2. Contraceptive Devices
Female Reproductive System
Natural Methods
Barrier Methods
Hormonal Methods
Surgical Methods
Delivery Process
Fetal Presentation
Abortion

4. Side Sectional View of Female Reproductive
System

5. Female External Genitalia
BACK TO TOPICS

7. Contraceptive is a regimen of one or
more actions, devices, or medications
followed in order to deliberately
prevent or reduce the likelihood of a
woman becoming pregnant or giving
birth. Methods and intentions typically
termed birth control may be considered
a pivotal ingredient to family
planning.
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9. Abstinence
Refraining from sex with a partner
Refraining from intercourse with a
partner
Celibacy: not engaging in solitary or
partnered sexual expression
Avoids risk of STDs

10. Cyclical charting (Natural family
planning)
Recording of monthly menstrual
events to aid in inducing or
preventing pregnancy
Avoidance of sexual intercourse
during fertile days.
 Variety of techniques:

11. a. Calender method
•First unsafe day is 18 days less than
length of shortest cycle
•Last unsafe day is 11 days less than
length of longest cycle
•Unsafe days may range from 8 days
(day 10-17) to 12 Days (Day 8-20)

13. b. Basal body temperature
•based on body temperature,
immediately upon rising
•not helpful for predicting date of
ovulation

15. c. Cervical mucus method (Ovulation or Billings method)
•based on changes in cervical mucus secretion
•Spinnbarkbeit: special type of mucus that is clear,
slippery, and stretchable
•occurs a few days prior ovulation and peaks at ovulation
•intercourse must be avoided from a few days before to
several days after ovulation
d. Symptom-thermal method
•combines BBT and ovulation method
•Fertile period ends 3 days after elevated temp or 4 days
after peak mucus

16. Advantages
•health
•religious or ethical
•low cost
Disadvantages
•high failure rate
•constant vigilance
•avoidance of sexual intercourse can be long and
impractical

17. Withdrawal
1. Typical failure rate is 19%
2. Advantage
•man assumes responsibility
3. Disadvantages
•difficult for men to predict
ejaculation
•pre-ejaculatory fluid can carry sperm
• BACK TO TOPICS

19. Cervical Cap

21. The cervical cap is a flexible rubber cup-
like device that is filled with spermicide and
self-inserted over the cervix prior to
intercourse. The device is left in place
several hours after intercourse. The cap is a
prescribed device fitted by a health care
professional and is more expensive than other
barrier methods such as condoms.
1. small, thimble-shaped soft rubber device
that fits over cervix; used with spermicide

22. 3.Advantages:
•Can be inserted many hours before sex play.
•Easy to carry around, comfortable.
•Does not alter the menstrual cycle.
•Does not affect future fertility.
•May help you better know your body.
4.Disadvantages:
•Does not protect against HIV/AIDS.
•Some women cannot be fitted.
•Can be difficult to insert or remove.
•Can be dislodged during intercourse.
•

23. Diaphragm

25. The diaphragm is a flexible rubber
cup that is filled with spermicide and
self-inserted over the cervix prior to
intercourse. The device is left in place
several hours after intercourse. The
diaphragm is a prescribed device fitted
by a health care professonal and is more
expensive than other barrier methods
such as condoms.
1. dome-shaped rubber device worn over
cervix; proper use includes spermicide

26. 3. advantages:
•6 hrs before intercourse through 24 hrs after
•used with spermicide, it reduces risk of STDs
•no hormones involved
•reduces risk of pelvic inflammatory disease
(PID)
4. disadvantages:
•must be fitted by health professional
•must remain in place at least 6 hrs

27. Female Condom

29. The female condom, like the male
condom, is a barrier contraceptive made of
latex or polyurethane. The condom has a
ring on each end. The ring that is placed
inside the vagina fits over the cervix,
while the other ring, which is open, rests
outside of the vagina and covers the
vulva. The female condom is sold over-the-
counter.
1. can be inserted 8 hrs before intercourse

30. 3. advantages
•no side effects
•available
•moderate protection from STDs
4 disadvantages
•some loss of sensitivity
•requires motivation
•not as affect in preventing STDs as male
condom

31. Male Condom

33. The male condom is a barrier
contraceptive made of latex or
polyurethane. The condom must be
fitted over the erect penis. The condom
is sold over-the-counter and when
used properly is an inexpensive,
effective barrier to pregnancy and
sexually-transmitted disease.
1. contraceptive sheath worn over
erect penis
•

