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Contraception

Contraception. Fall 2011. CONTRACEPTION. THE VOLUNTARY. THE VOLUNTARY PREVENTION OF PREGNANCY. PREVENTION OF PREGNANCY. WHAT IS YOUR IDEA OF THE IDEAL CONTRACEPTIVE. Natural Family planning.

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Contraception

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  1. Contraception Fall 2011

  2. CONTRACEPTION THE VOLUNTARY THE VOLUNTARY PREVENTION OF PREGNANCY PREVENTION OF PREGNANCY

  3. WHAT IS YOUR IDEA OF THE IDEAL CONTRACEPTIVE

  4. Natural Family planning • Relies on the avoidance of intercourse during the presumed fertile days of the menstural cycle

  5. Rhythm or calendar method • Calculate the time at which ovulation is likely to occur based on the length of previous menstrual cycles • The woman must keep a diary of her menstrual cycles • Abstain on the fertile days

  6. Basal body temperature Keep a chart of temperature taken at the same time each day

  7. Cervical mucus testing • Assess for the mucus to be: • Copious • Transparent • Thin, watery • Stretchable

  8. Fertility awareness • Assess Mittelschmerz • Test Tape • Predictor tests for ovulation

  9. Methods of Contraception

  10. Spermacides Foams Jellies CHEMICAL BARRIERS creams suppositories gels

  11. Patient teaching 1. Place deeply in the vagina so it comes in contact with the cervix before each intercourse 2. Maximun effectiveness lasts about one hour. Must reapply. 3. Suppositories take 10-30 minutes to dissolve 4. Don’t douche for six hours following use

  12. Barrier methods • Condoms • Diaphragm • Cervical cap • Vaginal sponge • IUD

  13. diaphragm

  14. Cervical cap

  15. Vaginal sponge

  16. IUD

  17. Hormonal Therapy Suppresses ovulation

  18. Combined estrogen-progestin • Combined oral contraceptives (COC) • Birth control pills • Transdermal patch • Ortho Evra • Vaginal contraceptive ring • Nuva ring • Injectible combination contraceptive • Lunelle, Depo Provera

  19. Oral contraceptives • Benefits and risks • Box 10-1 pp. 193 • Usaully risks are less than the risks of pregnancy

  20. Postcoital emergency contraception (EC) is used after unprotected intercourse (condom breaks, rape, contraceptive not used correctly or did not use contraceptive

  21. Postcoital emergency contraception • Oral Therapy - Two tablets taken 72 hours after unprotected intercourse and 2 tables taken 12 hours later. • Preven (kit) available by prescription - estrogen and progestin. • Plan B – progestin-only method. Available OTC to women over 18 years old. • May insert IUD within 5 days

  22. Think About This ! Most women can use the same diaphragm for years if proper care is maintained. Which of the following situations would warrant re-measurement and refitting? • Weight gain or loss of 5 lbs • Surgery involving general anesthesia • Pelvic infection • Pelvic surgery or delivery of a baby

  23. SURGICAL INTERVENTIONS Stoppage of the passage of sperm

  24. Vasectomy The vas deferens are cut and ligated. Sterility confirmed when sperm are no longer present in semen

  25. Male hormones are still produced, so male secondary sex characteristics are not affected • Sperm production continues

  26. Patient teaching • Patient Teaching: • Apply ice to scrotum • Moderate activity for two days Sterility is not immediate – use alternate method of birth control

  27. TUBAL LIGATION

  28. Tubal Ligation The fallopian Tube is ligated and sperm and ovum can no longer meet.

  29. TUBAL LIGATION Prevent passage of sperm or egg in the fallopian tubes by Remove part of tube Cautery

  30. Tubal Ligation • May be done immediately following delivery or at a later date • Side effects: • Infection, Hemorrhage, Perforation of intestines • Reversal is only 15% success rate

  31. Tubal Sterilization Use of non-surgical method Insertion of small coil (Essure) into the fallopian tubes Tubes become blocked as tissue grows

  32. Consents and Regulations • All states have regulations for informed consent which include: • Explanation of risks • Benefits • Alternatives • Statement regarding it as a permanent, irreversible • method of birth control • ** There is a 30 day waiting period between giving • consent and the sterilization. • Many states permit sterilization without • reference to her marital status or mates consent. • If federal funds are used, the person must be 21 years old. Minors cannot be sterilized.

  33. THE END

  34. The nurse would teach the breastfeeding woman it is BEST to use use which of the following? A. Birth Control Pills B. Estrogen injections C. IUD D. Condom and spermicidal foam

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