this slide will help you to understand about population explosion, women empowerment and family planning and its methods.

1. POPULATION
EXPLOSION
SAURABH SINGH
TOMAR
ASSIT.PROFESSOR
(COMMUNITY HEALTH NURSING)
E-MAIL-saurabh.singh406@gmail.com
COMMUNITY HEALTH NURSING

2. INTRODUCTION
• The meaning of population is “the whole number of people or inhabitants
in a country or region”.
• The meaning of population explosion is “a sudden, large increase in the
size and number of population”.
• In simple words, it could be defined as increase in birth rates and
decrease in death rates.

3. DEFINITION
POPULATION
• Population May be defined as a group of organisms of the same species
occupying a particular space.
OVER POPULATION: (POPULATION EXPLOSION)
• Over population is a condition when an organism number exceeds the
carrying capacity of its habitat.
• over population is not a function of size or density it is determined using the
ratio of population to available resources.

4. CAUSES OF POPULATION EXPLOSION
• INCREASE IN BIRTH RATE
• DECREASE IN DEATH RATE
• BETTER MEDICAL FACILITIES
• INCREASE IMMIGRATION
• DECREASE IN EMIGRATION
• ILLITERACY

5. INCREASE IN BIRTH RATE:
• Birth rate is the no of child born /1000 people/year. With the advent of better
medical facility, economic prosperity, social beliefs the birth rate increases which
causes increase in population
DECREASE IN DEATH RATE:
• Death rate is expressed in units of deaths/ 1000 persons/year. The development of
technologies has resulted in decrease in death rate.
Good and clean atmosphere, sufficient nutrients, better medial facility has provided
longer and healthy life.
BETTER MEDICAL FACILITY
• New inventions of medicines, awareness towards better health and control of
various diseases like TB, Small pox, cancer, has resulted in increase of population
INCREASE IMMIGRATION: THE COUNTRIES
like USA where the development had brought good environment for citizens to stay,
earn , and enjoy had resulted in increase in immigration

6. DECREASE EMIGRATION: IN CASE OF
• Developing Countries the basic requirement of citizens like peace,
development opportunities are satisfied hence migration is avoided this
may cause over population
ILLITERACY:
Due to some social beliefs, lack of knowledge towards family planning, desire
for male child are some of the factors which causes increase in population
OTHER FACTORS
• Place of women in society
• Value of children in society
• Widow marriage
• Customs and belief
• Industrialization
• Urbanization
• Better health facilities
• Good housing condition

7. CONSEQUENCES OF OVERPOPULATION
 LAND OR SPACE
 HOUSING PROBLEMS
 FOOD SUPPLY
 WATER SUPPLY
 SEWAGE DISPOSAL
 SANITATION
 HEALTH CARE AND EDUCATION
 UNEMPLOYMENT AND POVERTY
 CRIMES
 TRAFFIC PROBLEM
 FUEL AND ENERGY PROBLEMS

9. ON HEALTH
ON SOCIAL
CONDITION
ON ECONOMIC
CONDITION
DELIQUENT
BEHAVIOUR
TRAFFICKING
SMUGGLING
BEGGARY
STARVATON
POVERTY
UNEMPLOYMENT
INCREASE
MORBIDITY
AND
MORTALITY
MORE
POPULATION
MORE NEED TO
HAVE BREAD
EARNERS
FLOODS
DEFORESTATION
GLOBAL
WARMING
WATER BORN
DISEASE
NEED FOR MORE
HEALTH
SERVICES
HEALTH
PROBLEM

10. INCREASED
POPULATION
BREAKING OF
LAWS , POLICIESPROSTITUTION
BEGGARY STEALING DELINQUENT
BEHAVIOR
MURDER
TO FULFILL NEEDS
OF HUNGER
DECREASED
PURCHASING
POWER
STARVATION
SOCIAL CRIMES
VIOLENCETRAFFICKING

11. ECONOMIC IMPACT
• Population explosion has its impact on economy of individual society
and community.
• Increased population causes more of unemployment poverty and
starvation. All these factors have impact on the health of individual
which is turn further increases economic burden on the family.
• Following impact can be seen –
• Poverty
• Illiteracy- affect the earning capability
• Unemployment
• Starvation – health problems – more economic burden
• More health problems – burden of health facilities on nation
• More population – deforestation – environment pollution – more
health problems- more economic burden
• More population – unemployment-more social crimes .

