FAMILY REPRODUCTIVE LIFE PLANNING

REPRODUCTIVE LIFE PLANNING  The Responsible Parenthood and

 Includes all the decisions an individual or a Reproductive Health Act of 2012 (RPRH
couple make about whether and when to Law) - mandates the universal provision
have children, how many children to have, of reproductive health (RH) services
and how they are spaced. including family planning (FP) to ensure
that unmet needs of MFP are met.
 Benefits to the mother, child, and whole
family: Desired Behaviors:
1. Ensures health and well-being of women  All couples and individuals of
and families throughout life. reproductive age use modern family
2. Helps avoid unwanted pregnancy and planning methods to practice proper
proper spacing of birth. birth spacing of 3-5 years
3. Protects against STI/STD, includes  All couples and individuals of
HIV/AIDS. reproductive age seek FP information
4. Provides good health benefits for the and counseling and avail of FP services
children through proper nutrition, love from health service providers
and care.  Couples and individuals of reproductive
5. Helps reduce the incidence of hereditary age become satisfied FP users, discuss
disease such as blood disorders. FP among themselves and endorse FP to
6. Keeps family member live a healthier, others
more productive and fulfilled life.
Family Planning (FP) Program is a health
Evolution of Philippine FAMILY PLANNING intervention to promote the overall health of
Program: all Filipinos by:
 1970 to 1985 - PFPP started as a family 1. Preventing high-risk and unplanned
planning service delivery component to pregnancies;
achieve fertility reduction by 2. Reducing maternal deaths; and
contraceptive. 3. Responding to unmet needs for FP
 1986 to 1993 – reoriented to health among women.
intervention by improving the health of  Unmet Need
women and children.  Couples and individuals with
 1994 to 1999 – integration with other unmet need are those who are
RH programs giving importance to fecund and sexually active, and
recognizing choice and rights of FP report not wanting any more
users. children or wanting to delay the
 In year 2000 up to the present the next pregnancy but are not
national FP policy, AO No. 50-A, s. 2001 using any modern method of
- formulated to prescribe the key contraception (artificial or
policies of FP services in the country, natural).
which is “Family planning as a means  This is also includes couples or
towards responsible parenthood.” individuals who expressed desire
 DOH also issued AO No. 0005, series of to shift from traditional method
2011 - to ensure Quality Standards in to modern FP.
the Delivery of FP Program and Services
through Compliance to Informed Choice RPRH Law
and Voluntarism.  The Responsible Parenthood and
 The Executive Order (EO) No. 12- Reproductive Health (RPRH) Law of 2012
Attaining and Sustaining “Zero Unmet RA 10354 is a landmark legislation aimed at
Need for Modern Family Planning” - by protecting, promoting and fulfilling
President Rodrigo Duterte on January 9, women’s reproductive health and rights by
2017. accelerating the provision/delivery of and

