FAMILY PLANNING

AND OTHER REPRODUCTIVE

ISSUES
Philippines: Situationer

Source: NSO as cited by Ms. Faith Bacon in 2008

 Philippines: Situationer
High maternal mortality ratio or about 3-
5T women dying/year.

Over 78T women hospitalized for

complications of induced Abortion.
Unwanted pregnancy causes over
400,000 induced abortion every year.

Source: Bacon, F. (Nov.2008) State of Philippine population and Reproductive Health

 Philippines:Situationer
Profile of women who have abortion:
● 68% are poor
● 91% are married
● 57% are with 3 or more children
● 87% are catholic

Source: Bacon, F. (Nov.2008) State of Philippine population and Reproductive Health

Family Planning
• ‘refers to a program which enables couples and
individuals to decide FREELY and
RESPONSIBLY the number and spacing of
their children and to have the information and
means to carry out their decisions, and to have
INFORMED CHOICE and ACCESS to a full
range of safe, legal and effective family
planning methods, techniques and devices.’
(Drafted RH Bill, 2008)
Key Concepts

This literally means ‘the prevention of conception’.

“Any technique designed to either prevent

the release of an ovum, prevent fertilization
of an ovum, or prevent a fertilized ovum
from implanting in the uterine wall.”
(McAnulty & Burnette, 2001, p. 180)
Key Concepts

Contraceptives which act

after conception to terminate
a pregnancy.
Key Concepts

Informed- Iindividuals have

the clear, accurate, and
specific information that they
need and understand their own
needs.
Choice- individuals have a
History of Contraception

• Early methods of contraception

could be traced way back to the
Paleolithic Era (10,000 B.C.) when
women used plant drugs as
contraceptives.
History of Contraception

1850 B.C. E.- women

inserted plugs of crocodile
dung or fermented dough in
their vagina close to the
cervix to serve as barriers to
sperm.
History of Contraception

Elephant dung was used in the

Islamic world as late as 13th
century.
History of Contraception

4th Century- Aristotle

recommended that women
should apply a blend of olive
oil, cedar oil, lead ointment
or frankincense in the vagina.
History of Contraception

Among the Greek and

Romans, women used wool
plugs soaked in honey or
cedar gum as vaginal
methods.
History of Contraception

Some Romans put pepper in

the uterus or smear blood
from the ticks of a wild black
bull into the vagina.
History of Contraception

• 16th Century- A physician in the

name of Fallopius described a
linen condom that was used to
prevent syphilis.
History of Contraception

This is a method used in China during the

17th century, which used to divert
seminal fluid from the penis into the
bladder from which it would later be
flushed away during urination.
History of Contraception
• 18th Century- Condoms made of
gut (intestine) were available.
• 1870s- condoms were mass
produced during this time.
History of Contraception

1930s- a method wherein a

square of wood block was
used as vaginal barrier, was
condemned as an instrument
of torture.
Contraceptive Methods
• Two Types:
1. Natural Family Planning Methods
2. Modern (Artificial) Family
Planning Methods
 Contraceptive Methods
• DOUCHING- a method of cleansing the
vaginal canal by squirting liquid into the
vagina; not recommended as a method
of birth control
• CHANCE- this is not considered as a
method of birth control
Contraceptive Methods

- This is commonly known as WITHDRAWAL

or Coitus Interruptus.
- “A birth control method that requires a man to
remove his penis from the vagina and away
from the woman’s genital area just before
ejaculation.” (McAnulty & Burnette, 2001, p.
186)
- Also called as ‘cycle-based methods’,
‘Fertility Awareness’, ‘rhythm
method’ or the ‘Billing method.’
- “A birth control method requiring
familiarity with changes in bodily
functions during ovulation;
abstinence (or outercourse) is
practiced when the woman is
ovulating.” (McAnulty & Burnette,
2001, p.186)
1. BASAL BODY TEMPERATURE (BBT)
METHOD