12. ECONOMIC IMPACT
MORE
REPRODUCTION
INCREASED ECONOMIC
BURDEN
INCREASED
POPULATION
MORE MORTALITY
MORE HEALTH
PROBLEMS
MALNUTRITION
STARVATION
DECREASING
EARNING
ILLITERACY
DECREASED
SERVICES AND
MORE PEOPLES
DECREASED
CAPABILITY TO GET
EDUCATION
UNEMPLOYMENT
DECREASED EARNING AND
DECREASED PURCHASING
POWER
POVERTY

13. POPULATION CONTROL
Overall development – population control can be achieved by
overall development of women. It means women need to be empowered and
they should be developed socially, economically, and educationally so as to
decide and take appropriate measures to have small size family which helps to
reduce the population growth and achieve the population control.
WOMEN EMPOWERMENT and its –
I. SOCIAL DEVELOPMENT .
II. ECONOMIC DEVELOPMENT.
III. EDUCATIONAL DEVELOPMENT .

15. INTRODUCTION
• Women empowerment means strengthening the capacity of women in
order to identify understand , and control there lives.
Women Empowerment refers to -increasing the spiritual, political,
social, educational, gender, or economic strength of individuals and
communities of women.
• Women’s empowerment in India is heavily dependent on many different
variables that include geographical location (urban/rural), educational
status, social status (caste and class), and age.

16. DEFINITION
• “Empowerment is the process of increasing the authority and
responsibility of individuals or groups to make choices and to
transform those choices into desired actions and outcomes”.
1. Women empowerment is the process by which women
strengthens their capacity individually and collectively to identify ,
understand and overcome gender discrimination thus taking
control of their lives.
According to arrow(1995)
2. Women Empowerment refers to-increasing the spiritual, political,
social, educational, gender, or economic strength of individuals
and communities of women.

18. WOMEN IN INDIA
 Total population - 1210.2 million (2011) {Almost equal to the combined
population of U.S.A., Indonesia, Brazil, Pakistan, Bangladesh and Japan put
together}
 Women population - 586.5 million (48.5%)
 Sex ratio: 943/1000 men
 Child Sex ratio: 919 /1000

19. Women need to be developed socially, educationally and
economically and politically in order to achieve
empowerment among them.

20. SOCIAL DEVELOPMENT
• Social development of women means raising the status of women in the society.
Women are usually dominated by men in the society.
• Social legislation has brought a change by developing the women socially. Now a
days if women is compared with the women of earlier ages they are having more
privileges.
• This is due to certain legislations-
• In 1950 new constitutions of India accorded equal right to the women. Now all
women enjoying equal political right with men. They have the right to vote and
have right to hold public offices.
• In 1955 Hindu marriage act and divorce act has removed several disabilities. No
Hindu can marry second time unless wife or husband is dead or divorced.
• In 1978 the child marriage restraint amendment act has raised the marriage of
girls from 15 to 18 years and for boys 18 to 21 years .
• In 1976 the equal remuneration act provide for equal payment for women and
men workers.

21. EDUCATIONAL DEVELOPMENT-
 Women needs to be educationally developed it has been seen that women
receive less formal education than men and at the same time women own
knowledge , abilities and coping mechanisms often go unrecognized.
 Education will help them in creating awareness regarding demerits and
merits of large and small family size as well as other aspects of health.
 If women is educated than she can educate the whole family members and
can care the family by adopting appropriate measures.
 Lack of education is the obstacle in the development in the women. So there
is need to take all the special effort to raise the literacy rate among women
and girls education.
 The central govt. is providing financial assistance under the plan schemes to
establish schools and colleges exclusively for girls in backward areas.

