Republic of the Philippines

Region 2
UNIVERSITY OF LA SALETTE, INC.
Santiago City, Isabela

IN PARTIAL FULFILLMENT OF THE COURSE REQUIREMENT IN MCN (MATERNAL

AND CHILD NURSING) 1

AN UPDATE ON FAMILY PLANNING

Submitted to:

MRS. JEANE C. LAURELIO, RM, RN

Submitted by:

KHEROVINE C. TAYABAN
 TYPES OF FAMILY PLANNING

1. NATURAL METHODS- also known as FERTILITY AWARENESS-BASED

METHODS (FAB)
-these methods focus on the awareness of the beginning and end of the fertile time
of woman’s menstrual cycle.

2. HORMONAL CONTRACEPTIVE METHODS

LOW-DOSED COMBINED ORAL CONTRACEPTIVES (LOW-DOSE COCs)
-this is also known as PILLS. These COCs DO NOT DISRUPT AN
EXISTING PREGNANCY.
TWO TYPES:
1. 28-day pack- 21 “active pills’ that contains hormone and 7
“inactive/remainder”.
2. 21-day pack- contains “active” hormones estrogen and
progesterone. When finishing the 21 tablets, 7 days rest period
is required before starting another pack. Woman taking it is
safe within the 7 days rest period so back up/abstinence from
sex is not advised.
OTHER COMBINED CONTRACEPTIVES
1. CONTRACEPTIVE PATCH- it is a form of contraceptive applied to
the skin. It contains estrogen progestin similar to the natural hormones
in a woman’s body and released slowly in the bloodstream.
MECHANISM OF ACTION
 Inhibiting ovulation
 Thickening of cervical mucus
ADVANTAGES
 Effective (99%)
 No daily pill intake
 Regulates menstrual flow such that monthly cycles are regular,
lighter, with fewer days of bleeding
 Can stopped at any time by the client
 Does not interrupt sex
 Increased sexual enjoyment as there is no need to worry about
getting pregnant
 Convenient and simple to use
 Safe
 Has significant non- contraceptive benefits to similar to COCs
  Monthly periods regular and predictable
 Reduce symptoms of gynecologic conditions such as painful
menses and endometriosis
 Reduce the risk for ovarian and endometrial cancer
 Decreases risk of iron deficiency anemia
 Can be used at any age from adolescence to menopause
DISADVANTAGES
 Maybe less effective in women with body weight greater than 90
kg
 Affects quantity and quality of breast milk
 Has to replace patch weekly
 Does not protect against sexually-transmitted infections
 Increased risk to the users over 35 years old who smoke and have
other health problems
WHO CANNOT USE THE PATCH
 Pregnant
 Smoking and are 35 years old or over
 35 years old or over and stopped smoking less than a year ago
 Breastfeeding
 Overweight
 History of thrombosis
 Heart disease
 Being a combined contraceptive like the COC, the eligibility
for the use is the same as that of the COC.
POSSIBLE SIDE EFFECTS
These are not signs of illness and not all women will experience them.
These include:
 Skin irritation or rashes at the side of the patch.
 Headache
 Menstrual bleeding irregularities
 Fluid retention
 Nausea
 Breast tenderness
WHEN TO START
 Any day within the first five days of the menstrual cycle
(first day is preferable).
 Any time it is reasonably certain that she is not pregnant. If
more than five days since menstrual bleeding started, she
can start using the patch but should avoid unprotected sex
 for the next seven days. Condom use is advisable at this
time.
PATCH CYCLE:
 Apply a new patch once a week, every week, for three weeks (21
days). Stop for seven days (patch-free days).

COMBINED INJECTABLE
-The combined injectable is a contraceptive containing estrogen and progestin in an
injectable form.
-The current available combined injectable in the country contains
Norethisterone 50 mg and Estradiol Valerate 5 mg in oily solution.

MECHANISM OF ACTION
 The contraceptive effect is primarily on ovulation inhibition and
thickening of the cervical mucus.
 The contraceptive effect is similar to that achieved by daily intake
of the COC.
ADVANTAGES
 Does not required daily action. No need to take a pill daily.
 Private. No one else can tell that the woman is using a contraceptive.
 More regular monthly bleeding as compared to DMPA.
DISADVANTAGES
 Requires injection every month.
 Delay return to fertility after the woman stops the method. It takes an
average about one month longer than with the COC.
 Does not protect against sexually transmitted infections (STIs),
including HIV.
EFFECTIVENESS
 Correct use (no missed or late injection):99%
 Typical use (some missed or late injections): 97%
POSSIBLE SIDE EFFECTS
 change in monthly bleeding, which lessen within three months of
starting injections include:
 Lighter and fewer days of bleeding
 Irregular
 Infrequent or prolonged bleeding
 No monthly bleeding

 Headaches
 Dizziness
  Breast tenderness
WHO CANNOT USE
 Pregnancy
 Breastfeeding an infant that is less than six months old
 Smoke cigarettes and are 35 years old or over
 Hypertension
 Migraine headaches
 Serious diseases of the liver, heart, or blood vessels
 Breast cancer
 Undiagnosed abnormal vaginal bleeding
HOW TO USE
 First injection is given on the first day of the menstrual cycle.
 Succeeding injections are given every 30 +/- 3 days.
 The injectable must be stored at controlled room temperature (15-30
C). Do not freeze.
 Administration:
 Follow infection prevention measures for administering
injections.
 Slow deep intramuscular injection preferably intragluteal,
alternatively into the upper arm.
 Place a plaster over the injection site after injection to prevent
any reflux of the solution.
 Client Instructions
 What to expect:
-Vaginal bleeding episode will occur wit in one or two weeks after the
first injection. This is normal and if use is continued, bleeding episodes
will occur at a 30 day interval. Pregnancy should be ruled out if no
withdrawal bleeding occurs within 30 days after an injection.

 Follow-up:
- Return to the clinic every 30 days for your next injection. Try to come on time.
- If, for some reason, the next injection was not given after 30 days, abstain from
sexual intercourse or use a condom until you get the next injection.
- come back to the clinic no matter how late you are. You may still be able to use the
injectable.
- Return to the clinic at any time if:
 You develop any of the warning signs.
 You have any questions or problems.
 You think you are pregnant.
  PROGESTIN-ONLY PILLS( POPs)
-also known as "the minipill"
-Contains only progestin hormone, does not contain estrogen.
- can be very effective during breastfeeding, less effective for women not breastfeeding.
KINDS OF POPs AVAILABLE:

0.5 mg lynestrenol

75 ug desogestrel
o BOTH ARE AVAILABLE IN A 28-TABLET
PACKAGE
 PROGESTIN-ONLY INJECTABLES (POIs)

Warning Signs

The combined injectable contraceptive has the following warning signs similar to COCs. The
client is advised to immediately return to the clinic or consult a physician when any of the
following occurs:

J - Jaundice

A - Abdominal pain (severe)

C - Chest pain

H - Headaches (severe)
E - Eye problems such as brief loss of vision, seeing flashes of light or zigzag lines

S - Severe leg pains

TYPES OF IUD

Common types of IUDs available worldwide as follows:

 Copper-bearing, which includes the TCu380A, (TCu380A with safe load; and TCu 200, the
multiload ( MLCu 250 and Cu375), and the Nova T.

 Medicated with a steroid hormone, such as Mirena@, the levonorgestral-releasing

intrauturine system (LNG-IUS)

The main IUD featured in this learning package is the TCu380A (or Copper T), which is:

 Widely used

 Well known for its effectiveness, ease of insertion and removal, wide margin safely,
acceptability to clients, and low cost

 Effective for at least 12 years