C.I. SOL REYES 1

 access to reproductive health care services  Toxemia
and information. 3. Too many-birth number - had four or more
 Family Planning program is anchored on the deliveries
following basic principles:  problems during pregnancy and may
1. Responsible Parenthood: Each family require Caesarean Section
has the right and duty to determine the 4. Too close-birth intervals of less than 3 years
desired number of children they might  complications may have; Anemia and
have and when they might have them. Malnutrition
 Responsible Parenting -proper  Increased vulnerability and Illnesses
upbringing and education of children  Physical Stress
so that they grow up to be upright, 5. Too ill or unhealthy or with medical condition
productive and civic-minded citizens.
2. Respect for Life: The 1987 Constitution Ten (10) Basic Rights of All Family Planning
states that the government protects the Clients:
sanctity of life. Abortion is NOT a FP 1. Information 6. Confidentiality
method. 2. Access 7. Dignity
3. Birth Spacing: refers to interval 3. Choice 8. Comfort
between pregnancies (ideally 3-5 years) 4. Safety 9. Continuity
4. Informed Choice: upholding and 5. Privacy 10. Opinion
ensuring the rights of couples to
determine the number and spacing of Nine (9) ICV Decision Principles:
their children  Decision-making about an FP method without
coercion, undue influence or fraud:
1. No target or quota on individual service
PHILIPPINE FAMILY PLANNING PROGRAM providers
 Vision 2. No incentives for clients and/or providers
 To empower women and men to live 3. No denial of rights and benefits for those
healthy, productive, and fulfilling lives who do not accept FP
with rights to achieve their desired family 4. No discrimination against applicants of NFP
size through quality, medically sound , and grants
legally permissible FP methods 5. Not allowed: funding for programs with
 Mission INVOLUNTARY sterilization or coercive
 The DOH in partnership with LGUs, NGOs, abortion
the private sectors and communities  Giving full information about risks and
ensures the availability of FP information benefits of available FP methods:
and services to men and women who need 6. Comprehensible information on chosen FP
them. methods
 Program Goal: 7. Full disclosure of experimental
 To provide universal access to FP contraceptive methods & procedures
information, education and services 8. Informed consent for BTL / NSV
whenever and wherever these are needed. 9. Other methods even for clients choosing
permanent methods
Maternal High Risk Factors:
1. Too Young - below 18 years old; could have Client with Special Needs:
the following complications:  Anything you want to discuss?
 Hemorrhage / Anemia  Will parents or partner find out?
 Toxemia  Need contraception?
 Iron Deficiency Anemia  HIV/AIDS worries?
 Miscarriage / Stillbirth  Partner problems?
 Prolonged Labor  Pregnancy?
2. Too Old – 35 years old and above; could have  About sex?
the following complications:  About the body?
 Hemorrhage
 Prolonged Labor

C.I. SOL REYES 2

 Family Planning for Older Women:  ABSTINENCE
 Important to consider:  Is commonly defined as NO…
 Pregnancy is possible right up to  oral sex
menopause  vaginal sex
 Healthy older women can safely use any  anal sex
family planning method  genital-to-genital rubbing with another
 When to stop using family planning person
methods  Effectiveness: 100%
 You must keep protecting yourself from STIs  Pros:
and HIV/AIDS  No risk or worry about STI or
pregnancy
Family Planning after Childbirth:  Allows relationship to develop without
 Let’s plan for the future the pressure of sex
 Pregnant now?  No side effects or health risks
 You can think about family planning  Cons:
methods NOW  Can be hard to follow
 Recently gave birth?  Many people fail to use protection
 Are you breastfeeding? when abstinence ends

Family Planning after Abortion:

 You can get pregnant again quickly METHODS OF CONTRACEPTION:
 I can help you choose and use a method
 All family planning methods are safe now if
1) FOLK METHODS
you have no infection
A. PRECOITAL AND POSTCOITAL DOUCHE
Clients Living with HIV/AIDS:
 Plain water, vinegar, and a number of
 You need continued protection from STIs
“feminine hygiene” products are widely
and HIV/AIDS
used as postcoital douches.
 Pregnancy can be risky for you and your
 Serves to flush the semen out of the vagina,
child
and the additives to the water may possess
 You can find a family planning method that
some spermicidal properties.
is right for you
 BUT: sperm have been found within the
cervical mucus within 90 seconds after
ejaculation. Hence, the method is
ineffective and unreliable.
CONTRACEPTION
 is the intentional prevention of pregnancy B. PROLONGED LACTATION / LACTATIONA
during sexual intercourse Amenorrhea METHOD (LAM)
 Birth control is the device and/or practice to  The use of breastfeeding as a temporary
decrease the risk of conceiving, or bearing, introductory postpartum method of
offspring. postponing pregnancy based on
 Things to consider about contraceptive physiological infertility experienced by
methods: breastfeeding women
1. Personal values  The lactational amenorrhea method (LAM)
2. Ability to use a method correctly can be a highly efficient method for
3. How the method will affect sexual breastfeeding women to utilize physiology
enjoyment to space births.
4. Financial factors  Suckling results in a reduction in the release
5. Status of a couple’s relationship of gonadotropin releasing hormone,
6. Prior experiences luteinizing hormone, and follicle-stimulating
7. Future plans hormone.
 Beta-endorphins induced by suckling also
induce a decline in the secretion of
dopamine (normally suppresses the release