22. ECONOMICAL DEVELOPMENT
Educational development and social development will bring a change in the
economic condition of the women.
 Women can be empowered economically by-
1. Implementing Income Generation Schemes-
 Technical information is imparted and strategies to plan action
towards development and against injustices.
 Vocational courses for women
 Opening the polytechnics for women
 Rehabilitation of women –- by providing the vocational training cum
employment and residential care to old widows and deserted women.
2. To raise the economic level of women, women development
corporation are playing an important role in providing
employment opportunities to women so as to make them
economically dependent

23. 3) It is essential for the sustainable development of community that the
women should be empowered and developed socially educationally
politically and economically.
4) In 2000 the govt. of India adopted the national policy for the
empowerment of the women. This was to bring about the gender
justices
5 National health policy was under consideration in 2005. the aim of
this policy are
 Women equality in power sharing and active participation in
decision making .
 Comprehensive social and economical development of women .
 Partnership with community based programmes
 Strengthening and formation of relevant institutional mechanisms

24. POLITICAL DEVELOPMENT
 % of seats held by women in local councils/decision making bodies.
 % of women in decision-making positions in local government.
 % of women in the local civil service.
 % of women/men registered as voters/ % of eligible women/men who
vote.
 % of women in senior/junior decision making positions within unions.
 % of union members who are women/men.

25. OTHER NEED FOR WOMEN EMPOWERMNENT
BECAUSE WOMEN ARE DEPRIVED OF:
• Decision Making Power
• Freedom of Movement
• Access to Education
• Access to Employment
• Exposure to Media
• Domestic Violence

26. WHY NEED OF WOMEN
EMPOWERMENT ?
• The main problems that were faced by women in past
days(and still today up to some extent):
• Gender discrimination
• Woman education
• Female infanticide
• Dowry
• Marriage in same caste and child marriage(still existing)
• Atrocities on Women: Raped, kicked, killed, subdued &
humiliated almost daily.

27. Water
&
Sanitation
Asset
base
Health
&
Nutrition
Political
Participation
Marketing
CreditTechnology
Skills
Education
HOLISTIC APPROACH TO EMPOWERMENT

28. WOMEN EMPOWERMENT
PROGRAMMES
 SWAYAMSIDHA
 SWA-SHAKTI PROJECT
 SUPPORT TO TRAINING AND EMPLOYMENT PROGRAMME FOR
WOMEN (STEP)
 SWABLAMBAN
 CRECHES/ DAY CARE CENTERS FOR THE CHILDREN OF WORKING
AND AILING MOTHERS
 HOSTELS FOR WORKING WOMEN
 SWADHAR
 RASHTRIYA MAHILA KOSH (RMK

29. SWAYAMSIDHA: ( INDIRA MAHILA YOJNA)
• It is an integrated project for the development and empowerment of women
through Self Help Groups (SHGs) with emphasis on covering service, developing
access to micro-enterprises.
• About 10 lakh women have taken membership.
SWAM-SHAKTI PROJECT
• Earlier known as the Rural Women’s Development and Empowerment Project, was
sanctioned in October 1998 as centrally sponsored scheme to be implemented in
the states of Bihar, Chhattisgarh, Gujarat, Haryana, Jharkhand, Karnataka, Madhya
Pradesh, Uttaranchal and Uttar Pradesh
SUPPORT TO TRAINING AND EMPLOYMENT PROGRAMME
FOR WOMEN (STEP)
• The program seeks to provide updated skills and new knowledge to poor asset less
women in eight traditional sectors of employment, agriculture, animal husbandry,
dairying, fisheries, handlooms, handcrafts, Khadi and Village industry and
sericulture

30. SWADHAR:
• This scheme was launched in 2001-2002 as a central sector scheme for providing
holistic and integrated services to women in difficult circumstances.
NATIONAL POLICY FOR THE EMPOWERMENT OF WOMEN
(2001)
The goal - of this Policy is to bring about the advancement, development and
empowerment of women.
RASHTRIYA MAHILA KOSH (RMK)
• Also known as the National Credit Fund for Women was set up as a
registered society
under the Societies Registration Act, 1860 on March 30, 1993.
•Credit support or micro-finance to poor women to start income generating
activities such as in - Dairy , Agriculture ,Shop keeping ,Vending and
Handicrafts.

