 Some pregnancies have been classified as “high risk”: pregnancies in women who are too ________ ( ____yrs), or the pregnancies are too ________ (>__ births) or too ________ (<____ apart). 

young( 35yrs) too many (>4 births) too close (<2yrs apart).

FAMILY PLANNING SERVICES Flashcards by Iseoluwa Ojo

 Some pregnancies have been classified as “high risk”: pregnancies in women who are too ________
(<___yrs), too ________ (>____yrs), or the pregnancies are too ________ (>__ births) or too ________ (<____ apart).


young(<18yrs),

too old (>35yrs)

too many (>4 births)

too close (<2yrs apart).

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13% of all maternal deaths in Africa result from ____________

unsafe abortion

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Reproductive age is from ____ to ____

15 to 49

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Family planning helps to avoid __________ and __________

high risk pregnancies

unsafe abortions

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Family planning is a way of ________ and living that is adopted ________ upon the basis of ________, attitudes and responsible decisions by ________ and ________ in order to promote ________ and ________ of the family group and thus contribute effectively to the social development of the country (WHO)

thinking ; voluntarily

knowledge ; individuals ; couples

health ; welfare

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Family planning(FP)

FP provides the individual and couples with the knowledge and services to:
 Decide when to _______ childbearing
 Decide when to _______ childbearing
 _______ the pregnancies for the benefit of the entire family
 Match the _______ of children born to the family with ______________ to adequately care for them
 Enable _______ couples to have children

start; stop

Space ; number

available resources

sub-fertile

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Benefits of family planning to the child
 Birth spacing allows a mother to replenish her reserve thereby avoiding the problems of ____________ babies
 Reduces _________ for food and other necessities of life.
 Reduces the incidence of _________ which can arise when a pregnant woman weans her baby who would otherwise have been on breast milk
 Children born to _________ women are more likely to have congenital defects e.g. Down’s syndrome, cleft lip and palate

low birth weight

competition ; malnutrition

elderly women

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Benefits of family planning to the woman
 FP prevents ________ pregnancies
 It helps the woman or the couple have the ________ of children they want or can adequately support
 ________ methods of contraception control the spread of sexually transmitted diseases from one person to the partner

high risk

number ; Barrier

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Benefits of family planning to the woman
 Pills reduce the chances of women having _______ and _______ _______ and also protect against _______
 Pills and intra-uterine contraceptive devices protect against _______ pregnancies
 FP services offer the woman the opportunity of _______ her _______ before beginning childbearing.

ovarian and endometrial cancers

anaemia

ectopic pregnancies

completing her education

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Family planning and population growth
 FP not only improves the _______ of life of the mother and child but that of the society at large
 FP services have been used as strategies for checking high ___________________ .

quality

population growth rate

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The consequences of high fertility rate include:
- Reduction in the ____________ of family members
- _________ on public utilities and facilities like water, electricity, education and health services
- Decline in _________________

quality of life

Pressure

Gross Domestic Product

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Family planning methods
 __________ family planning (NFP)/_______________ based methods (FAM)
 _______________ method (LAM)
 Coitus __________
 __________(IUCD)
 __________ contraceptives
 __________
 __________ contraceptives
 ________-pills
 __________
 __________ methods
 __________ contraception

 Natural family planning (NFP)/Fertility awareness based methods (FAM)
 Lactational amenorrhea method (LAM)
 Coitus interruptus
 Intra-uterine contraceptive device (IUCD)
 Injectable contraceptives
 Implant
 Combined oral contraceptives
 Mini-pills
 Spermicides
 Barrier methods
 Surgical contraception

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Natural family planning & Fertility awareness based methods
 When couples are using NFP, they should ________________________ during the at-risk fertile days.
 With FAM, couples use another method such as _______ or _________ during those days

 There’s a high pregnancy rate but may be the only option available to people of some ________________

abstain from intercourse

barriers ; withdrawal

religious beliefs

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Common ways of knowing date of ovulation include:
- _________ /_________
- Basal _______________
- _________ _________ (Billings)
- Sympto-thermal method
- Cycle _________

Calendar/rhythm
Basal body temperature
Cervical mucus (Billings)
Cycle beads

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Contraindications of NFM/FAM
 Women with _________ menses
 ____________ mothers whose periods have not yet returned
 Women whose partners are not ___________ to the method

irregular; Breastfeeding

committed

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Lactational Amenorrhea Method
 In general, _________ delays the return of fertility in the postpartum period.
 LAM is based on _________ _________.

