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IDENTIFICATION AND PRESCRIPTION OF VARIOUS FAMILY PLANNING METHODS

PREPARED BY CAROLINE KEMUNTO

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INTRODUCTION

Given the variety of methods at the client’s disposal, not all methods are suited for use by an individual, so many things are to be considered before prescribing a method, one of the mandates of the family planning clinician is to ensure that besides a client having a preferred method, they should help them to use the safest method.

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PILLS

Made of two synthetic hormones progesterone and estrogen. The combined pill( CoC ) and the progesterone-only pill (pop) or mini pill. Should be taken one pill every day at the same time daily. Each new packet is started after the resting period where one is expected to have received their menstrual period.

BEFORE PRESCRIBING PILLS; Ensure that the client does not suffer from any chronic illness that will be exacerbated by the introduction of the hormones. Progesterone has a tendency of causing fluid retention hence may lead to a hypertension crisis

The client should not be pregnant.

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CONTRACEPTIVE IMPLANTS

BEFORE USE ENSURE:

  • THAT THE CLIENT IS NOT PREGNANT
  • HAS NO HISTORY OF HEART ATTACK OR BLOOD CLOTS
  • NO HISTORY OF BREAST CANCER
  • UNDIAGNOSED ABNORMAL GENITAL BLEEDING

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BIRTH CONTROL PATCH

BEFORE USE:

  • THE CLIENT SHOULD NOT E SUFFERING FROM HIGH BLOOD PRESSURE IT MAY LEAD TO A CRISIS
  • ANY TYPE OF CANCER
  • THOSE WHO ARE PREGNANT
  • UNEXPLAINED VAGINAL BLEEDING
  • REACTION TO MATERIAL USED O MAKE THE PATCH

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VAGINAL RING

BEFORE USE ENSURE:

  • THE PATIENT DOES NOT HAVE DEEP VENOUS THROMBOSIS
  • HAS NOT SUFFERED PULMONARY EMBOLISM
  • HEART ATTACK

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SYNTHETIC HORMONE INJECTION

A progesterone dominant method given via injection every 3 months

THOSE ELIGIBLE TO USE AE CLIENTS WHO DON’T HAVE THE FOLLOWING:

  • MENSTRUAL IRREGULARITIES
  • CLIENTS WEIGHING MORE THAN 90KGS
  • CLIENTS WHO HAVE NOT HAD CHILDREN BEFORE
  • HYPERTENSIVES

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INTRA UTERINE DEVICES

BEFORE USE ENSURE:

    • CLIENT IS IN A MONOGAMOUS RELATIONSHIP BECAUSE IT PREDISPOSES ONE TO INFECTIONS
    • THE CLIENT IS THE REPRODUCTIVE AGE
    • IS ON THE LAST DAY OF HER PERIODS TO RULE OUT PREGNANCY
    • NOT HAVING ANY BLEEDING DISORDERS OR ANEMIC

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WITHDRAWAL METHOD

BEFORE USE:

  • ENSURE THE CLIENT UNDERSTANDS WELL THAT WITHDRAWAL IS BEFORE EJACULATION AND THAT SEMEN CONTAINS SOME AMOUNT OF SPERMS IN SOME INSTANCES
  • REQUIRES DELIGENCE

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NATURAL FAMILY PLANNING METHOD:

These methods depend on the body’s natural, physiological changes and symptoms to identify the fertile and infertile phases of the menstrual cycle, they can be referred to as fertility-based awareness methods, commonly used by those whose religious and cultural beliefs do not permit them to use other devices or hormonal methods, they include;

BASAL BODY TEMP. (BBT)

CALENDAR METHOD(RHYTM METHOD)

MUCOUS METHOD

BREAST FEEDING.

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BASAL BODY TEMPRETURE

BEFORE USE;

  • Ensure that you are not in menopause
  • Ensure that the couple is disciplined enough to be able to use this method.
  • Ensure that a back up method is used during fertility

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THE CALENDAR METHOD

BEFORE USE;

  • COUPLE SHOULD CO-OPERATE
  • CLIENT SHOULD NOT BE IN MENOPAUSE

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CALENDAR METHOD CONTINUED;

WHO SHOULD USE THE CALENDAR METHOD

  • Women with a regular cycle
  • If the cycle is never shorter than 26days
  • If your cycle is never longer than 32 days

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CERVICAL MUCOUS METHOD

BEFORE USE ENSURE:

  • CLIENT IS ABLE TO DIFFERENTIATE BETWEEN SEMEN, SEXUAL LUBRICATION, FROM THE CERVICAL LUBRICATION LEAST THEY FALL PREGNANT
  • NOT BREASTFEEDING SINCE THE CYCLE IS NOT BACK TO NORMAL
  • CLIENTS APPROACHING MENOPAUSE
  • CLIENTS WITH POLYCYSTIC OVARIAN SYNDROME SINCE THEY HAVE IRREGULAR PERIODS
  • PERSISTENT REPRODUCTIVE SYSTEM TRACT INFECTIONS

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LACTATIONAL AMENORRHOEA METHOD

BEFORE USE ENSURE:

  • Mother is breast feeding exclusively
  • Is not HIV Positive

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TUBAL LIGATION

BEFORE PROCEDURE;

  • Ensure that the client understands clearly that it is a permanent method that cannot be reversed in case of the death of the children or a change of spouse
  • Suitable for women who are approaching menopause who wouldn’t wish to have more children

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VASECTOMY

SIMILAR TO THOSE OF TUBAL LIGATION AND

  • Should use a backup method until tests show that semen does not contain sperms.

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EMERGENCY CONTRACEPTION

BEFORE USE:

  • Ensure the time limits have been considered ie before 72hrs elapse
  • Not recommended for daily use

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THE END