Family Planning - Module 1 Unit 2

Family Planning

To provide universal access to family planning information and services wherever and whenever these are needed. It aims to contribute in reducing infant deaths, neonatal deaths, under-five year old deaths and maternal deaths

How can family planning help you?:

- healthier mothers and children
- delaying pregnancy lets young people stay in school

Humanae Vitae

is an Encyclical Letter written by Pope Paul VI July 25, 1968.

On Human Life

English title of Humanae Vitae

Main Teachings of Humanae Vitae:

• Married LOVE
• Responsible Parenthood
• Natural Family Planning
• Contraceptive Mentality
• Wrongness of Artificial Contraception

NO DIDOW methods (This is for Natural Family Plannning):

- Drugs
- Injections
- Device
- Operation
- Withdrawal

Menarche

the first menstrual period

When will you know if boys reach puberty?

wet dreams / nocturnal emissions

How many chromosomes does sperm and egg cell have individually?:

Sperm = 23
Egg = 23

= 46

Menopause

cessation of menstruation

Andropause

the decrease of the male hormone testosterone

How to solve for the average menses cycle?:

1. Get past 3 months
2. Add them all
3. Divide the sum by 3
4. That is your average

The fertility cycle of a woman varies in length from:

Below 24 days (short cycle),
Within 25-35 days (average cycle),
To more than 36 days (long cycle)

Dry times =
Wet times =

infertile times
fertile times

PHASES OF MENSTRUAL CYCLE:

1. MENSTRUAL PHASE
2. PRE-OVULATORY PHASE
3. OVULATORY PHASE
4. POST-OVULATORY PHASE

MENSTRUAL PHASE:

- If the egg is not fertilized, the thickened uterine lining will be shed off
- Menstruation is the result of ovulation
- Woman observes bleeding, which indicate that there is no pregnancy
- The phase includes all days of menstrual bleeding which usually last 3-5 days

PRE-OVULATORY PHASE:

- Bleeding has stopped
- Egg cells begin to develop
- Lining of the uterus starts to thicken
- Mucus forms a plug, which prevents entry of sperms
- A woman experiences dry feeling and no mucus
- The pre-ovulatory is relatively fertile phase which includes all dry days after the menstrual bleeding stops

OVULATORY PHASE:

- This is the highlight of a woman's fertility
- One mature egg is released and stays in the fallopian tube for about 12-24 hours
- The uterine lining continues to thicken
- The mucus plug disappears
- The mucus becomes very water, stretchy, slipper, and clear.
- This helps sperm swim to the egg
- Mucus nourishes the sperm
- The ovulatory phase is the fertile phase. A woman experiences wet feeling with watery, slippery, stretchy, and clear mucus.

POST-OVULATORY PHASE:

- No egg is present. If there is no meeting of egg and sperm, the cell deteriorates and is absorbed.
- Lining of the uterus has thickened
- The mucus forms a plug again to prevent entry of sperms
- Women experience dry feeling with no mucus at all. If mucus is present, it is sticky, cloudy, crumbly, or pasty,
- Because there is no pregnancy, the woman will experience menstruation and another cycle begins.
- The post-ovulatory phase is absolutely infertile phase which covers about 10-16 days.

(2) Types of Natural Family Planning Methods:

1. Fertility Awareness Based Methods
2. Lactation Amenorrhea Methods

Fertility Awareness Based Methods (FAB):

• Basal Body Temperature (BBT)
• Mucus Method (MM)
• Sympto-thermal Method (Sympto-T)
• Standard Days Method (SDM)

Lactation Amenorrhea Method (LAM): (the types)

• LAM
• LAM -Interface

BASAL BODY TEMPERATURE materials needed:

- Ovulation Thermometer
- BBT Method Chart

Basal Body Temperature:

• Based on the changes in a woman's resting body temperature which is lower before ovulation until it rises to a higher level after ovulation.
• Infertile days begin from the fourth day of the high temperature reading to the last day of the cycle.
• All days from the start of the menstrual cycle up to the third high temperature reading are considered fertile days.

The Basal Body Temperature (BBT) is the body temperature at rest after at least (?) hours of continuous sleep.

three (3)

Best method of taking the basal body temperature using a digital thermometer is through the

axilla

Ovulation Thermometer should be placed at the (?) so that the woman will not rise up

bedside

The highest temperature reading in a BBT thermometer is

38˚C

The effectiveness rate of the Basal Body Temperature method is

99% (perfect use)

For BBT The temperature should be taken in the same manner/site throughout the

menstrual cycle

Shake Ovulation Thermometer until what degree

35*C

Cover line (BBT CHART)

is the point of reference for determining the thermal shift that occurs during ovulation (highest temperature on days 6-10)

THERMAL SHIFT

is indicated by the four (4) consecutive temperatures above the cover line

VERTICAL LINE

is drawn between days 3 & 4 of the thermal shift

FERTILE DAYS

are days to the left of the vertical line

INFERTILE DAYS

are all days to the right of the vertical line

CERVICAL MUCUS METHOD

By observing changes in the cervical mucus, the woman can learn when she is fertile or infertile

Which method has been scientifically tested and endoresed by WHO?