 Effectiveness: perfect use failure rate in first 6 mths: 0.5%; typical use failure rate: 2%

breastfeeding

exclusive breastfeeding

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LAM is effective only under the following conditions:
- Woman __________ __________ both __________ and __________
- Woman has __________
- Infant is less than __________ old

breastfeeding exclusively

night and day

amenorrhea ; 6 months

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Coitus interruptus
 This is withdrawal of the penis from the vagina just before ejaculation
 Typical use failure rate in first year = ______%
 May not be applicable for couples with sexual dysfunction such as _________ ___________
 Requires the ______ co-operation and instruction
 May reduce ____________ especially for the (man or woman?)
 May be used in conjunction with a ____________
 _______ protection against STIs

27%

premature ejaculation ; man’s

sexual pleasure ; woman

spermicide ; No

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Intra-uterine contraceptive device
 They can remain in the uterus for _________ and may be removed at anytime if pregnancy is desired
 Prevents _________
 Non-medicated type (_________) no longer used
 Medicated type include _________ (Cu-T380A), _________ (Cu-T250 & Cu-375), and _________ impregnated IUCDs
 It can be inserted at any time of the cycle provided the woman is not pregnant but preferably during _________ or _________ postpartum
 Highly effective: 94 – 99%

5 yrs ; implantation

lippes loop ; Copper T

multiload ; progesterone

menstruation ; six weeks

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Contraindications to IUCD
Absolute:
 ___________
 ___________ of reproductive organs  ___________ ___________ diseases
 Abnormal ___________ ___________

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 Pregnancy
 Malignancies of reproductive organs  Pelvic inflammatory diseases
 Abnormal vaginal bleeding

Contraindications to IUCD

Relative:
 Women with _______ sex partners
 Those who have _______ _________
 History of _______ in last _______
 History of _______ pregnancy

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multiple

never given birth

PID ; 3 mths

ectopic

Advantages of ICUDs:
 Effective
 Independent of ___________
 No ______________ required
 Easily available
 _______ lasting

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intercourse

day to day action

Long lasting

Disadvantages of IUCDs
 Increased risk of __________
 _________ may lead to pregnancy
 Abnormal __________ may occur
 No protection against ________
 Mild _________

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infection

Expulsion ; menstruation

STIs ; cramps

Injectable contraceptives

2 types given ______________ : norethisterone enanthate (_________) and Depot medroxy-progesterone Acetate (___________)

 it Suppresses _________ , _________ cervical mucus blocking sperm _________, _________ tubal and endometrial mobility and causes _________ of the endometrium

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intramuscularly

Noristerat ; Depo Provera

ovulation ; thickens ; entry

slow ; thinning

Advantages of injectable contraceptives :  Highly effective. Failure rate 3%  _______ acting  Not related to _____________  Makes _______________ less frequent and less painful  May increase blood _________ level  Protection against _________ and _________ _________

Long ; sexual intercourse sickle cell crisis haemoglobin ; ovarian endometrial cancer

Disadvantages of injectable contraceptives :  Requires frequent visit to the clinic (________ interval)  May cause ________ ________  Menses may ________ for several months  Return of fertility may be _______  May cause weight _______  (Does or Does not?) protect against STIs

2-3mths ; irregular bleeding cease ; delayed gain ; Does not

Contraindications for injectable contraceptives  _________  Abnormal _________ _________  Breastfeeding mothers less than _________ after delivery  _________ of the breast or genital organs  History of _________, _________ or _________ problem

Pregnancy ; uterine bleeding 6 weeks ; Malignancies stroke ; heart attack blood clot

Implants  ____________ contraceptives inserted under the skin of woman’s ________ by a minor surgical procedure.  Failure rate: 0.05%  Inhibits __________ , _______ endometrium, _________ cervical mucus

Progestin-only upper arm ovulation ; thins thickens

Types of implants : __________ (___ rods, no longer used), Jadelle (2 rods), ______ (____ rod), _________ (____ rod)

Norplant (6 rods Uniplant (1 rod) Implanon (1 rod)

Advantages of implants:  ______-lasting  Fertility returns to previous level after removal of rods  No __________ to clinic  Effective within _________  Other advantages as injectables

