Family Planning Methods

FAMILY PLANNING METHODS

“DELAY THE FIRST, POSTPONE THE SECOND AND PREVENT THE THIRD”

Definition

An Expert committee (1971) of the WHO defined family planning as: “A way of thinking and living that is adopted voluntarily upon the basic of knowledge, attitudes and responsible decision by individuals and couples, in-order to promote the health and welfare of the family and thus contributes effectively to the social development of the country”.

Natural Methods

·           Abstinence

·           Coitus interruptus or withdrawal method

·           Lactational amenorrhea

Biological Methods

•            Calender (rhythm) method

•            Basal body temperature method

•            Cervical mucus method (billings method)

Chemical Method

•            Foams

•            Creams, jellies and pastes

•            Soluble films

I. Mechanical Family Planning Method

·           Male condoms

·           Female condoms

·           Diaphragms

·           Cervical cap

·           Intrauterine devices (IUD)

·           Sponge

Hormonal Contraceptive Method

Contraceptive skin patch

·           Vaginal ring

·           Pills (Combined and Minipill)

·           Injection

·           Implant

·           Emergency Pill

·            Intrauterine device

COPPER T:

Copper T is a small T-shaped, barium-sulphate incorporated, polythene device that is placed inside uterus to obtain birth control. The placement is done with a plastic syringe called the IUD inserter.

A fine copper wire weighing 120 mg, with a surface area of 208 mm², is wound round the upright limb of T. Two fine filaments are attached to the lower tip of the vertical limb. Copper T along with its inserter is supplied in a pre-sterilized packet. Copper T is inserted on the 6th day following the menstrual period. The ideal time for postpartum insertion of Copper T is immediately after delivery .Copper T is introduced 12 weeks after abortion, a doctor or a trained paramedical person carries out the insertion.

Types of IUDS

There are two types of IUDs:

•  Nonmedicated Intrauterine Devices •  Medicated intrauterine devices

Nonmedicated intrauterine devices or first generation IUDs

These are made out of polyethylene or other polymers they actually entered market in different shapes and sizes they are Loops, Spirals, Coils, Rings, Bows. The lippes loop is the popularly known and commonly used device in the developing countries.

Medicated IUDs

The copper IUDs are named as second generation IUDs there are several forms of copper devices available now

Newer Devices

·            Variants of the T device

·           Cu-T-220C

·           Cu-T-380 A or Ag

·           Nova T

·           Multiload devices ML-Cu-250, ML- Cu -375

Advantages of Intra Uterine Devices (IUDs)

·           This is the most cost-effective method

·           Easy to use

·           There is no interruption of intercourse

·           It can be removed immediately incase of any problems or not required

·            Fertility returns with the first ovulation cycle following IUD removal

Disadvantages

•            IUDs do not protect against STDs

•            Needs clinician for insertion and removal

•            It may lead to side effect in some women

II. Permanent Methods of Family Planning

a. Female Sterilization

Laparoscopic Sterilization

Female sterilization is performed through abdomen using a laparoscope, the laparoscopic tubal ligation is a surgical sterilization method in which female's fallopian tubes are clamped or cut.

Mini-lap (Mini Laparotomy) Operation

A small abdominal incision measuring 2.5-3 cm is performed under local anaesthesia through the small incision, by following the fundus of the uterus fallopian tubes are reached and hooked up, knots are applied in two places this procedure is repeated for both the tubes.

Advantages

·           It is a permanent method to prevent unintended pregnancies

·           It is effective immediately

·            Does not need any daily attention

·            Cost-effective in the long term

·            Does not affect sexual pleasure

Disadvantages

·           Need to face surgery and its consequences

·           More complicated than male sterilization

·           Does not protect against sexually-transmitted infections

·           Lifting heavy weights not permitted for at least 6 months to avoid the occurrence of incisional hernia

b. Male Sterilization

Vasectomy is a surgical procedure for permanent male sterilization. During the procedure the male vas deference are cut and then tied or sealed in a way to prevent sperm from entering into the seminal stream and thereby prevent fertilization.

Advantages

·           Permanent method of contraceptive

·           Highly effective method

·           Very safe surgical procedure

Disadvantages

·           Usually irreversible

·           It does not provide protection against sexually transmitted disease and infections including HIV

·            Need skilled medical personnel to perform the procedure

National Family Welfare Services

The national family welfare services includes primary, secondary, and tertiary care. The care is provided at different levels including District, Taluk, PHC, and PHU level.

Family Welfare Schemes

·           National family welfare programme

·           National population policy

·           National Rural health mission

·           Urban family welfare schemes

·           sterilization schemes

·           Child survival and safe mother hood programmes

·           Reproductive and child health programmes

·           Implementation machinery

·           Social marketing of contraceptives

·           Medical termination of pregnancy

·           Prevention of prenatal sex determination

Benefits for the Pregnant Women Maternity Benefit (Amendment) Act 2017

The maternity benefit amendment act has increased the duration paid maternity leave available for women employees from the existing 12 weeks to 36 weeks.

Modi Government Maternity Benefits

Pregnant women and lactating mothers will receive `6000, `5000 of which will be given in three instalments, provided that certain conditions related to completion of registration of pregnancy and birth, antenatal care and immunisation are met. The scheme is also restricted to the first live birth.

Janani Suraksha Yojana

The aim of JSY Scheme is to encourage poor pregnant women to give birth in registered health institutions. Mothers receive `1600 when they arrive and register at the health institution to give birth. The ASHA receives `600 when accompanying a women to a health institution for delivery.

Dr. Muthulakshmi Reddy Maternity­ Benefit

Dr. Muthulakshmi Reddy Maternity benefit scheme fund is enhanced with `12000. the cash assistance will be given in three instalment. `4000 who avails all required antenatal services during pregnancy in PHC, `4000 is given to the mothers who deliver in the government institution, `4000 at the completion of immunization for the child upto three doses.

Dikri Yojana

Financial assistance for those families without male child and those adopted permanent family planning measures with one or two female children.

Varumun Kappom Scheme

The aim of the scheme is to reduce maternal mortality and morbidity of the pregnant and expected mothers and utilising the vast resources of health care providers with the involvement of federation of obstetrics and gynaecological society of India.

BPL Desi Ghee Scheme

Below poverty line pregnant women in Rajasthan are entitled to receive five litres of desi ghee after their first institutional delivery. Three litres to be given after the first ANC test (between 4 to 6 month of pregnancy) and the other two litres at the time of discharge after the delivery.

Kalewa Yojna (KY)

Kalewayojna is funded by NHRM and implemented by DWCD where in free warm and nutritious food is provided for two days to women who have delivered in health facility especially at Community health centre level. This food is cooked by self-help groups.

Janani Express Yojana

Providing benefit of transportation to expectant mothers for institutional deliveries to deal with emergency circumstances during the pre and post delivery period.