34. 2. advantages:
•availability
•protection of STD's
•usually, no side effects
•male responsibility
3. disadvantages
•requires motivation and consistency
•condom can slip off
•penis must be withdrawn immediately after

37. Spermicides are chemical products inserted in
a woman's vagina before sex that inactivate or
kill sperm.
1. sperm=killing agents placed in vagina
2. various forms: foam, gel, suppositories
3. Most effective when used with another barrier
method
4. Typical failure rate=21%, PUFR=6%

38. 5. advantages:
•availability
•no hormones
•some protection from STDs
•no known side effects
6. disadvantages
•can irritate
•increased risk of yeast infections
•taste interferes with oral sex

39. Intrauterine Device

41. The intrauterine device shown uses
copper as the active contraceptive, others
use progesterone in a plastic device. IUDs
are very effective at preventing pregnancy
(less than 2% chance per year for the
progesterone IUD, less than 1% chance per
year for the copper IUD). IUDs come with
increased risk of ectopic pregnancy and
perforation of the uterus and do not
protect against sexually transmitted
disease. IUDs are prescribed and placed by

42. 1. contraceptive device placed within
uterine
2. prevents passage of sperm to fallopian
tube
3. used to be thought that IUD's prevent
implantation of fertilized egg in uterus
4. Typical failure rate=0.8-2%,
PUFR=.1-1.5%, depending on brand

43. 5. advantages
•requires little attention
•low cost after initial purchase
•progestin- or progesterone-releasing IUD
decrease menstrual flow
6. disadvantages
•high initial cost
•no protection against STDs
•many possible problems: spontaneously expelled;
ecotopic pregnancy, uterine wall perforation,
BACK TO
TOPICS

45. Hormone-Based Contraceptives

46.  Combination oral contraceptives (birth
control pills)
1. contraceptive hormones taken daily by
mouth
2. combination of low estrogen to inhibit
ovulation and progesterone to thicken mucus,
inhibit ovulation, and hamper implantation.
3. pills vary in whether hormone levels are
constant or change during cycle

47. 5. advantages:
•effective
•easy
•generally safe
•decreases menstrual cramps, shortens period
6. disadvantages
•must be taken daily
•cost
•effects from hormones
•can decrease milk production
•health problems for some women
•no protection from STDs

48. Progestin-only Contraceptives

49.  Progestin-only contraceptives
1. use a synthetic progesterone only
2. prevents ovulation, inhibits sperm movement, and thins
endometrium
3. Different kinds
a. Norplant: placed beneath skin of arm
•effective up to five years
•surgery can cause pain or problems
b. Depo-Provera: injected once every three months
c. Minipill: prevents ovulation
•must be taken every day
•can cause a lack of periods BACK TO TOPICS

51. Tubal Ligation

54. Surgical sterilization which permanently
prevents the transport of the egg to the
uterus by means of sealing the fallopian
tubes is called tubal ligation, commonly
called "having one's tubes tied". This
operation can be performed laparoscopically
or in conjunction with a Cesarean section,
after the baby is delivered. Tubal ligation is
considered permanent but reversals can be
done in many cases.
1. Interrupts fallopian tubes by sealing
tubes

55. 4. advantages:
•highly effective
•permanent
•increased enjoyment of sexual activities
5. Disadvantages
•permanent
•surgery
•no protection from STDs'
•if fails, higher risk of ectopic pregnancy

56. Vasectomy

59. Vasectomy is a simple, painless procedure
that is very effective in preventing
pregnancy. Men usually have no side effects
from vasectomy, and no change in sexual
performance or function.
1. cut an tie the vas deferens
2. Sperm still present up to 8 weeks after
surbey
3. Typical failure rate= 0.15%; PUFR=0.1%

60. 4. advantages
•highly effective
•permanent
•relatively safe
5, Disadvantages:
•permanent
•not immediate
•no protection from STDs'
•occasional regret
BACK TO TOPICS

62. Delivery presentation describes the way
the fetus is positioned to come down the
birth canal for delivery. The presentation
is defined by fetal attitude, the presenting
part, and maternal and fetal landmarks.