Long repeated visits 24hrs

Disadvantages of implants :  Similar to injectables  Insertion can cause _________ , _________ or _________  Cannot ___________________ on her own Contraindications: similar to injectables

bruising ; infection bleeding discontinue method

Combined oral contraceptive pills  Contain _________ and _________ in various combinations  Suppresses _________, _________ endometrium, _________ cervical mucus, _________ tubal & endometrial motility  Failure rate (typical use): 8%

estrogens ; progesterones ovulation ; thins thickens ; slows

Advantages of Combined oral contraceptive pills :  Highly effective if used correctly  Can be _________ independently  Not related to sexual intercourse  Reduces __________; prevents _______  Regularizes irregular period  Some protection against ________ of the womb, ovary and benign breast disease

discontinued menstrual flow; anaemia cancer

Disadvantages of Combined oral contraceptive pills :  Has to be taken ________  Can cause mild _________ , nausea, vomiting, ________, weight ______, breast __________ , ________ changes  Does not protect against STIs  ____________ is difficult for some people Contraindications: pregnancy, raised BP, blood clot disorders, tumors of breast or genital organs, >35yrs and smoker, breastfeeding, liver dx, abnormal uterine bleeding

headache ; spotting gain ; tenderness, mood Compliance

________ pills (mini pills)  Contain only ________. It can therefore be used by _________ mothers.  Failure rate: 8%  Mechanism, advantages, disadvantages and contraindications similar to injectables

Progestin-only progesterone. lactating

Spermicides  Come in ________ , ________, ________ and _____________.  ________ or ________ spermatozoa preventing fertilization  Active agent is Nonxynol-9 inserted ________ before sex  (highly or Not highly?) effective  Does not affect ________ and ________

creams ; tablets jellies ; aerosol foam. Kill ; immobilize 20mins ; Not highly lactation and menstruation

Contraindications of spermicides : __________ to preparation, not for women who ___________________

allergy have sex frequently

Barrier methods DIAPHRAGM  _________-shaped rubber cup with (flexible or rigid?) rim.  Inserted into vagina (before or after?) intercourse and acts as a mechanical barrier to sperm __________  Failure rate: 16%

Dome ; flexible before ; migration

Advantages of Diaphragm : Can be worn by _______, protects against (some or all?) STIs, no systemic effect Disadvantage of Diaphragm : not ______________ in Nigeria, requires medical exam and fitting by a _________ , needs special care and storage

client Some readily available provider

CONDOMS:  Mechanical barrier preventing _______ of spermatozoa  Male condom should be rolled on _______ penis and one condom must be used for each ________  Failure rate: 15%

entry erect ; act

The female condom is a __________ sheath that is inserted into the vagina (before, during or after?) sex  Failure rate: 21%

polyurethane before sex

Advantages of condoms : no medical prescription, widely available, protects against STIs, few side effects Disadvantages of condoms : decreases sexual enjoyment for some couples, male condom may burst, female condom has to be held in place during intercourse

Yeahh

Surgical contraception  For couples who do not want more children  ___________ for women  ___________ for men  Failure rate: < 1%

Tubal ligation Vasectomy

 Advantages of Surgical contraception : provides __________ contraception, _____ effective, does not affect _________ or _________  Disadvantages of Surgical contraception : minor ________ required, slight chance of failure, reversal is _________

permanent ; cost menstruation ; libido surgery ; expensive

Emergency contraception  Acts (before or after?) intercourse to prevent pregnancy TYPES: 1. ______ dose _______ 2. _______ method with ______ 3. ______ IUCD

after 1. High dose POPs 2. Yuzpe method with COCs 3. Copper IUCD

Emergency Contraception  Should be commenced within ________  Prevents pregnancy after _______, ________ or ________ method failure

72hrs rape; mistake barrier

Family planning provision  Counseling is a key component of family planning services. Counseling is one person helping another as they talk person-to-person  It has 6 steps:  G – _______  A – _______  T – _______  H – _______  E – _______  R - _______ or _______

 G – GREET  A – ASK  T – TELL  H – HELP  E – EXPLAIN  R - RETURN or REFER

Family planning provision  Counseling has succeeded when:  Clients feel they got the help they wanted  Clients know what to do and feel confident that they can do it  Clients feel respected and appreciated  Clients come back when they need to  And, most important, clients use their methods effectively and with satisfaction

I agree

Family planning provision  Infection prevention is another key element and entails:  _______ washing  _______-level __________ or ___________ of instruments that touch intact mucous membranes or broken skin  ___________ of instruments that touch tissue beneath the skin  Wearing of _______  Doing pelvic examinations only when ___________  Disposal of single use equipment and supplies properly and safely  Washing of linen

washing High-level disinfection ; sterilization Sterilization ; gloves necessary

FAMILY PLANNING SERVICES Flashcards

(49 cards)