32. PROMOTION OF SMALL FAMILY NORMS :- Population control can be achieve
by the promoting small family norms
The deference in family size can make a tremendous difference in birth rate .
The small family norms were promoted by the slogan “DO YA THEN BUS” in the year
1970 because of 3 child family model
In 1980 campaign was “SONS OR DAUGHTER TWO WILL DO” or SECOND CHILD
AFTER 3 year. These slogan were achieve small family
The emphasis is still to adopt small family. Various ways can be adopted to achieve and
promote small family norms :-
 Family welfare programme
 Family planning methods
 Mass communication
 Information education and communication
 Registration of eligible couple
 Target couples (who have 2-3 living children) to be directed family
planning methods
 Involment of health education institution for promotion of small
family
 Empowering the women

34. INTRODUCTION:-
• “Family planning is the practice of controlling the number of children and the intervals
between their births particularly by means of contraception or voluntary sterilization”
• “Family planning means having only the number of children you want and only when
you want to have them. The purpose of family planning to limit the number of children
in the family and to delay or postpone for some time before having children”
DEFINITION
It is define as the way of thinking and living that is adopted voluntary upon the basis of
knowledge attitudes and responsible decisions by individuals and couples in order to
promote the health and welfare of the family group and thus contribute effectively to
the social development of a country.
According to WHO(1971)

36. TEMPORARY FAMILY
PLANNING
CONDOMES
FOAMS
FILMS
GELS AND
CREAMS
VAGINAL
TABLETS
LAM
COITUS
INTERRUPTS
ABSTINENCE
MECHANICAL
METHOD
EMERGENCY
METHODS
CHEMICAL
METHODS
NATURAL
FAMILY
PLANNING
HORMONAL
METHODS
BIOLOGICAL
METHOD
FEMALE
STERILISATION
MALE
STERILISATION
PERMANENT FAMILY
PLANNING
LEA’S
SHIELDS
SPONGES
IUDS
DIAPHRAGM
FEMCAP
CALENDAR
METHOD
TEMPERATURE
METHODS
MUCUS AND
CERVICAL
METHOD
ORAL
CONTRACE
-PTIVES
INJECTIONS
IMPLANTS
THE PATCH

39. Natural family planning methods do not interfere with the health of
person and these do not have any kind of side effects. This is only
method which are 100% effective and safe.
There are mainly 3 types of natural methods-
a.) ABSTINENCE
B.) COITUS INTERRUPTS OR WITHDRAWAL METHODS
C.) L ACTATIONAL AMENORRHEA METHODS (LAM)

40. A) ABSTINENCE
Abstinence means not having any kind of sex (oral,anal,vaginal) and
not engaging in any kind of activities that put you or your partner in
contact with either body fluids such as semen vaginal flues and
blood. It is away to postpone, not taking the physical and emotional
risks such as pregnancy which one is not ready to handle it
• This method is useful as there is no medical or hormonal side
effects and it does not cost anything.

41. B) COITUS INTERRUPTS OR WITHDRAWAL METHODS
 coitus interrupts involves the withdrawal of penis from the
vagina just before the ejaculation. This prevents the semen
from the entering into the women's fallopian tube.
C) LACTATIONAL AMENORRHEA METHODS (LAM)-
 it is a family planning method for the breastfeeding women. It
provides natural protection against pregnancy for up to 6
months. Breast feeding suppresses ovulation. This method can
be used by women who is breastfeeding her baby day and
night.