C.I. SOL REYES 3

 of prolactin). This results in a condition of  Condom is applied on erect penis, rolled
amenorrhea and anovulation. During the from the tip to the end of the shaft, before
first 6 months, if breastfeeding is exclusive, vulvar or vaginal contact.
menses are mostly anovulatory and fertility  Most condoms have reservoir tip to allow
remains low. for collection of ejaculate. When using a
 A recent WHO Study on LAM revealed that condom without a reservoir end, a small
during the first 6 months of nursing, space must be left at the end to collect the
cumulative pregnancy rates ranged from ejaculate, so that the condom does not
0.9 to 1.2 percent. However, at 12 months, break at the time of ejaculation.
pregnancy rates rose as high as 7.4 percent.  Care must be taken in removing the
When using lactation as a method of birth condom after intercourse. For optimal
control, the mother must provide effectiveness, the man should withdraw his
breastfeeding as the only form of infant penis from the vagina while it is still erect
nutrition. and hold the condom rim to prevent
 Three (3) Criteria for LAM: spillage.
1) Amenorrhea (menses have not yet  Pros: It protects against both pregnancy
returned) and STIs; Available in most drug stores and
2) Fully or almost fully breastfeeding her is affordable
infant  Cons: May reduce sensitivity and
3) Infant is less than 6 months old spontaneity during intercourse; May cause
 Supplemental feedings may alter both the skin irritation
pattern of lactation and the intensity of
infant suckling, which secondarily may B. FEMALE CONDOM
affect suppression of ovulation.  Is a thin polyurethane sheath with a flexible
 The method should be practiced as the only ring at each end
form of birth control for a maximum of 6  The inner ring, at the closed end of the
months after birth. condom, serves as the means of insertion
and fits over the cervix like a diaphragm.
C. WITHDRAWAL / COITUS INTERRUPTUS The second ring remains outside the vagina
 It is the withdrawal of the penis before and covers a portion of the woman’s
ejaculation (deposition of the semen perineum. It also covers the base of the
outside the female genital tract) man’s penis during intercourse.
 DISADVANTAGE: Demanding sufficient self-  A woman needs to be careful not to twist
control by the man so that withdrawal can the sheath when she inserts the condom,
precede ejaculation. Failure may result from because twisting makes male penetration
escape of semen before orgasm or the possible.
deposition of semen on the external female  Advantages: Offers extra STI protection;
genitalia near the vagina. Can be inserted up to 8 hours before
 Advantages: No health problems or side- intercourse
effects; No supplies needed  Disadvantages: Some women do not feel
 Disadvantages: Couple may feel it comfortable with this method; They can be
interrupts sex (the reason for its Latin name expensive
coitus interruptus). The man must take
responsibility for this method; No STI C. DIAPHRAGM
Protection  Consists of a steel band that forms a ring
and is covered with rubber so that when
diaphragm is inserted, the ring lodges high
2) MECHANICAL METHODS in the vagina with the rubber covering of
the cervix.
A. MALE CONDOM  It is used with spermicidal cream or jelly
 Is small, light weight, disposable and and offers a good level of protection from
inexpensive. conception.
 Has no side effects, requires no medical  Three types of diaphragm:
examination or supervision. 1) flat spring