-A cycle-based method that relies on identifying

a drop in body temperature that occurs just
prior to ovulation.
- there is a drop in body temperature in 12-24
hours prior to ovulation and a subsequent rise
for 10 or more days after
1. BASAL BODY TEMPERATURE (BBT)
METHOD

Avoid unprotected sex from the first day

of menstrual bleeding until the
woman’s temperature has risen above
her regular temperature and stayed up
to 3 full days.
1. BASAL BODY TEMPERATURE (BBT)
METHOD

Disadvantages:
o other factors may affect temperature
o sperm can survive in a woman’s body
for up to 5 days.
2. CERVICAL MUCUS CHARTING

A cycle-based method that relies on

identifying qualitative and
quantitative changes in mucus
secretions that are associated with the
fertile period.
2. CERVICAL MUCUS CHARTING
During ovulation period, mucus
secretion is slippery, sticky and clear;
 2. CERVICAL MUCUS CHARTING
Fertile Period: Ist
DAY of sticky mucus
secretion to 4DAYS
AFTER the last day on
which mucus is
observed
3.CALENDAR CHARTING
A cycle-based method that requires a
woman to record her menstrual cycles
for several months. Once she has done
this, she finds her longest and shortest
cycles.
3.CALENDAR CHARTING
In determining the first fertile day,
subtract 20 from the shortest cycle (e.g.
SC=26; 26-20=6 days
In determining the last fertile day,
subtract 10 from the longest cycle (e.g.
LC=29; 29-10=19 days)
3.CALENDAR CHARTING

Different sources used slightly different

calculations for determining the fertile
period.
Example: In McAnulty and Burnette the
constant numbers are 20 and 10 and in the
John Hopkins’ standard the numbers are 18
& 11.
1. Spermicides

Chemicals that kill sperm; if it is in the

form of a ‘foam’, it should be used not
earlier than 30 minutes before
intercourse.
2. Condoms
- Also called as a rubber or
prophylactic.

male condom is the only male barrier

method.
The female condom has two rings.
2. Condoms
- It is either lubricated or dry.
POLYURETHANE condom-
it is thinner than latex; less
likely to break (than a latex)
from heat, oily lubricants or
light.
3. Female barrier methods
These include: a) Sponge, b)
Diaphragm, c) Cervical cap, &
d) female condom
3. Female barrier methods
SPONGE- is a polyurethane disk measuring 2
¼ inches in diameter and ¾ inch thick, with a
dimple in the middle and attached cloth strap
that is used to remove the sponge.
 3. Female barrier methods
Diaphragm- a dome-shaped rubber
cup with a flexible rim.
- It works to stop the sperm from
entering the cervix and by holding
spermicide against the cervix
3. Female barrier methods
Diaphragm
-It cannot be used during menstruation.
3. Female barrier methods

Cervical cap
-it is designed to fit snugly over the cervix.
3. Female barrier methods
Cervical cap
3. Female barrier methods
Female condom
-a thin polyurethane pouch with a
flexible polyurethane ring at both
end.
- It can be inserted up to 8 hours
prior to intercourse.
3. Intrauterine Device (IUD)
A small plastic or copper object inserted in the
uterus.
- it inhibits fertilization in the uterine wall.
- Specific IUDs are called ‘the loop,’ ‘copper
T,’ ‘TCu-380A,’ ‘Nova T’
3. Intrauterine Device (IUD)
Types of IUDs:
a. Copper-bearing IUDs-most widely used
b. Hormone-releasing IUDs – (made of plastic;
steadily release small amounts of the hormone
progesterone or another progestine such as
levorgestel)
c. Inert or unmedicated IUDs- (made of plastic
or stainless steel.
4. Hormonal Methods
Types :
a. Combined Oral Contraceptives (COCs)
b. Progestin only contraceptives
c. Norplant
d. Depo-provera
e. Postcoital contraception
 Combined Oral Contraceptives
• It(COCs)
is commonly known as ‘the pill.’
• It is a combination of estrogen and
progestin.
 Progestin only Contraceptives
(POCs)from COCs, it contains only one kind
• Different
of hormone, a PROGESTIN. They do not
contain estrogen.
 Progestin only Contraceptives
• It(POCs)
is also known as POCs, POPs and minipill.
• Similar with the use of COCs, the woman
swallow a pill everyday to prevent pregnancy.
 Norplant
•Isa set of 6 small, plastic capsules. The capsules
are placed under the skin of a woman’s upper arm.