43. • It is well known that pregnancy is possible only in the creation period of
a menstrual cycle and there fore it is better to avoid sexual contact
during that period.
• The women is fertile only for 100 to 120 hrs during a month. This period
is known as window fertility period. Avoiding sexual intimacy during this
period pregnancy can be avoided.
• To determine the window of fertility several methods are used such as-
A. Calendar method
B. Temperature methods
C. Mucus and cervical method

44. A.)CALENDAR METHOD
In this method women has to make a record of her periods for six months.
Each month, the number of days between the starting of one period and the
next one is recorded for the last six month. The longest and shortest is
recorded between the periods.
For the shorted interval subtract 18 days and for longest period interval subtract 11
days .
For Eg.- a women who has recorded 28 days as the shortest interval and 30 days as
the longest interval between the periods. So her period of ovulation will be
calculated by –
 From shorted interval , subtract 18
28-18= 10 days
 From longest interval subtract
30-11= 19
So the phase of ovulation will be 10th to 19th from the day of periods (unsafe period)
So the 1st safe period will be 1st to 9th day
And 2nd safe period will be 20th to 30th day

45. SUN MON TUE WED THUR FRI SAT
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30
NOTE- the bold number show the days when conception can
occur. So during this time women should avoid unprotected sex

46. B) Temperature methods
• This method helps to women to know when they are ovulating simply by the
checking the temperature in every morning. In this method women has to
take temperature every morning after waking from at least five hours of
undisturbed sleep and before getting out of bed. The same thermometer is
used in same time.
• A record of temperature is kept and three successive higher average
temperature are identified which shows that ovulation has occurred.
• For most people, 96-98 degrees Fahrenheit is their typical temperature
before ovulation. After ovulation , it goes up to 97-99°F.
• Some basal thermometers are used in your mouth, and others are used in
your rectum (butt). Rectal thermometers are usually more accurate and
reliable.

47. C) Mucus and cervical change method
• The color (white, yellow), consistency (thick, sticky), and the feel (dry,
wet) of cervical mucus can help in determining the safe and unsafe days
to have sex. Examine your discharge, and if you notice it to be white,
stretchy, or wet, it indicates your ovulation phase. During this phase sex
should be avoided.
Effectiveness %: 75% and less

49. • Chemical methods have spermicidal effect. (kill the sperms inside the vagina)
spermicides work by killing sperms and making sperm unable to move towards
the egg. NONOXINOL-9 is the commonest spermicides which is used in these
products.
• The spermicides are effective for about 45 to 60 minutes. These are put into
the vagina before inter-course.
• The main types of chemical methods used are as follows
A. Foams
B. Vaginal tablets
C. Gels, jellies and creams
D. films

50. A. Foams-
These are in aerosol form which are used immediately before sex and are inserted into
the vagina with a special syringe.
Eg.- DELFEN syringe.
B. Vaginal tablets-
these are also known as pessaries these are inserted into the vagina
Eg- double check, orthoforme .
C. Gels jellies and creams –
these are mainly used for spreading into contraceptive caps before insertion.
Eg –
• Durex Duragel
• Gynoll –ll (jelly)
• Ortho- cream (cream)
D. VCF (vaginal contraceptive films)
It is a small square of cleare film that is placed in the vagina. Once it inside the vagina vcf
turns into a gel. The gel contain a spermicide called nonoxynol -9 and it helps to kill
the sperm and it avoid the pregnancy.