C.I. SOL REYES 4

 2) coil spring  Advantages: They are affordable and
3) arcing spring available at most drug stores; They provide
 Diaphragm must be inserted before lubrication during sex
intercourse, with approximately one  Disadvantages: May cause skin irritation
teaspoonful (or 1.5 inches from the tube) of which can increase risk of STIs; They can be
spermicidal jelly placed around in its rim messy No STI Protection
and in the cup.
 Advantages: It can be put in up to 6 hours
before sex, so it doesn’t affect spontaneity; 4) HORMONAL METHODS
When taken care of, diaphragms last for a
long time A. CONTRACEPTIVE PILLS
 Disadvantages: It is difficult for women to  Types:
insert and remove; Some couples are 1. COMBINED
allergic to the contraceptive cream; No STI 2. SEQUENTIAL
Protection 3. MINI PILL
 Possible side effects vary from woman to
D. SPONGE woman. Most side effects disappear after 3
 Available without prescription. months.
 Is a pillow-shaped, soft, absorbent synthetic 1. Changes in menstrual cycle
sponge containing a spermicide (breakthrough bleeding)
 It is made with a concave cupped area on 2. Nausea
one side, which is designed to fit over the 3. Breast tenderness
cervix. It also has a loop for easier removal. 4. Mood Changes
 The sponge acts as a contraceptive by 5. Drug interaction with certain
releasing the spermicide nonoxymol-9 medications
gradually over a 24 hour period.  CONTRAINDICATIONS:
 Professional fitting is not required, it may 1. Older than 35 years of age
be used for up to 24 hours, one-size fits all 2. Cigarette Smoking
and acts as both a barrier and a spermicide. 3. Hypertension
4. Thrombophlebitis
5. Breast malignancy
3) CHEMICAL METHOD 6. Vascular or heart diseases
7. Less than 6 weeks of breastfeeding
A. SPERMICIDES  GENERAL CONSIDERATIONS:
 Available in foams, jellies, vaginal films, and 1. Must be prescribed by the physician,
suppositories nurse practitioner or nurse midwife
 Effectiveness: Perfect User: 85%* Typical after a pelvic examination or Pap smear.
User: 71%* 2. Generally recommended to be taken on
 Foams and gels can be used immediately. Sunday (the first Sunday after the
Vaginal films and suppositories requires a beginning of the menstrual flow),
15 minute wait. Effectiveness rate increases although woman may choose to begin
when combined with a barrier method. on any day.
 How To Use: Spermicides work by creating a  After childbirth, the woman should
chemical and physical barrier inside the start the contraceptive on the
vagina by doing two things: Sunday closest to 2 weeks after
 contains Nonoxyl-9 which kills sperm delivery
or makes them immobile  After an abortion, then on the first
 forming a temporary plug around the Sunday after the procedure
cervix 3. The woman should be advised to use
 Each application is effective up to 1 hour, second form of contraception during
and needs to be reapplied for each act of the initial 7 days on which she takes the
sex Need to remain in cervix for the next 6 pills (because pills are not effective on
hours the first 7 days).