• Each capsule contains a progestin, similar to

natural hormone that a woman’s body makes. A
set of Norplant capsules can prevent pregnancy
for at least 5 years.
 DMPA injectable
• DMPA is the most common type of
injectable contraceptive. It is given
every 3 months.
•It is also known as depot-
medroxyprogesterone acetate, Depo-
Provera, Depo and Megestron
Postcoital
Contraception
• Also called as ‘Morning-after Pills’.
• A method of contraception whereby a woman
takes substantial doses of hormones after
intercourse to prevent possible pregnancy
Male Sterilization
• Also known as vasectomy.
• It involves severing the vas deferens to
permanently prevent a man from
impregnating anyone.
• No-scalpel method
Male sterilization
Female sterilization
• Commonly known as ‘tubal ligation’ or the
tying off or binding of the fallopian tubes.

• Types:
1) Minilaparotomy &
2) Laparoscopy
 Female sterilization
• MINILAPAROTOMY- involves making a single
2-5cm incision just above the pubic hairline.

• LAPAROSCOPY- generally involves two incisions,

which are smaller than the incision of a
minilaparotomy. An incision is made at the navel (
where the laparoscope will enter)and an incision in
the pubic hairline (where the operating channel will
enter).
FAILURE RATES (actual
usage)
Method Failure rate
(typical use)
Protection from
STDs/STIs

Cervical cap (in parous woman) 36% Some

& Sponge ( in parous woman)

Postcoital contraceptives 25% No

Female condom 21% Yes

All Natural Family Planning methods 20% No

Withdrawal 19% No

Spermicides alone 18-21% Some

FAILURE RATES (actual
usage)
Method Failure rate Protection from
(typical use) STDs/STIs
Sponge (in nulliparous woman) 18% some
Diaphragm , &
Cervical cap (in nulliparous
woman)

Male condom ALONE 12% some

Male condom with spermicide 5% yes
COCs/Pill 3% no
FAILURE RATES (actual
usage)
Method Failure rate (typical Protection from
use) STDs/STIs
IUD 0.1-2.0% no
Female 0.4% no
sterilization
DMPA injectable 0.3% some
Male sterilization 0.1% no
Norplant .09% no
 Important points to consider:
• There are no PERFECT methods of contraception.
• Not all methods could protect a person from STDs/
STIs (and HIV-AIDS).
• Different people have different reactions to modern
methods thus there is a need to decipher which among
the choices is suitable to one’s condition.
• Always seek for the advise of health providers before
using any of these methods.
This topic was introduced not for
us to resort in self-medication. The
purpose is to inform students what
are the possible choices.
Individuals MUST consult their
health providers before using any
form of family planning methods
(be it NFP or modern family
planning).
We must equip ourselves with
information, because that is the
only way we can have informed
decisions about our reproductive
health.
Sources:
• Bacon, Faith. (November 2008). State of
Philippine Population and Reproductive
Health. Paper presented during the SOSC 3
symposium at NCAS Auditorium.
• Drafted RH Bill (2008)
• Hatcher, R. et.al.,(1997). The Essentials of
Contraceptive Technology. John Hopkins
Center for Communication Programs,
Baltimore, Maryland.
• McAnulty, R & M. Burnette. (2001).
Exploring Human Sexuality: Making