CERVICAL MUCUS METHOD

Other name of Cervical Mucus Method (The creator)

Billings Method

Mucus Types for Cervical Mucus Method:

1. Dry/Thacky/Thick = not fertile
2. Creamy/Sticky = not fertile
3. Cloudy/Stretchy = semi-fertile
4. Watery/Stretchy/Egg white = Fertile

What you feel during CERVICAL MUCUS METHOD:

1. Wet
2. Dry

What you see during CERVICAL MUCUS METHOD:

1. Nothing
2. Blood
3. Mucus

The effectiveness rate of the Cervical Mucus Method is

97%

Who can use the Cervical Mucus Method?:

• Women with menstrual cycles of any length
• Women willing to observe and record changes in their cervical mucus secretions and interpret the records

WHO? observes & records (CMM)

OBSERVING:
woman
RECORDING:
couple

WHAT? observes & records (CMM)

OBSERVING:
Feeling at vaginal area (wet/dry)
RECORDING:
Feeling at vaginal area (wet/dry)

WHEN? observes & records (CMM)

OBSERVING:
- Everyday from first day of menstruation
- Throughout the day
- Before and after urinating
RECORDING:
In the evening, before going to sleep

HOW? observes & records (CMM)

OBSERVING:
Ask self: What do I feel in my vaginal area? What do I see in my underwear?
RECORDING:
Use chart symbols: R, D, X, , 1,2,3, M,

WHERE? observes & records (CMM)

OBSERVING:
Vaginal area (puwerta)
RECORDING:
Mucus Method Chart

Rules of Cervical Mucus Method:

1. Peak-Day Rule
2. Early Days Rule
3. Mucus Method Rule

PEAK DAY RULE:

- Count three days after the Peak Day. During the Post Peak days, the woman will feel dry and see sticky mucus or no mucus at all.
- Peak day - very water (most fertile day)
- On the 4th day after the Peak Day, lovemaking is available to the couple night or day until the next menstruation without resulting in pregnancy.

EARLY DAYS RULE (EDR):

- On dry days following menstruation, lovemaking will be on alternate evenings only.
- Lovemaking can only happen at night because the woman will still be observing the cervical mucus throughout the day.
- Alternate evenings only = to be able to differentiate between cervical mucus and seminal fluid (if the partner ejaculates inside the woman)
- If there are no dry days following menstruation, EDR cannot be applied.

MUCUS METHOD RULE:

- Avoid love making during menstruation.
- Avoid love making during the pre ovulatory phase or dry days following menstruation until the Early Days Rule (EDR) is learned.
- Avoid lovemaking on all days and nights when a woman has wet feeling and/or observes wet mucus.

BBT TECHNOLOGY

The basal body temperature is based on a woman's resting body temperature which is lower before ovulation until it rises to a higher level beginning around the time of ovulation.

CMM TECHNOLOGY

The Cervical Mucus Method is based on the daily observation of what a woman sees and feels at the vaginal area throughout the day. Cervical mucus changes indicate whether days are fertile or not and can be used to avoid or achieve pregnancy.

Sympto-thermal Method

Based on the combination of the Basal Body Temperature & Cervical Mucus Method together with other signs (breast engorgement, unilateral lower abdominal pain) which indicate that the woman is fertile or infertile.

The effectiveness rate of the Sympto-thermal Method is

98%

Sympto-thermal Method (what do you do):

1. Taking of the woman's basal body temperature daily
2. Observing the cervical mucus daily

STANDARD DAYS METHOD (SDM):

- It is based on the woman's menstrual cycle.
- It identifies cycle days 8-19 as the woman's fertile period.
- It works for women with menstrual cycles of 26-32 days.
- Colored beads are used to help the woman keep track of her fertile and infertile days.

For women with cycles of 26-32 days, days 8-19 have been identified as their

fertile window

Effectiveness Rate of the Standard Day Method is

95.25%

THE VERTICAL BEADS is also known as

indicator beads

To use THE VERTICAL BEADS effectively, the couple needs to (?) during the GREEN bead days , when she can become pregnant.

abstain from intercourse

RED bead

marks the first day of menstruation.

GREEN beads

represent the days when a woman can become pregnant (fertile days).

BROWN beads

the days when a woman cannot become pregnant (infertile days).

CHOCOLATE BROWN bead

determine if the woman is within the required cycle range.

LACTATIONAL AMENORRHEA METHOD (LAM):

- It is a modern, temporary family planning method that has been developed as a tool to help support both breastfeeding and family planning use.
- It is based on the natural infertility resulting from certain patterns of breastfeeding.
- Women who are fully breastfeeding and have no menstruation yet can use Breastfeeding as a family planning method within six months after delivery.

Exclusive breastfeeding

no other liquid or solid food is given to infant except breast milk

Feeding interval for Exclusive breastfeeding should not exceed (?) during the day and (?) at night

4 hours & 6 hours

AMENORRHEA

Woman's menstruation (menstrual cycle) has not yet returned (this does not include the spotting or Lochia that occurs 56 days post-partum)

The effectiveness rate of the LACTATIONAL AMENORRHEA METHOD is

99.5%