C.I. SOL REYES 5

 4. Pills must be taken consistently to be taken. The Sunday start is common
effective. because it tends to prevent periods on
 can be taken in the morning, at weekends. However, a backup method
bedtime or with a meal of contraception is necessary during the
 the time of the day makes no first month of use.
difference; it is the consistency that
is important A. (2) MINI PILLS
 some women prefer taking pills at  Contains only progesterone
bedtime, rather than morning to  Ovulation may occur but progestin halts
eliminate any nausea they endometrium to fully develop: implantation
otherwise experience will not occur.
 How to Use:  Taken every day, even though there’s
1. Start as directed by your clinician. Use menstrual flow.
back-up method when starting. Pill must  May be taken during breastfeeding
be taken orally, every day, at the same  Advantages:
time. If miss taking 1 pill, follow  has fewer side effects
instructions on package. It contains  can be used by lactating women
estrogen and progesterone. because it does not inhibit milk
Effectiveness: Perfect User - 99.7%; production
Typical User - 92%  may be used by women over 35 and
2. Missed pills may not only increase the those with a history of headaches and
risk of pregnancy but may also increase mild hypertension
your chance of experiencing some side
effects, such as bleeding between
periods. A. (3) INJECTIONS AND IMPLANTS
 Advantages: The pill regulates a woman’s
period; Periods are lighter with less cramps; 1. SUBDERMAL IMPLANTS
It does not interrupt sex  Consist of Silastic capsules containing
 Disadvantages: Some women have a hard levonorgestrel, a progestin, which are
time remembering to take the pill; Some implanted in the woman’s arm.
women experience side effects; No STI  Are effective for up to 5 years in the
protection woman’s arm.
 Typically, six rods are inserted (although
A. (1) COMBINED ORAL CONTRACEPTIVES the manufacturer is currently
 Commonly called birth control pills or “the developing norplant II, which uses only
pill”. two rods).
 Are combination of a synthetic estrogen  Prevent ovulation in most women.
and progestin  Stimulate the production of thick
 One of the most popular contraceptive cervical mucus, which inhibits sperm
options available to women. penetration.
 Are safe, highly effective and rapidly  Provide effective continuous
reversible. contraception that is removed from the
 Taken daily for 21 days ,following one of the act of coitus.
two methods:  Women should be advised that the
1. Day-one start – the woman begins implant may be visible, especially in very
taking the pill the first day of her slender users, and that it requires a
menstrual cycle. This method prevents minor surgical procedure to insert and
ovulation in the first cycle, so no backup remove implants.
method of contraception is needed  Possible side effects include:
2. Sunday start: the woman begins taking • spotting
the pill on the Sunday after the first day • irregular bleeding or amenorrhea
of the menstrual cycle and ending on a • an increased incidence of ovarian
Saturday. In most cases, menses will cysts
occur 1 to 4 days after the last pill is • weight gain

C.I. SOL REYES 6

 • headaches B. VASECTOMY
• fluid retention  Small incision made on each side of the
• acne scrotum. Vas deferens is then cut and
• hair loss tied, cauterized or plugged, blocking the
• mood changes and depression passage of spermatozoa
 Ambulatory, under local anesthesia.
2. Depot-Medroxyprogesterone acetate 99.5% effective
(DMPA) (DEPO-PROVERA)  Does not interfere with production of
 Provides highly effective birth control sperm; does not pass beyond severed vas
for 3 months. deferens and absorbed at that point.
 Administered as a single IM injection of (seminal fluid continues but w/o sperm)
150 mg.  Advantages:
 Acts primarily by suppressing ovulation.  Very effective 3 months after the
DMPA provides levels of progesterone procedure
high enough to block the luteinizing  Permanent, safe, simple & easy to
hormone surge, thereby suppressing the perform
ovulation.  Can be performed in a clinic, office or
 Thickens the cervical mucus to block at a primary care center
sperm penetration  No resupplies or repeated clinic visits
 Side effects include menstrual  No apparent long term risks
irregularities, headache, weight gain,  An option for couples whose female
breast tenderness, and depression. partner could not undergo
 Safe, convenient, private, and relatively permanent contraception
inexpensive.  A man who had vasectomy will not
lose his sexual ability and ejaculation
 Does not affect male hormonal
function
5) SURGICAL METHODS
 Disadvantages:
 Classifications:
 Slightly uncomfortable due to slight
1. AS TO DECISION
pain and swelling 2-3 days after
2. AS TO PURPOSE
procedure
 Reversibility is difficult and expensive
 Methods:
 Bleeding may result in hematoma in
the scrotum
A. TUBAL LIGATION
 A few men develop chronic pain after
 Fallopian tubes are occluded by cautery,
vasectomy (postvasectomy pain
crushing, clamping, or blocking & thereby
syndrome)
preventing passage of both sperm and
ova.
C. HYSTERECTOMY
 Effectiveness: 99.5%
 It is a surgery to remove a woman's
 Operations performed:
uterus or womb.
 Laparoscopy – using a lighted
 After a hysterectomy, the woman no
laparoscope
longer has menstrual periods and can't
 Culdoscopy - a tube inserted through
become pregnant.
the posterior fornix of the vagina
 Sometimes the surgery also removes the
 Colpotomy – incision through the
ovaries and fallopian tubes. If the woman
vagina
has both ovaries taken out, she will
 Complications of female sterilization
enter menopause.
procedures include coagulation burns on
the bowel, bowel perforation, pain,
infection, hemorrhage, and adverse
anesthesia effects. 6) NATURAL FAMILY PLANNING METHODS
 Reversal of a tubal ligation depends on  As the name implies, these are those that
the type of procedure performed. involve no introduction of chemical or
foreign material into the body.

