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TRANSCRIPT
Introduction
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Women’s HealthFamily Planning and Contraception
Developed by D. Ann Currie , R.N., M.S.N.
2012
Goal of Family Planning
To assist the clients with reproductive decision making, enabling the client to have control of the number of pregnancies, spacing the time between children, and to prevent pregnancy if desired
Decision to use a contraceptive
May be made by the individual man or woman or jointly as a couple
Legal Issues related to Family Planning and Contraception May vary from state to state concerning
minors,sterilization,and abortions. Informed consent-need to document
information provided and understanding of client -the nurse should use (BRAIDED)when counseling client on contraceptive methods
decision about contraception should be made voluntarily with informed consent
BRAIDED B- Benefits/Advantages R-Risks/Disadvantages A- Alternatives/Other methods available I-Inquiries/ Allow time for questions D-Decisions/opportunity to decide or
change mind E-Explanation/about method/how to use D-Documentation /everything taught
What to teach about each method What it is, How it is used , or How it works? advantages disadvantages effectiveness side effects risks contraindications long term effects
Assessment
Obtain a history to identify the client’s past and current health status and potential risks factors.
Sexual history Reproductive health Future plans for childbearing Psychosocial data- lifestyle, motivation,
religious beliefs,cultural influences,
Assessment Financial factors these factors may affect the
selection,access,and use of aparticular method
Don’t assume anything….ask. Knowledge of and concern about
contraceptive methods need to be determined to identify deficits and need
Assessment
For accurate and additional information
Identify actual or potential problems from the assessment.
Provide privacy for assessment and discussion about contraceptive methods
Methods of Family Planning or Contraception
Natural methods- abstinence Coitus interruptus -(withdrawal) Fertility awareness methods-
calendar method,basal body temperature (BBT), cervical mucus method, symptothermal method
Methods of Family Planning and Contraception
Mechanical methods- Barrier methods- Condoms- Male/Female Diaphragm Spermicides Intrauterine device(IUD)
Methods of Family Planning and Contraception
Chemical Methods- Oral Contraceptives(birth control pills) Subdermal implants(Norplant) Long-acting progestin injections Postcoital contraception Surgical Methods-Vasectomy Tubal ligation
Natural methods
Safe Situational methods requiring
increased self awareness Self control to be effective
Fertility Awareness Methods Based on an understanding of the
woman’s ovulation cycle and the timing of sexual intercourse
All methods attempt to identify the female fertility and to avoid unprotected intercourse during that time period
Free,safe,and acceptable to couple’s religious beliefs prohibit other methods
Female Reproductive Cycle
Cont. Increases awareness of the woman’s body encourages communication can be used to prevent or plan a
pregnancy Requires extensive counseling and
education interfere with sexual spontaneity difficult with irregular cycles no protection for STI’s
Calendar method Rhythm method 75-91 effective 6-8 months period shortest and longest cycles 18days from shortest cycle 11days from longest cycle avoid sex during fertile period
BBT Based on the thermal shift in the
menstrual cycle 75-97% effective drop prior to ovulation then raises .5-
1 degree F with ovulation Avoid intercourse when temperature
drops and for 3 days after. Factors which could effect BBT
Cervical mucus Ovulation or Billing’s Method Based on the cervical mucus changes
that occur during the menstrual cycle 75-97% effective Cervical mucus changes in response to
levels of estrogen and progesterone Assess for amount, color,consistency,
and viscosity
Cervical Mucus Assessment
Factors to assess
Infertile period Fertile period
Vaginal characteristic
dry Wet,moist
Cervical mucus amount
scant profuse
color Cloudy,white-yellow
clear
Cervical Mucus Assessment-contviscosity none Strectchable,
spinnbarkheit present,
Microscopic appearance
No ferning ferning
Dominant hormone
progesterone estrogen
Symptothermal Method
Incorporates the assessment of multiple indicators of ovulation-BBT, and cervical mucus,increased libido,abdominal bloating,mittelschmerz ,breast tenderness,pelvic tenderness,pelvic or vulvar fullness,softer cervix located higher in the vagina
75-97% effective
Mechanical Methods
Male condom-86-97 % effective water based lubricants proper technique to apply protection from pregnancy and Std’s Female condoms-79-95% effective Proper technique to apply no prescription is needed--OTC
Male Condom
Applying Male Condom
Female condom
Diaphragm 80-94% effective Dome- shaped appliance made of rubber
with flexible rim that fits over cervix used with spermicidal jelly or cream physician will assess for size reassessment after birth of baby or
weight loss or gain. Proper technique to apply
Diaphragm
Insertion of Diaphragm
Spermicides
Chemical barrier to prevent pregnancy by killing sperm or neutralizing vaginal secretions
74-94% effective creams,jelly,melting suppositories,
foaming tablets,foam,and films
Intrauterine device-IUD
A device placed in the uterus to prevent pregnancy
98.5-99.2 % effective Placed and removed by health
professional check for side effects
Oral Contraceptives-Birth control pills
Act by inhibiting the release of an ovum,blocking the cyclical release of gonadotropin-releasing hormones and changing cervical mucus
95099.5% effective combined oral contraceptives-
estrogen and progestin progestin-only pill-minipill
Subdermal implant(Norplant)
Consist of 6 silastic capsules containing levonorgestrel-progestin
98.5-99.5% effective placed and removed by health
care provider 5 years
Long-acting Progestin injection
Depo-Provera long-acting progestin that blocks lh
surge,suppresses ovulation and thickens cervical mucus
97.7% effective Repeat every 80-90 days
Postcoital contraception
Emergency method-not to be used on a frequent or regular basis
reduces pregnancy rates by 75-85% oral contraceptives-MAP (morning
after pill) insertion of IUD abortions
Vasectomy Male sterilization the vas deferens is resected through
small incision in the scrotum resulting in blockage of the passage of the sperm
Health care provider must do in clinic,office or hospital
sperm count to check for sterility 99.5%effective
Tubal ligation
Surgical procedure done in hospital cuts, tied ,or cauterized the fallopian tubes preventing sperm from fertilizing ovum
99.2-99.6% effective
OTHER
QUESTIONS
Thank you
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