pills & copper t

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Temporary Family Planning Methods Presented by Mamata Manandhar M Sc Nursing 2011 Batch

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Page 1: Pills & Copper T

Temporary Family Planning Methods

Presented byMamata Manandhar

M Sc Nursing2011 Batch

Page 2: Pills & Copper T
Page 3: Pills & Copper T

Oral Pills• Oral contraceptive widely known as "pill" has

become the most popular spacing method since early sixties.

• Oral pills are the most effective reversible, safe and convenient form of contraceptives.

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Oral Pills contd..

• It is estimated that over 200 million women from the developed and developing countries are using" pills" .

• Combined pills are the most popular oral contraceptives pills containing two synthetic hormones – an estrogen and progesterone.

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Oral Pills contd..

• In Nepal, two brands of low-dose combined pills are marketed by Nepal CRS Company under the brand name of Sunaulo Gulf and Nilocon White.

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Health benefits and advantages

• Highly effective reversible contraception

• Menstrual cycle regulation

• Reduce menstrual cramps

• Decreases risk of iron deficiency (anemia)

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Contd..• Decreases risk of ovarian, endometrial cancers

and ovarian cysts

• Protection against PID

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Disadvantages/risks

• Requires regular and dependable supply.

• Client dependent

• Offers no protection against STDs/HIV.

• Not most appropriate choice for lactating women

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Precautions

• Has a suspected pregnancy by history, symptoms, or signs

• Six weeks to 6 months postpartum

• Taking anti-seizure drugs for epilepsy or rifampin for tuberculosis

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Contraindications

• Current or past history of venous thrombo -embolic disorders

• Breastfeeding

• Breast cancer

• Active liver disease

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Contd..• Smoking over 15 cigarettes a day and over age

35

• High blood pressure

• Headaches

• Women with ischemic or valvular heart disease.

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Timing of initiation

• If pills are begun within 5 days of the start of menses, no backup method is needed.

• If pills are begun after the fifth day of the menstrual cycle, a backup method must be used for 7 days.

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Contd..Postpartum• Breastfeeding mothers

• Non-breastfeeding mothers (after 3 weeks postpartum)

• Within 7 days following spontaneous or induced first trimester abortion

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Instructions for missed pills

• If she forgets to take a pill, she should take that pill as soon as she remembers and then take the next pill as usual.

• If she forgets to take two pills, she should two pills on each of the next two days and use a condom along with the pills for the rest of the cycle.

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Contd…

• If the woman misses three pills, another form of contraception should be taken immediately

• If two menstrual periods are missed completely, the woman should be examined for pregnancy.

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IUCDs• The copper-bearing intrauterine device (IUD)

is a small, flexible plastic frame with copper sleeves or wire around it.

• A specifically trained health care provider inserts it into a woman’s uterus.

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Contd..• IUDs are a form of long-acting reversible

contraception, which is the most effective type of reversible birth control.

Types of IUDs– Copper-releasing (Copper T 380A)– Progestin-releasing

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Effectiveness of IUCD

• There is less than 1 pregnancy per 100 women using an IUD over the first year

• Studies have found that the TCu-380A is effective for 12 years.

• Return of fertility after IUD is removed.

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Mechanisms of Action

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Benefits

• Highly effective (0.6B0.81 pregnancies per 100

women during the first year of use)

• Effective immediately

• Long-term method

• Do not interfere with intercourse

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Benefits contd..

• Immediate return to fertility upon removal

• Do not affect breastfeeding

• Few side effects

• After follow-up visit, client needs to return to clinic

only if problems

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Benefits contd..

• Decrease ectopic pregnancy

• also used as an emergency contraception

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Limitations

Pelvic examination required screening for STDs recommended before insertion

Require trained provider for insertion and removal

Increase menstrual bleeding and cramping during the first few months

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Contd..May be spontaneously expelled

Rarely (< 1/1000 cases), perforation of the uterus may occur during insertion

May increase risk of PID and subsequent infertility in women at risk for STIs.

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Side Effects and Complications

• Most women have some bleeding following insertion of an IUD, and menstrual cramps.

• Menstrual bleeding may be heavier and longer than usual, and spotting can occur.

• These side effects decrease over time.

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References

1. Park K.Park K. Park’s Textbook of Preventive & Social Medicine. 21st

edition. Bhanot publishers. 2011.

2. SBA MODULE 24

3. http://www.crs.org.np/nilocon-white

4. http://www.nlm.nih.gov/medlineplus/ency/article/001946.htm

5. http://www.crs.org.np/iud

6. http://www2.pathfinder.org/pf/pubs/module4.pdf

7. http://en.wikipedia.org/wiki/Intrauterine_device

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Any Questions??

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THANK YOU…..