63. Fetal station
This is the relationship between the
presenting part, whether that be the head,
shoulder, buttocks, or feet, and two parts of the
maternal pelvis called the ischial spines.
Normally the ischial spines are the narrowest part
of the pelvis, and are a natural measuring point
for the delivery progress. If the presenting part
lies above the ischial spines, the station is
reported as a negative number from 0 to -3 where
each number is a centimeter. If the presenting
part lies below the ischial spines, the station is
reported as a positive number from 0 to 3 where

65. 0 Station

66. +1 Station

67. +2 Station

68. +3 Station

69. Fetal lie:
This is the relationship between
the head to tailbone axis of the fetus
and the head to tailbone axis of the
mother. If the two are parallel, then
the fetus is said to be in a longitudinal
lie. If the two are at 90-degree angles
to each other, the fetus is said to be in
a transverse lie. Nearly all (99.5%)
fetuses are in a longitudinal lie.

70. Transverse Lie

71. Longitudinal Lie

72. Fetal attitude:
The fetal attitude describes the
relationship of the fetus' body parts to
one another. The normal fetal attitude is
commonly referred to as the fetal position:
the head is tucked down to the chest, with
arms and legs drawn in towards the center
of the chest. Abnormal fetal attitudes may
include a head that is extended back or
other body parts extended or positioned
behind the back. Abnormal fetal attitudes
can increase the diameter of theBACK TO TOPICS

74. Cephalic (head first) presentation is considered
normal, but a breech (feet or buttocks first) delivery can
be very difficult, even dangerous for the mother and the

76. Types of Breech Presentation

77. If your baby is breech, his bottom is the part
of his body closest to the birth canal. No one is
sure what causes a breech presentation, but it
happens in 3% to 5% of single-baby deliveries.
There are three types of breech presentation:
complete, incomplete, and frank.
Complete breech is when both of the baby's
knees are bent and his feet and bottom are closest
to the birth canal.
Incomplete breech is when one of the baby's
knees is bent and his foot and bottom are closest
to the birth canal.
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79. An abortion is the removal or expulsion
of an embryo or fetus from the uterus,
resulting in or caused by its death. This can
occur spontaneously as a miscarriage, or be
artificially induced by chemical, surgical or
other means.
Abortion (from the Latin word aboriri,
"to perish") may be briefly defined as "the loss
of a fetal life."

80. • Abortion
• Loss of pregnancy before viability of fetus;
may be
• spontaneous, therapeutic or elective (clients
may use
• term “miscarriage” for spontaneous
abortion.)
•

81. • Types:
• a. Threatened abortion
–cervix closed
–some bleeding and contractions
–fetus is not expelled
• b. Inevitable
–cervix open
–heavier bleeding and stronger contractions
–loss of fetus usually not avoidable

82. Incomplete
1. expulsion of fetus is incomplete
2. membranes or placenta retained
Complete
1. all products of conception expelled
Missed
1. fetus dies in uterus, but is not
expelled

83. • . Habitual
– three pregnancy in a row culminating in
• spontaneous abortion
– may indicate need for investigation into underlying
causes

84. • Assessment findings:
• Vaginal bleeding (observing carefully for
accurate
• determination of amount, saving all
perineal pads).
• Contractions; pelvic cramping, backache
• Lowered hemoglobin if blood loss significant
• Passage of fetus/tissue
•

85. • Nursing interventions:
• Save all tissue passed (Histopathology
examination).
• Keep client at rest and teach reason for bed
rest.
• Increased fluids PO or IV as ordered.
• Prepare client for surgical intervention (D &
C or suction evacuation) if needed

86. • Provide discharge teaching about limited activities
• and coitus after bleeding ceases.
• Observe reaction of mothers and others, provide
• emotional support and give opportunity to
express
• feelings of grief and loss.
• Administer Rhogam if mother is Rh negative.
•

87. Two Types of Abortion:
Spontaneous abortions
Is generally referred to as miscarriages, occur
when an embryo or fetus is lost due to natural
causes before the 20th week of gestation
Induced abortion
A pregnancy can be intentionally aborted in
many ways. The manner selected depends chiefly
upon the gestational age of the fetus, in addition
to the legality, regional availability, and doctor-
patient preference for specific procedures.

88. Types of Induced Abortion:
Surgical Abortion
In the first twelve weeks, suction-aspiration
or vacuum abortion is the most common method.
Medical Abortion
Effective in the first trimester of pregnancy,
medical (sometimes called chemical abortion)
Combined regimens include methotrexate or
mifepristone, followed by a prostaglandin (either
misoprostol or gemeprost)

90. Medical Abortion