C.I. SOL REYES 7

  The effectiveness of these methods varies the temperature rise and for 3 days
greatly, depending mainly on the couple's after. Because temperature rise does
ability to refrain from having sex on fertile not occur until after ovulation, a woman
days. who had intercourse just before the rise
is at risk of pregnancy. To decrease risk,
A. CALENDAR METHOD some couples abstain from intercourse
 requires couple to abstain from coitus on for several days before the anticipated
days of a menstrual cycle when the woman time of ovulation and then for 3 days
is most likely to conceive (3 or 4 days after after.
ovulation)  Instruction in taking the BBT:
 the woman keeps a diary of 6 menstrual  Use the BBT or Ovulation
cycles Thermometer
 Shake the thermometer to 35
1. RHYTHM/CALENDAR/OGINO KNAUSSE degrees C or below in the evening
METHOD and place it at the bedside.
 Predicting your first fertile day. If your  Starting on the first day of
shortest cycle is 26 days long, subtract menstruation, take the temperature
18 from 26. That leaves 8. If day 1 was upon waking up every morning
the fourth day of the month, the day before any activity, after at least
you will mark X will be the 11th. That's three hours of continuous sleep.
the first day you're likely to be fertile. So  Take the temperature by placing
on that day, you should start abstaining the silver bulb under the tongue or
from sex or start using a cervical cap, axilla for 5 minutes.
condom, diaphragm, or female condom.  Read and record the temperature
 Predicting your last fertile day. If your immediately after taking it.
longest cycle is 30 days, subtract 11  COVER LINE = The point of reference for
from 30. That leaves 19. If day 1 was the determining the thermal shift that
fourth day of the month, the day you occurs during ovulation
will mark X will be the 22nd. That's the  Determining the Cover Line:
last day you're likely to be fertile during  Identify the temperature
your current cycle. So you may start to reading of the first 10 days of
have unprotected vaginal intercourse the cycle
after that day.  Disregard the temperatures of
the first five days.
a) BASAL BODY TEMPERATURE (BBT)  Find the highest temperature
 Method to detect ovulation from 6 to 10.
 Requires woman to take BBT every  Draw a horizontal line across
morning upon awakening before any the chart on the highest of the
activity and record the readings on a temperatures from days 6 to
temperature graph by the use of BBT 10.
thermometer  Thermal Shift
 Effectiveness: 98%  Determining the Thermal Shift:
 Woman with regular cycles should be  Watch for three (3) consecutive
able to predict when ovulation will temperature recordings above
occur. The method is based on the fact the cover line.
that temperature sometimes drops just  Count these three consecutive
before ovulation (about 0.5F) and temperatures above the cover
almost always rises and remains line and mark them as days 1,
elevated for several days after. 2, 3.
 Temperature rise occurs in response to  Then draw a vertical line
the increased progesterone levels that between 2 and 3 from top to
occur in the second half of the cycle. bottom of the chart.
 To avoid conception, the couple
abstains from intercourse on the day of

