Family Planning

Methods(Control of Fertility)

Prof. Dr. Rabea M. Ali

• Family Planning Services:
Defined as "educational, comprehensive
medical activities which enable individuals to
determine the number and spacing of their
children.
 METHODS OF CONTRACEPTION:

• Natural birth control.

• Barrier methods, include the diaphragm, cervical
cap, male condom, and female condom and
spermicidal foam and sponges.
• Long-acting reversible contraception, such as intra
uterine device (IUD).
• Hormonal contraception, including the birth control
pill, the vaginal ring, the contraceptive skin patch.
• emergency contraception.
• permanent contraception, such as vasectomy and
tubal ligation.
 The Natural Family Planning Methods
• Natural family planning is a form of birth
control that doesn't involve pills or devices. As
a result, it doesn't have side effects.
 Types of Natural Family Planning
• Basal Body Temperature (BBT) Method:
temperature can rise between 0.5 and 1
degree when ovulating. With this method,
take temperature before get out of bed each
morning, before have anything to eat or drink.
BBT by itself isn't a good way to prevent
pregnancy because charting temperature tells
when ovulation has already happened.
• Rhythm method: One of the oldest ways of
natural family planning, this is based simply on
the calendar. A woman's normal menstrual
cycle lasts between 28 and 32 days. Ovulation
usually happens around day 14. So must be
avoid unprotected sex.
• Cervical mucus or ovulation method: check
this by gently placing middle finger into vagina
and pushing it. For the first few days after
period, find vagina is dry and cannot feel any
mucus.
• When ovulating the mucus of cervix is clear,
stretchy, and wet, like raw egg whites.
• Sympto-thermal method: combine several
methods, usually BBT and cervical mucus.
Using more than one method can give a better
idea what's going on in the body.
• Breastfeeding: (lactational infertility): gave
birth less than 6 months ago, breastfeeding
exclusively (no formula, no solid food, only
breast milk), haven’t had a period since giving
birth
 Advantages of A Natural Family Planning :

• It doesn't cause any side effects.

• Natural family planning is acceptable to all faiths and
cultures.
• Natural family planning can be used either to avoid
pregnancy or to become pregnant.
• It doesn't involve chemicals or physical products.
• It can help to recognize normal and abnormal vaginal
secretions, so can be aware of possible infection.
• It involves partner in the process, which can help increase
feelings of closeness and trust.
 Disadvantages:

• Natural family planning does not protect against STIs

such as chlamydia or HIV.
• need to avoid sex, or use contraception such as
condoms, during the time might get pregnant, which
some couples can find difficult.
• It can be much less effective than other methods of
contraception if the methods aren't followed
accurately.
• need to keep a daily record of fertility signs.
• It's not suitable for every woman.
• Stress, illness, travel, lifestyle and hormonal
treatments can disrupt fertility signs
 Barrier Methods
• Barrier Methods: include the diaphragm, male
condom, and female condom and spermicidal
foam, barrier methods are used only when
have sexual intercourse. Be sure to read the
instructions before using a barrier method, It
is very important that use a barrier method
correctly every time have sex.
• A contraceptive diaphragm: is a circular dome
made of thin, soft silicone that's inserted into
the vagina before sex.
• MALE CONDOM
• The condom is a rubber sheath worn over the
erected penis to prevent sperms from
entering the woman's uterus.
• The Female Condom: is a birth control
(contraceptive) device that acts as a barrier to
keep sperm from entering the uterus. The
female condom is a soft, loose-fitting pouch
with a ring on each end.
• Spermicide: is a chemical that inactivates
sperm. It comes in different forms, including
foams, creams, gels, suppositories.
 Advantages of Barrier Methods
• Protect from STD
• Do not affect a woman's or man's future fertility.
• Are only used at the time of sexual intercourse.
• Are safe for a woman to use while she is
breastfeeding.
• Do not affect other health conditions, such as
high blood pressure or diabetes .
• Are less expensive than hormonal methods of
birth control, and some are available without a
prescription.
 Disadvantages

• Some couples say that condoms affect the

spontaneity of sex. Some feel that there is a decrease
in sensation. It can sometimes slip off or split.
• With the male condom, withdrawal is necessary
almost immediately after ejaculation, with care taken
not to spill any semen.
• Some people may be allergic to the condom’s latex or
plastic, causing discomfort or irritation.
• A condom can be used only once. Condoms should
never be reused.
 Intra-Uterine Device
• "IUD"intrau-terine device." Shaped like a "T",
an IUD fits inside uterus. It prevents
pregnancy by stopping sperm from reaching
and fertilizing eggs.
• There are 2 types: hormonal and copper.
• Hormonal IUD releases the hormone
progestin into the body. It prevents pregnancy
by making the mucus in cervical canal too
thick for sperm to get through, by stopping
ovaries from releasing eggs, and by preventing
a fertilized egg from attaching to the lining of
uterus.
• The copper IUD is wrapped in thin copper
wire that’s toxic to sperm. It also keeps a
fertilized egg from implanting in the uterus
 Advantage of IUD
• They last a long time.
• It is highly effective, with a 98-99 percent
success rate over five years of IUD use
• They’re safe to use during breastfeeding.
• Its action lasts for ten years if it is not removed
in between
• It doesn’t interfere with intercourse
• It does not cause weight gain
• It does not usually affect mood or sex drive
 Disadvantages of IUD
• It doesn’t offer any protection against sexually
transmitted infections (STIs)
• There is a slight risk of acquiring uterine
infection during IUD insertion within 20 days
of the procedure.
• Uterine perforation may occur during
insertion. This may manifest as lower
abdominal pain, Perforation will require
surgical removal.
 Hormonal Contraception
• There are a number of forms of hormonal
contraception, including the birth control pill,
contraceptive skin patch
• The hormones in contraceptives don’t only
prevent ovulation. Some also prevent fertilized
eggs from implanting into the womb. Others
cause the mucus in the cervix to become thick
and sticky, making it harder for the sperm to
move and reach the egg cell.
 The Oral Contraceptive Pill
• The oral contraceptive pill: is a type of birth
control that is designed to be taken orally by
women. It includes a combination of an
estrogen and a progestogen (specifically a
progestin).
 The Contraceptive Skin Patch
• The Contraceptive Skin Patch: is about 5 cm in
size, and very thin. It can be placed on the
woman’s behind, belly, the outside of her
upper arm. It’s important to make sure that it
sticks to the skin properly and doesn’t rub
against clothing too much. Activities like
having a shower, a bath or swimming usually
don’t make it come off.
 The Advantages of Hormonal
Contraceptives

