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Similar to contraception obg nursing-171119180501.pptx
contraception obg nursing-171119180501.pptx
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- 2. • Contraception=against conception •The preventive methods to help women avoid unwanted pregnancies are called contraceptive methods.
- 3. Need for contraception •To avoid unwanted pregnancies • To regulate the timing of pregnancy • To regulate the interval between pregnancy
- 4. Ideal contraceptive??? • Safe •Effective • Acceptable • Reversible • Inexpensive • Long lasting • Requires little or no medical supervision
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- 6. Contraceptive methods Spacing methodsTerminal methods 1)Barrier 1)Male fertilisation 2)IUDs 2)Female fertilisation 3)Hormonal 4)Emergency contraception
- 7. Barrier methods • Malecondoms • Female condoms • Diaphragm • Spermicides
- 8. Male condom • Mostcommonly known and used contraceptive • Better known in India as NIRODH
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- 11. spermicides • Spermicides aresurface active agents which attach themselves to spermatozoa and kill them. • Available in various forms like 1. Foams 2. Creams 3. Suppositories 4. Soluble films
- 12. Intra uterine devices •1st generation: -Inert/non-medicated devices Eg:lippes loop(left as long as required) • 2nd genration: -Metallic IUDs -Cu-T380 A(10 years) -Nova T(5 years) -Multiload devices • 3rd generation: -Hormonal IUDs -progestasert(2 years) -Mirena(LNG-20)(10 years)
- 13. • Contraindication • Timing:Atthe time of menstruation post partum,post pueperal Side effects:1)bleeding 2)pain 3)PID 4)perforation of uterus 5)Ectopic pregnancy
- 14. Hormonal contraceptives • Combinedpill: -combination of estrogen and progestogen -MALA-N,MALA-D(0.15mg levonorgestrel & 0.03mg ethinyl estradiol) Prgestogen only pill -used in people above 40 years of age & CVS problem Post coital contraception: -Levonorgestrel -Ullipristal -Mifepristone
- 15. Adverse effects • Cardiovasculareffects • Carcinogenesis • Metabolic effects • Liver adenomas • Weight gain • Breast tenderness
- 16. Depot formulations • Injectables: DMPA-150mg IM inj every 3 monthly Subdermal impants: Norplant-6 silastic capsules, each containing 35 mg of levonorgestrol -protection for 5 years
- 17. misc • Abstinence:only methodthat is 100% effective • Coitus interuptus • Rhythm method • BBT • Cervical mucus • Symptothermic method
- 18. Terminal methods • Permanentmethods • One time method -Guidelines • Husbands age:25-50 years • Wife’s age:20-45 • 2 living children at the time of operation
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- 20. Male sterilisation • Complications: •Operative • Sperm granules • Spontaneous recanalisation • Psychological Post op advice: Not sterile till 30 ejaculations Avoid bathing till 24 hours of operation Avoiding heavy weights and wearing a langot
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- 22. Evaluation of contraceptivemethods • Pearl index: -failures per 100 women years of exposure Pearl index= total accidental pregnancies X1200 total months of exposure Life table analysis:failure rate for each month of use.then the cumulative rate is found out
- 23. Family planning inindia • India was the first country in the world to have launched a National Programme for Family Planning in 1952. • Over the decades, the programme has undergone transformation in terms of policy and actual programme implementation and currently being repositioned to not only achieve population stabilization goals but also promote reproductive health and reduce maternal, infant & child mortality and morbidity
- 24. Whom to target??? •Eligible couple: -Currently married couple where in the wife is in the reproductive age (15-45 years) • Unmet need of contraception: -Women with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child. -The concept of unmet need points to the gap between women's reproductive intentions and their contraceptive behaviour -Lack of awareness and accessibility
- 25. UNMET NEED OFCONTRACEPTION Urban Rural Total NFHS 3 INDIA 12.1 13.2 12.9 13.9 MP 13.5 11.6 12.1 12.1 Table 1.1:Data showing the unmet need of contraception in people of INDIA and MP(NFHS 4)
- 26. Initiatives • Doorstep deliveryof contraceptives • Incentives for ASHA and people for spacing the pregnancies • Incentives for ASHA and people for permanent sterilisation • Awareness programs for birth spacing and contraception
- 27. Family planning methodServivce provider IUCD 380 A and Cu IUCD 375 Trained & certified ANMs, LHVs, SNs and doctors Combined Oral Contraceptive (Mala-N) Trained ASHAs, ANMs, LHVs, SNs and doctors Condoms Trained ASHAs, ANMs, LHVs, SNs and doctors Emergency Contraceptive Pill (Ezy Pill) Trained ASHAs, ANMs, LHVs, SNs and doctors Minilap Trained & certified MBBS doctors & Specialist Doctors Laparoscopic Sterilization Trained & certified MBBS doctors & Specialist Doctors NSV: No Scalpel Vasectomy Trained & certified MBBS doctors & Specialist Doctors
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