C.I. SOL REYES 8

 b) BILLINGS METHOD/ CERVICAL MUCUS intercourse on days 8-19 to avoid
METHOD pregnancy.
 Involves assessment of cervical mucus  The couple uses a device which the
that occurs during menstrual cycle. color-coded “cycle beads” to mark
 The amount and character of cervical the fertile and infertile days of the
mucus change because of the influence menstrual cycle.
of estrogen and progesterone.
 During the follicular phase of the cycle 2) Two-Day Method
(from the end of menses prior to  A simple-fertility awareness-based
ovulation), cervical mucus is thin and method of NFP that involves:
scanty, and may be even more absent.  cervical secretions as an
At the time of ovulation, the mucus indicator of fertility
(Estrogen-dominant mucus) is clearer,  women checking the presence
more stretchable (a quality called of secretions everyday
Spinnbarkheit), and more permeable to  they do not need to distinguish
sperm. During the luteal phase characteristics of secretions
(following ovulation through the time (i.e. amount, color, consistency,
just prior to the onset of menses), slipperiness, stretchability or
cervical mucus is thick and sticky viscosity)
(Progesterone-dominant mucus) and  If the woman notices any secretions
forms a network that traps sperm, today or yesterday, she should
making passage difficult. consider herself fertile and avoid
 Prior to using the cervical mucus intercourse today, thus the name
method, the woman abstains from Two-Day
intercourse for entire menstrual cycle,  If she has had 2 consecutive days
during which she assesses her cervical without secretions, her probability
mucus daily for amount, feeling of of becoming pregnant today is very
slipperiness or wetness, color, clearness, low or practically nil.
and Spinnbarkheit.
d) SEX DURING MENSTRUATION
c) SYMPTOTHERMAL METHOD  Sex During Menstruation is Completely
 Consists of various assessments made Safe
and recorded by the couple.  Many men fear that sex during
 Includes information regarding cycle menstruation can harm them in some
length, coitus, cervical mucus changes, way. The most important thing to keep
and secondary signs such as increased in mind is that having sex during a
libido, abdominal bloating, woman's period is not at all unsafe.
mittelschmerz (midcycle abdominal The only thing that you have to worry
pain), and BBT. about is the possibility of contracting a
 Through various assessments, the sexually transmitted disease (STD).
couple learns to recognize signs that Women are more likely to pass on any
include ovulation. STD that she has due to the fact that
 This combined approach tends to there is contact with both blood and
improve the effectiveness of fertility vaginal fluid. Of course, it is important
awareness as a method of birth control to remember that an STD can be
and is the best taught by an expert in passed during any time of the month.
the method. It is important to make sure that you
still use protection if you make the
1) Standard Days Method decision to have sex during
 A “new” method of NFP in which all menstruation.
users with menstrual cycles  Know That Pregnancy Isn't Impossible
between 26 and 32 days are During a Period
counseled to abstain from sexual  There is a common misconception that
pregnancy is impossible when a

C.I. SOL REYES 9

 woman has her period. This is not true 7) ABORTIFACIENTS
at all. Most women tend to get
pregnant about fourteen days after A. INTRAUTERINE DEVICE
their period. Women are most fertile  Is designed to be inserted into the uterus by
and ovulating during this time. It is a qualified health care provider and left in
important to keep in mind that women place for an extended period, providing
do sometimes get pregnant during continuous contraceptive protection.
other times of the month, however. If  Advantages of IUD include: high rate of
you are under the misconception that effectiveness, continuous contraceptive
you do not need to use protection protection, no coitus-related activity, and
during menstruation because you relative inexpensiveness over time.
cannot get pregnant during this time,  Two IUDs are currently available. The
you have been misinformed. It is still copper T380A (Paragard) is highly effective
important to use protection if you are IUD that can be left in place for up to 10
not ready for pregnancy. years. Copper covers parts of the stem and
arms of the device.
Advantages of NFP:
 No interference with the woman’s B. MORNING AFTER PILL (not available in
normal physiology Philippines)
 Requires no drugs or devices  Emergency contraception pill, commonly
 No known physical side effects called the morning-after pill, is a safe and
 Can be used at all stages of reproductive effective way to prevent pregnancy after
life unprotected intercourse. There are two
 Both partners share the responsibility kinds of emergency contraception.
for FP  There are two types of emergency pills:
 May improve communication about 1) Levonorgestrel pills
sexuality 2) Ulipristal acetate
 May help sub fertile couples to conceive  Both kinds of emergency contraception can
 Enables couple to take control of their be used up to five days (120
fertility hours) after unprotected intercourse. You
 Morally and culturally acceptable may want to use it if:
 Cost-effective  you weren't using any birth control
when you had sex
Disadvantages of NFP:  you forgot to take your birth control
 It takes time to learn, recognize and pills, patch, ring, or other birth control
chart fertility symptoms method
 Requires initial teaching from an  your partner's condom broke or slipped
experienced NFP teacher off
 Some women find charting difficult  your partner didn't pull out in time
 There may be fear of unplanned  you were forced to have unprotected
pregnancy because though the method vaginal sex
failure is low, there is a higher user  Pregnancy doesn't happen right after sex.
failure rate particularly during the That's why it's possible to prevent
learning phase pregnancy even after the fact. It can take up
 Both partners require a high degree of to six days for the sperm and egg to meet
motivation and commitment after having sex.
 There may be difficulty in using the  Emergency contraception pills work by
natural methods at times of stress, after keeping a woman's ovary from releasing an
childbirth, after taking the contraceptive egg for longer than usual. Pregnancy cannot
pill or during pre-menopause happen if there is no egg to join with sperm.
 Levonogestrel pills are up to 89% effective
when taken within 72 hours (three days)
after unprotected sex. They continue to
reduce the risk of pregnancy up to 120