• The reliability: Studies have shown that only

about 1 out of 1,000 women get pregnant per
cycle if they take the pill or use a
contraceptive skin patch properly.
• Hormonal contraceptives can also relieve
period pain. If a teenage girl or woman has
acne, the hormones may improve her skin too.
Disadvantages of Hormonal Contraceptive

• Have side effects such as headaches, nausea,

and vaginal yeast infections.
• The hormones can also cause spotting
between periods or lead to mood swings, and
may reduce women’s sexual desire.
• And there is a small risk of blood clots forming
(thrombosis). This risk is higher in women over
the age of 40, as well as in women who
smoke, are very overweight.
 Emergency Contraception
• Emergency contraception refers to methods of
contraception that can be used to prevent
pregnancy after sexual intercourse. These are
recommended for use within 5 days but are
more effective the sooner they are used after
the act of intercourse.
 In What Situations Can Emergency Contraception be Used?

• When no contraceptive has been used.

• Sexual assault when the woman was not
protected.
• Condom breakage, or incorrect use.
• Three (3) or more consecutively missed
combined oral contraceptive pills.
• Failed withdrawal (e.g. ejaculation in the
vagina or on external genitalia).
• Expulsion of an intrauterine contraceptive
device (IUD) or hormonal contraceptive
implant.
 Advantages of Emergency Contraception

• Emergency contraception is safe and effective

in preventing pregnancy after unprotected
sex.
• Emergency contraception is private. It is
choice if partner knows about it.
• Emergency contraception is very effective
when used early, with only 3% of women
becoming pregnant if used within 24 hours of
unprotected sexual intercourse.
 Disadvantages of Emergency Contraception

• It does not work if women are already

pregnant.
• It has a limited time frame of 5 days following
unprotected intercourse.
• Women still have a small chance of getting
pregnant.
 Permanent Contraception
Permanent contraception is methods of
sterilization that prevent pregnancy
permanently.

The procedure for men is a vasectomy

and for women it is tubal ligation.
• A vasectomy :
Is a procedure to cut and tie the tubes (vas
deferens) that carry the sperm up from the
testicles.
Men who have had vasectomies still ejaculate
and produce semen but since there is no
sperm in it, the woman’s egg can’t be
fertilized.
 Advantages of Vasectomy
• Vasectomy are permanent and one of the
most effective kinds of birth control out there
— more than 99% effective at preventing
pregnancy.
• Vasectomy are super convenient, don’t have
to pay attention to during sex, so it won’t
interfere with the action
 Disadvantage of Vasectomy
• Vasectomies are meant to be permanent. Even
if get vasectomy reversed, fertility may never
come back.
• Vasectomy reversal surgery is complicated and
expensive.
• Vasectomies are very safe, and most people
don’t have any problems. But all medical
procedures have some possible risks.
• Not protect from STD
• Tubal ligation: is a procedure to close both
fallopian tubes in a woman. This means that
sperm can’t get to the egg to fertilise it.
• The tubes are closed using rings or clips or by
cutting and tying.
 Advantages:

• More than 99% effective at preventing

pregnancy.
• Blocking the fallopian tubes and removal of
the tubes should be effective immediately –
but use contraception until next period.
• It will not affect sex drive or interfere with sex.
• It will not affect hormone levels.
 Disadvantages:

• It does not protect against STIs.

• It can fail – the fallopian tubes can rejoin and
make fertile again, although this is rare.
• There's a very small risk of complications,
including internal bleeding, infection or
damage to other organs.
• If get pregnant after the operation, there's an
increased risk it'll be an ectopic pregnancy
 Reference
• Glasier A, Cameron ST, Blithe D, Scherrer B, Mathe H,
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10.1016/j.contraception.2011.02.009. Epub 2011 Apr 2.
• (2) Effect of BMI and body weight on pregnancy rates
with LNG as emergency contraception: analysis of four
WHO HRP studies.
• Festin MP, Peregoudov A, Seuc A, Kiarie J, Temmerman
M. Contraception. 2017 Jan;95(1):50-54. doi:
10.1016/j.contraception.2016.08.001. Epub 2016 Aug
12.
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contraceptive: Efficacy, safety, and personal
considerations. In RA Hatcher et al., eds.,
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• http://www.nhs.uk/Conditions/contraception-
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