52. • Mechanical contraceptive methods prevents
the sperm and egg from meeting to each
other. These devices can be inserted into the
vagina to prevent ejaculated sperm from
passing through the cervix and entering the
womb.
• There are numbers of mechanical methods
given bellow-

53. BARRIER
METHODS
IUDS
CONDOMS
LEA’S SHIELD
SPONGES
DIAPHRAGM
FEMCAP
Male
condoms
Female
condoms

55. (A) BARRIER METHODS
• Barrier methods of contraception are objects or
medicines that blocks the sperms and helps to prevents the
pregnancy some barriers methods can also helps to prevent
the spread of sexually transmitted disease. (STD)
• TYPES- there are many kind of barrier methods –

56. 1. CONDOMS
a) Male condoms-
• male condoms are the most common barrier method of contraception.
They are made of latex, polyurethane or lamb skin. They may be coated
with the silicone, water based gel, or spermicides. Condoms fit over the
men’s penis and block the semen from getting into the vagina.
• Male condoms helps to reduce the spread of STD

57. ADVANTAGES DISADVANTAGES
It is safe and have no hormonal
side effects
It prevent STD, HIV/AIDS, And
pregnancy
This method is cheap and easily
available without any prescription.
Available free at family planning
clinics and health centre.
Protect against pelvic
inflammatory disease .
Easy to use and all ages of men
can use it.
Make the sex less enjoyable
for partners.
 some peoples may feel
embarrassed at the time of
purchasing.
Condoms may develop itching
who are allergic.

58. b)Female condom-
• These are the thin polyurethane sheath shaped like a sock with
flexible rings at each end.
• It placed inside the vagina 8 hrs before the sex. It should not be
used with the male condom.
• Female condoms also prevent the spread of STD

60. ADVANTAGES DISADVANTAGES
Protect against STD, and
HIV/AIDS
It can getting without doctor’s
prescription
These are available in low
prices.
Awkward to use
Must be removed right after
the intercourse.
Can not use simultaneously
with the male condoms.

61. 2.DIAPHRAGM
• A diaphragm is a soft latex rubber dome shaped, that covers the
cervix and help to prevent sperm from reaching in cervix.
• It is a spermicide which is used to coat the inside and outer adge
of this dome shaped silicon or latex cup with the flexible rim. It is
inserted into the back or the vagina so that it covers the cervix
where it blocks sperms. It can use 6 hrs before the sex. And can
stay there for 24 hrs.

63. 3.FEM CAP(CERVICAL CAP)
• Fem cap is a small rubber cap that covers the cervix and block
sperm from entering the cervix.
• The women inserted into the back of her vagina so that it covers
the cervix where it blocks sperms.
• Put a tsp of spermicide in cap and slide it into the vagina.
• Protects for 42 hours, needs to stay in at least 6 hours after sex
• Doctor/clinic visit needed for prescription and fitting
• Perfect effectiveness rate = 91%
• Typical effectiveness rate = 80%

65. 4.LEA’S SHIELD
• Lea shield is an oval shaped made up of silicon rubber.
• A spermicides is used to coat the inside of devices. Then it is
inserted into the back of her vagina so that it covers the cervix
where it blocks sperms.
• It can be worn for up to 48 hrs.

66. 5.SPONGES
• Sponges are the barrier devices to prevent the pregnancy.
• The sponges are the soaked with the vinegar or olive oil or
contain spermicides.
• It placed in the vagina near to the cervix before the sex it helps
to block sperms to reaching to the cervix.
• The sponges can be left for up to 24 hrs.
• It is small polyurethane foam sponges measuring 5cmx2.5cm,
saturated with the spermicides- nonoxynol-9,
• It is less effective than the diaphragm.

69. • The intra uterine devices are the small plastic “T” shaped
device placed into the women’s uterus to prevent the
pregnancy.
• IUDs are medicated and non medicated devices which
provides it’s contraceptive action in the uterine cavity
continuously for a prolonged period of time(Lasts 5 years)
• Releases synthetic progestin hormone that
• changes cervical mucus, fallopian tubes and the uterine
lining. Stops or slows sperm and egg.
• Insertion can cause a few minutes of pain, but removal is
fast and easy.
• Clinic / doctor visit needed for insertion & removal.
• Effectiveness: 99.8%