C.I. SOL REYES 10

 hours (five days) after unprotected sex, but C. BIRTH CONTROL PATCH (not available in
they are less effective as time passes. Philippines)
 Emergency contraception is safe,  The birth control patch is a thin, beige,
and millions of women have used it. Various 1¾-inch (4½-centimeter) square patch
forms of emergency contraception have that sticks to the skin. It releases
been used for more than 30 years. There hormones through the skin into the
have been no reports of serious bloodstream to prevent pregnancy.
complications. Hormones are chemical substances that
 Side effects are uncommon, and usually control the functioning of the body's
stop within a day or two. Possible side organs.
effects include:  The combination of the hormones
 an earlier or later, heavier or lighter progesterone and estrogen in the patch
period than usual prevents ovulation. If an egg isn't
 breast tenderness, dizziness, or released, a female can't get pregnant
headaches  because there's nothing for sperm to
 nausea or vomiting (If you vomit within fertilize.
two hours of taking the pill(s), it won't  The hormones in the patch also thicken
be effective and you need to take it the mucus produced in the cervix,
again) making it difficult for sperm to enter
 Frequent use may cause periods to and reach any eggs that may have been
become irregular and unpredictable. released. The hormones can also
Emergency contraception should not be sometimes affect the lining of the
used as a form of ongoing birth control uterus so that if the egg is fertilized it
because there are other forms of birth will have a hard time attaching to the
control that are a lot more effective and wall of the uterus.
less expensive.  When you use the patch correctly, it’s
 Emergency contraception does not great at preventing pregnancy. But
protect against STI’s. You may want to things like forgetting to change your
consider getting tested if there is a patch or taking certain medicines can
possibility that unprotected sex put you make it not work as well.
at risk.
 Take the morning-after pill as soon as
possible after unprotected intercourse. It  If the client has no method in mind, discuss
will reduce your risk of pregnancy if you with her the following:
start it up to 120 hours (five days) after  Your experiences with family planning
unprotected intercourse.  What you have heard about family planning
 Some brands have one pill, and some have methods?
two. The instructions on brands with two  Your plans for having children
pills may say to take the pills 12 hours  Protection from sexually transmitted
apart. But research shows it is just as infections (STIs) or HIV/AIDS
effective and safe to take both pills at the  Your partner’s or family’s attitudes
same time.  Other needs and concerns
 After you take emergency contraception,
it's normal for your next period to be
different from usual.
 Be sure to tell any health care provider that
you may see before your next period that
you have taken the morning-after pill. If you
do not have your period within three weeks
after taking emergency contraception, or if
you have any symptoms of pregnancy, take
a pregnancy test or schedule an
appointment with your health care
provider.

C.I. SOL REYES 11