUD:
✓ Heavy bleeding and pain
✓ Pelvic inflammatory diseases
✓ Ectopic pregnancy
✓ May come out accidently if not properly inserted.

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⋆ HORMONAL CONTRACEPTIVES
⋆ ✓ Hormonal contraceptives (the pill, the patch, and
the vaginal ring) all contain a small amount of human-
made estrogen and progestin hormones.
⋆ ✓ These hormones inhibit your body's natural
hormones to prevent pregnancy in a few ways. The
hormonal contraceptive usually stops the body from
ovulating.

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PERMANENT STERLIZATION
Sterilization is a permanent form of birth control that is extremely
effective at preventing pregnancy. But it is difficult to reverse if you
change your mind, and it does not protect against STDs. Both men
and women can be sterilized. For women, a Tubectomy is
performed; for men, a vasectomy is performed.
❖ Tubectomy
❖ vasectomy
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Happy Happy

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