70. • There are mainly 2 types of IUDs
A. Non medicated
B. Medicated
OR
NON -MEDICATED
A. First generation IUDs
MEDICATED
A. Second generation IUDs (copper IUDs)
B. Third generation IUDs (hormones releasing IUDs)

71. • Non medicated devices are made of polyethylene or
polymers and are referred as the 1st generation IUDs.
• First generation iuds are the inert iuds made up of
plastic(lippes loops) or stational steel(chinese rings).
• These come in different sizes and shapes. These are-
a) Lippes loops
b) Spirals
c) Coils
d) Rings
e) And bows

72. a. LIPPES LOOPS
• Lippes loop is a double shaped device made of polyethylene,
a plastic material that is non toxic non tissue reactive and
extremely durable.
• It consist a small amount of a barium sulphate to allow the x-
ray observation.
• The loop has attached threads or tail made of fine nylon,
which project into the vagina after insertion.

73. • Medicated or the bioactive IUDs release the metal ions as in copper or hormones such
as progesterone. Depending upon this the medicated types of IUDs are of two types.-
a) Second generation
b) Third generation
• Second generation IUDs- they are copper bioactive devices
Earlier Devices –
I. copper-7
II. copper T – 200 B
NEWER DEVICES –
 Variants of the T devices -
I. Cu-T-220 C
II. Cu-T-380 A or Ag
 Nova T
 Multilaode devices
I. ML-Cu-250
II. ML-Cu-375

74. Cu T 200 B Cu T 220 C

75. Multi load 375
Nova T

76. I. COPPER-7
• 7-Shaped IUD: - Further development of the concept of intra-
uterine contraception by metallic copper has resulted in
copper barring IUD, which contains 89mg copper wire, wound
around the vertical limb of a 7-shaped polypropylene device,
to give an effective surface of approximately 200mm2 used
for 3years as intra-uterine contraceptive treatment.
• This device release copper ion at a mean daily dose of
9.87µg/day continuously in the uterine cavity for up to
40months
• The Cu-7 appears to be substantially smaller then other.
• It can be easily inserted because of it’s special 7-configuration
in addition to its small size.
• Insertion can usually be accomplished without the need for
cervical dilation and further more removal is generally
painless.

77. Copper-7

78. ll. COPPER T – 200 B
• It is 3.6 cm in length and 3.2 cm in width. Copper is wound arounds
its vertical stem.
• Contains 200 sq mm surface area of wire containing Copper.
• Cu wire wounded round the vertical stem, T shaped frame made of
Polyethylene, with polyethylene threads.
• life span is 3 years
• Failure rate 3%
COPPER T – 200 B

79. lll. Cu-T 380 A
• Holds 380 mm2 of Cu, wire wounded on stem with extra copper
sleeves on both arms of T.
• “A” indicates Arms, indicating importance of copper sleeve on each
arm with introduction of sleeves efficacy and lifespan is
increased.
• life span 10 yrs.
Cu-T 380 A

80. iv. ML-Cu-375
• Multiload is an IUD, an intra uterine device which is a small
plastic rod, called stem, with two small flexible side-arms.
• This device containing the female hormone
LEVONORGESTREL, this hormone cause changes in cervical
mucus and uterine lining.
• It helps to making difficulties for sperm to reach into the
uterus and harder for a fertilized egg to attach to the uterus.
• It can prevent pregnancy for up to 5 years.

82. • Third generation IUDs are hormone releasing
devices. These are medicated with the steroids,
progesterone.
A. Progestasert – contacting progesterone hormone,
B. Levonova(LNG-20) contacting levonorgestrel
hormone

83. A. PROGESTASERT
• it is a T Shaped intrauterine device that filled with 38mg of
progesteron the natural hormone.
• The hormone is released slowly in the uterus at the rate of 65
mcg.
• It is one of the most effective forms of birth control with a
one-year failure rate around 0.2%.[ The device is placed in
the uterus and lasts three to five years.
• Studies have shown that pregnancy can occur in up to 2 of
each 100 women using a progesterone IUD during the first
year of use.

