Reproductive Health Care and Family Planning
Ability to reproduce and
Safe motherhood – safe
pregnancy and child birth with resultant safe mother and infant
Safe sex with no fear of
pregnancy and of controlling diseases.
Practices that help individuals or couples achieve the following:
Avoid unwanted pregnancy
Achieve wanted pregnancy
and child birth
· Spacing the pregnancies
Determine the number of
children in the family
Choose the age for
Measures designed to prevent pregnancy due to coital act either
temporary or permanenty
The menstrual cycle is divided into three phases for purpose of
assessment of likelihood of conception.
Phase-1: relatively infertile phase last from onset of
menstruation until the time of preovulation.
Phase-2: fertile phase. last from seven days preovulation to 48hrs
Phase-3: absolutely infertile phase lasts from 48hrs after
ovulation until the onset of menstrual, bleeding about 10 – 16 days.
Methods to determine the phase of the cycle:
Testing cervical mucus:
During phase 1 and 3, the mucus is scanty , thick and breaks
quickly when stretches. During phase 2, the mucus is more abundant thick and
clear and stretches easily.
Measuring basal body temperature:
Basal body temperature should be measured in the morning. A
sustained rise of temperature of 0.2 to 0.6 C indicates that ovulation has
Abstinence Complete abstinence
Coitus interruptus - During sex the man withdraws his penis
from the vagina before he ejaculates
It suppresses ovulation and thickens cervical secretions. It is
effective in women less than 6 weeks of postpartum, who are breastfeeding.
It reduces sperm transport and changes the endometrium thus unfavorable
for fertilization. It is effective for women who have had unprotected
intercourse within 72 hours and for victims of sexual assault.
Natural method that does
not require devices or medicine in the body.
There are no side
No cost. Is morally and
Better than not using
any birth control method
Types: -Latex (plain or treated with spermicide)
The spermicide will
immobilize or kills sperm providing added protection if breakage or leaks
Direction of use:
The condom should be applied before vaginal penetration and should
cover the entire length of the erected penis. Adequate lubrication should be
used and the condom should be removed immediately after ejaculation and
i) flat spring ii) Coil spring iii) Arching spring
The diaphragm should lie just posterior to symphysis pubis and
deep into the cul-de-sac, so that the cervix is completely covered and behind
the centre of the membrane. Spermicide should be applied before each coital
act. The diaphragm should left in place for a maximum of 8 hrs after the last
It is a dome shaped cup
that fits over the cervix.
It cannot be left in the
cervix for more than 48 hours.
Only women with normal
pap smear can use.
They are agents that cause destruction of the sperm cell membrane;
thereby affecting mobility.
Creams and Jellies
Films & sponges
All contain spermicidal agents usually nontoxic.
They are flexible plastic device medicated with slowly released
hormones. Copper – released devices interferes with the ability of sperm to
pass through the uterine cavity.
Progestin releasing device thicken the cervical mucus and thin the
endometrial lining thus prevents conception.
Copper - T 380 A
Levonova / Mirena
Bladder empty, lithotomy
speculum is introduced in vagina and cervix are cleansed by antiseptic lotion.
Anterior lip grasped by
Allis forceps. Uterine sound passed through the cervical canal to normal
position of uterus and length of cavity.
Insert the device
through the cervical Os up to the fundus and after positioning, inserter is
withdrawn keeping the plunger in position.
Excess of nylon thread
is to be cut.
Uterine and pelvic
They consist of synthetic oestrogen and progestin preparations,
act by suppressing lactation, thickening of cervical mucus and alteration of
Breast fullness or
If one pill is missed,
instruct the patient to take two pills at the next scheduled time and complete
the pack as usual.
If two or more
consecutive pills are missed, instruct the patient to finish the package of
They cause suppression of ovulation, thickening of cervical mucus
and alteration of the endometrium.
They cause suppression of ovulation, thickening of cervical mucus,
alteration of endometrium and change in tubal motility.
It consists of thin, flexible capsules filled with levonorgestrel
that are inserted under the skin of women’s arm. They cause suppression of
ovulation, thickening of cervical mucosa, alteration of the endometrium and
change in tubal motility.
Weight gain or loss
Irregular bleeding or
It is appropriate to couples who desire permanent sterilization.
1. FEMALE: Tubal ligation OR Tubectomy
2. Interval tubal
Pomeroy procedure performed using a 3 to 4 cm suprapubic incision under local
anaesthesia with sedation.
rings are placed around loop of the tube, resulting in necrosis and occlusion.