Family theory, reproduction and contraception

Family

A group of two or more people who identify as a family and are bound by emotional ties and sharing, regardless of legal or genetic relationship.

Nuclear Family

Two parents and their children; parents may or may not be married.

Extended Family

Multiple generations living together in one household.

Single Parent Family

A family with only one parent raising children.

Childless Family

A couple without children.

Traditional Definition of Family

Family members related by legal or genetic relationships.

Non-Traditional Definition of Family

At least two people who identify as a family based on emotional closeness and shared life.

Subsystem

Individual family members within the family system.

Suprasystem

Groups or systems outside of the family that interact with it.

Family Development Theory

Views the family as a developing group that progresses through predictable stages of growth and change.

Stages of Family Development

Newly married couple, childbearing family, families with adolescents, families launching young adults, older family, and death of a partner.

Family Systems Theory

A family is a system where each member affects the others; a change in one member influences the entire family.

Family Boundaries

Imaginary but real lines that define roles and relationships between family members and with the outside world.

Family Stress Theory

Explains how families respond to stress; crisis occurs when stressors exceed coping abilities.

Factors Affecting Stress Response

Family type/stability, available resources, perception of the event, and learned coping strategies.

Family Role Theory

Roles are defined by culture, and individuals take on multiple roles such as parent, student, or employee.

Role Expectation

Behaviors and emotions that are expected of someone in a given role.

Role Stress or Strain

Difficulty fulfilling multiple role expectations, such as balancing work and parenting.

Role Transition

Changing from one role to another, often causing stress (e.g., becoming a parent).

Anticipatory Socialization

Preparation for new roles through education, classes, or discussion (e.g., childbirth classes).

Healthy Family Attributes

Commitment to growth, appreciation, communication, flexibility, problem solving, and balance of resources.

Cultural Beliefs About Health

Cultural systems define how health and illness are perceived, their causes, and acceptable treatments.

Southeast Asian Health Beliefs

Illness may be attributed to metaphysical, naturalistic, or supernatural causes; may swaddle infants to protect from “winds.”

Hispanic Health Beliefs

Illness may result from imbalance in energy or exposure to natural forces; strong influence of spirituality.

Religious Beliefs Impacting Health

Jehovah’s Witnesses refuse blood transfusions; some fundamentalist Christians may delay medical care in favor of prayer.

Cultural Concepts of Health

Culture defines what is considered healthy, the causes of disease, stigmatized conditions, and pain expression.

Patient Interaction Differences

Eye contact, communication style, and trust in providers may vary based on culture.

Pitfalls of Cultural Perspectives

Avoid stereotyping; assess each patient’s unique beliefs, values, and preferences.

Female Reproductive Organs

Hypothalamus, pituitary gland, ovaries, fallopian tubes, and uterus.

Gonad

A reproductive organ that produces gametes (egg or sperm).

Tropin

A hormone released by one gland that stimulates another gland to secrete hormones.

Gonadotropin

Hormone that acts on the gonads, such as FSH and LH.

Menstrual Cycle Key Points

Involves feedback loops, baseline hormone levels, and cyclical hormone surges controlling ovulation.

Two Main Cycles

Ovarian cycle (changes in ovaries) and uterine cycle (changes in uterine lining).

Ovarian Cycle Phases

Follicular phase, ovulation, and luteal phase.

Follicular Phase

FSH and LH stimulate follicle growth; estrogen rises; ends with ovulation.

Ovulation Phase

LH surge triggers egg release from ovary; estrogen peaks; may cause mild pain called mittelschmerz.

Luteal Phase

Corpus luteum secretes progesterone and estrogen to maintain uterine lining; if no pregnancy, levels drop and menstruation begins.

Corpus Luteum

Temporary endocrine structure that secretes progesterone after ovulation.

Mittelschmerz

Mild pain during ovulation caused by follicle rupture.

Uterine Cycle Phases

Menstrual, proliferative, and secretory phases.

Menstrual Phase

Shedding of uterine lining; estrogen and progesterone are lowest; typically days 1–7.

Proliferative Phase

Estrogen rises; uterine lining thickens to prepare for fertilized egg; typically days 8–14.

