Contraception

presented by
Ms. Sonali Gupta
lecturer
[Link] (n) chn
ninps
 INTRODUCTION

NEEDS AND IDEALS

CONTENTS CONTRACEPTIVE
METHODS
CONTRACEPTION =Against
conception
The preventive methods to
help women avoid unwanted
pregnancies are called
contraceptive methods.
NEED FOR
CONTRACEPTION

•TO AVOID UNWANTED PREGNANCIES

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CONTRACEPTIVE METHODS
SPACING METHODS TERMINAL
METHODS
1. BARRIER METHODS 1. MALE
FERTILIZATION
2. IUD’S 2. FEMALE
FERTIZATION
3. HORMONAL
4. EMERGENCY

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BARRIER METHODS
• MALE CONDOMS
• FEMALE CONDOMS
• SPERMICIDES
• DISAPHRAGM

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MALE CONDOM
• MOST COMMONLY USED
• ALSO KNOWN AS CONDOM

This Photo by Unknown Author is licensed under CC BY 8

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INTRAUTERINE DEVICES
• 1st generation: -Inert/non-medicated devices Eg:
lippes loop(left as long as required)
• • 2nd generation: -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)

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CONTRAINDICATIONS
• Timing: At the time of menstruation post partum,
post puerperal Side effects:
1)Bleeding
2)pain
3)PID
4)perforation of uterus
5)Ectopic pregnancy

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HORMONAL PILLS
• Combined pill: -
• combination of oestrogen and progestogen -MALA-
N,MALA-D(0.15mg levonorgestrel & 0.03mg ethinyl
oestradiol)
• Progestogen only pill -used in people above 40
years of age & CVS problem
• Post coital contraception: -Levonorgestrel -Ulipristal
-Mifepristone

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ADVERSE EFFECTS
• Cardiovascular effects
• Carcinogenesis
• Metabolic effects
• Liver adenomas
• Weight gain
• Breast tenderness

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DEPOT FORMULATIONS
• Injectables:
DMPA-150 mg IM inj every 3 monthly
Subdermal impants: Norplant-6 silastic capsules, each
containing 35 mg of levonorgestrol
protection for 5 years

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Miscellaneous
ABSTINENCE METHOD is the only method that is
100% effective
• Coitus interruptus
• Rhythm method
• BBT
• Cervical mucus
• Symptothermic method

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Emergency
• Emergency Contraception
• Hormones
• IUD
• Anti-progesterone

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Sterilization
• Permanent surgical contraception.
• Voluntary sterilisation.
• Male – vasectomy
• Female - tubal occlusion/tubectomy

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Terminal methods eligible
• Permanent methods
• 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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 Vasectomy
A segment of vas deferens of both the sides are resected and
both the ends are ligated.
• Methods:
1. No-Scalpel Vasectomy.
2. Electrocoagulation.
3. Fascial interposition.
Selection of candidate:
1. Psychologically adjusted.
2. Sexually active.

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Male sterilization caution
• Operative
• Sperm granules
• Spontaneous recanalization
• 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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Male sterilization complications
immediate
• Wound
• sepsis
• Scrotal hematoma
• Remote
• Impotency
• Granuloma
• Pain and discomfort
• Testicular cancer

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 Female sterilization
PERMANENT BIRTH CONTROL (CONTRACEPTION) FOR
FEMALES INVOLVES HAVING A PROCEDURE TO PREVENT
PREGNANCY PERMANENTLY.
OPTIONS INCLUDE:
●TUBAL LIGATION (COMMONLY TERMED HAVING THE
"TUBES TIED")
●BILATERAL SALPINGECTOMY (COMPLETE REMOVAL OF
THE FALLOPIAN TUBES)
THESE ARE BOTH SAFE AND HIGHLY EFFECTIVE
OPTIONS.
Tubectomy
During ovulation, an egg is released Another approach, called a bilateral
from the ovary. The fallopian tubes salpingectomy, involves removing
are the passageway for the egg to both of the fallopian tubes
travel from the ovary to the uterus , completely. These
and where the egg can be fertilized procedures prevent the egg and
by sperm. During a tubal ligation, sperm from meeting, thus
the fallopian tubes are both cut, preventing pregnancy. Both of these
separated and tied, or sealed shut. methods may also reduce your risk
of developing ovarian cancer in the
future.

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TYPES OF TUBECTOMY
Laparoscopy is done in the operating room any time other than
after childbirth. It requires general anesthesia.
●Mini-laparotomy is performed in an operating room, using
general or regional anesthesia, often within one to two days after
giving birth.
●Permanent birth control procedures can also be performed at the
time of a cesarean birth ("C-section"). No additional incisions are
required
FAMILY PLANNING
India was the first country in Eligible couple: -Currently married couple where
the world to have launched a in the wife is in the reproductive age (15-45
National Programme for
Family Planning in 1952. •
years) • Unmet need of contraception: -Women
Over the decades, the with unmet need are those who are fecund and
programme has undergone sexually active but are not using any method of
transformation in terms of contraception, and report not wanting any more
policy and actual programme children or wanting to delay the next child. -The
implementation and concept of unmet need points to the gap
currently being repositioned
to not only achieve
between women's reproductive intentions and
population stabilization goals their contraceptive behaviour -Lack of awareness
but also promote and accessibility
reproductive health and
reduce maternal, infant &
child mortality and morbidity

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INITIATIVES
• DOORSTEP DELIVERY OF CONTRACEPTIVES
• INCENTIVES FOR ASHA AND PEOPLE FOR SPACING THE PREGNANCIES
• INCENTIVES FOR ASHA AND PEOPLE FOR PERMANENT STERILIZATION
• AWARENESS PROGRAMS FOR BIRTH SPACING AND CONTRACEPTION

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Services providers and services
o IUCD 380 A AND CU IUCD 375
o TRAINED & CERTIFIED ANMS, ASHAS, LHVS, SNS
AND & CERTIFIED MBBS DOCTORS & SPECIALIST
DOCTORS
o COMBINED ORAL CONTRACEPTIVE (MALA-N)
o CONDOM
o EMERGENCY CONTRACEPTIVE PILL (EZY PILL)
o MINILAP LAPAROSCOPIC STERILIZATION
o NSV: NO SCALPEL VASECTOMY

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Thank you