Secretory Phase

Progesterone peaks; uterine lining secretes nutrients for possible implantation; PMS may occur; typically days 14–28.

Progesterone

Thermogenic hormone that raises body temperature after ovulation and supports pregnancy.

LMP (Last Menstrual Period)

Used to date pregnancy; first day of menstrual bleeding.

Site of Fertilization

Outer third of the fallopian tube, near the ovary.

Fimbriae

Finger-like projections that sweep the ovum into the fallopian tube.

Sperm Pathway

Produced in testes → matures in epididymis → travels through vas deferens → joins seminal fluid → ejaculated through urethra.

Spermatogenesis

Production of sperm in the testes.

Vasectomy

Surgical cutting or sealing of vas deferens to prevent sperm release; results in infertility but not sterility.

Types of Contraception

Abstinence, barrier methods, hormonal methods, long-acting methods, sterilization, non-hormonal, fertility awareness, emergency contraception.

Factors in Choosing Contraception

Health conditions, smoking, age, religion, cultural beliefs, partner status, family planning goals, and ability to adhere to regimen.

Barrier Methods

Condoms, diaphragm, cervical cap, contraceptive sponge; block sperm entry into uterus.

Diaphragm

Fitted barrier used with spermicide; must remain in place 6 hours after intercourse, removed within 24 hours.

Condoms

Barrier method available OTC; also protect against STDs.

Spermicides

Non-hormonal agents that destroy sperm or reduce motility; may irritate and increase infection risk.

Short-Acting Hormonal Methods

Pills, vaginal ring, skin patch, injection; require regular use on daily, weekly, or monthly schedule.

Birth Control Pills (BCPs)

Combined estrogen-progesterone pills suppress ovulation and change cervical mucus; 96–99% effective.

Progestin-Only Pills

Recommended for breastfeeding women; suppress ovulation with fewer effects on milk production.

BCP Common Side Effects

Headache, nausea, sore breasts, spotting, and menstrual changes.

BCP Danger Signs (ACHES)

Abdominal pain, Chest pain, Headache, Eye problems, Severe leg pain—possible serious complications.

BCP Contraindications

Hypertension, thromboembolic disease, smoking over age 35, obesity.

Antibiotic Interaction with BCPs

Some antibiotics reduce pill effectiveness; use backup contraception.

Vaginal Ring (NuvaRing)

Flexible device releasing estrogen and progesterone; replaced monthly.

Depo-Provera

Injectable progesterone given every 12 weeks; prevents ovulation and menstruation; not suitable for patients with anemia or liver disease.

Skin Patch (Xulane)

Applied weekly for 3 weeks, one patch-free week; delivers estrogen and progesterone transdermally.

Long-Acting Contraceptives

Include IUDs and subdermal implants; last several years with high effectiveness.

Intrauterine Device (IUD)

Copper or hormonal device inserted into uterus; damages sperm, prevents implantation; lasts 3–10 years.

Copper IUD

Non-hormonal; can increase menstrual flow; may also be used as emergency contraception.

Hormonal IUD

Releases progesterone; thickens cervical mucus and thins uterine lining.

IUD Common Side Effects

Cramping, irregular bleeding, heavier periods initially.

IUD Contraindications

History of STDs or PID; may cause infertility due to scarring.

Subdermal Implant (Nexplanon)

Progesterone-only implant in upper arm; effective for 3 years; thickens cervical mucus and suppresses ovulation.

Sterilization

Permanent contraception for men or women; surgical procedures that block reproductive pathways.

Tubal Ligation

Surgical procedure cutting or sealing fallopian tubes; immediately effective; no change in hormones or menses.

Essure

Former implant device for permanent female sterilization; no longer used due to complications.

Fertility Awareness Method

Tracking basal body temperature and cervical mucus to determine fertile days and avoid intercourse during ovulation.

Spinnbarkeit

Elastic, clear cervical mucus indicating ovulation and fertility.

Basal Body Temperature (BBT)

Slight temperature rise after ovulation caused by progesterone; helps predict fertile window.

Emergency Contraception

Used after unprotected intercourse; includes Plan B, Ella, or copper IUD insertion.

Copper IUD as Emergency Contraception

Can be placed up to 5 days after unprotected sex; most effective emergency method.