85. B. LNG-20(MIRENA)
• LNG-20 consists of a T-shaped polyethylene frame (T-body) with a
steroid reservoir around the vertical stem.
• The reservoir made of a mixture of LEVONORGESTREL and
silicone containing a total of 52 mg levonorgestrel. The
reservoir is covered by a semi-opaque silicone membrane.
• The T-body is 32 mm in both the horizontal and vertical
directions.
• The polyethylene of the T-body is compounded with barium
sulfate. The reservoir releases 20mcg per day which declines to
half rate after 5 years.
• Life span- 5 yrs in USA & 7 yrs in Europe and Asia.

87. THE RING(NUVA
RING)
• The ring is a flexible soft ring that release the synthetic
estrogen and progestin hormones that prevent from the
pregnancy.
• The ring is inserted into the vagina where it remains for 21
days. Than it is removed and kept out for seven days.
• It immediate effects and easy to use.
• It does not protects against STD including HIV
• The ring should kept in refrigerator to prolonged its life.
• Side effect may include nausea, headaches and vaginal
discomfort.
• Smokers should not use the rings.

91. • Hormonal methodes are effective if used properly.
• Oral contraceptive contains synthetic ESTROGEN (Ethinyl
,Oestradiol And Menstranol) and PROGESTERON
(pregnanes,oestranes and gonames)
CLASSIFICATION OF HORMONAL
CONTRACEPTIVE
1) Oral Contraceptives (Birth Control Pill)
a) Combined oral contraceptive pills (COCs)
b) Progestin –only pills(POPs)
2) Injections (Depo-Provera)
3) Implants (Norplant I & II)
4) THE PATCH(ORTHO EVRA)

92. • Pills can be taken to prevent
pregnancy
• Pills are safe and effective
when taken properly
• Pills are over 99% effective
• Pills DO NOT prevent STD’s

93. How does the pill work?
• How does the pill work?
• Stops ovulation
• Thins uterine lining
• Thickens cervical mucus.

94.  Prevents pregnancy
 Eases menstrual cramps
 Shortens period
 Regulates period
 Decreases incidence of ovarian cysts
 Prevents ovarian and uterine cancer
 Decreases acne
 Breast tenderness
 Nausea
 Increase in headaches
 Moodiness
 Weight change
 Spotting

95. • Once a day at the same time everyday
• Use condoms for first month
• Use condoms when on antibiotics
• Use condoms for 1 week if you miss a pill or
take one late
• The pill offers no protection from STD’s

97. • Contain low – dose of both synthetic estrogen and progestin.
• COCs inhibits ovulation(primary mechanism) and thickens
the cervical mucus and change sperm transport(secondary
mechanisms)
• There are two type of COCs are available-
I. MALA-N- available at all PHCs and urban family welfare
centers.
II. MALA-D – available in market at the cost of Rs 2/- per
packet.
III. Besides MALA- D there are some more brands name such
as ECROZ, PEARL, MOTI, CHOICE, APSARA, and SUVIDA, are
available in market easily.

98. Mala – N or Combined Oral Contraceptives (COCs) use two hormones
(estrogen and progestin) to prevent pregnancy.
A pack of oral contraceptive pill contains 28 pills (21 hormonal and 7 non-
hormonal (iron). A pill is to be taken everyday, the reminder for which is also
marked on the COC pack. MALA-N- available at all PHCs and urban family
welfare centers at free of cost.
PROGESTROGEN ESTROGEN
LEVONORGESTREL
Dose- 0.15mg
ETHINYL ESTRADIO
Dose- 0.03mg
COMPOSITION

99. MALA-D – available in market at the cost of Rs 2/- per
packet.
COMPOSITION
PROGESTROGEN ESTROGEN
LEVONORGESTREL
Dose- 0.15mg
ETHINYL ESTRADIO
Dose- 0.03mg

100. • These are monthly series of pills in which pills is taken daily. Progestin only piils
cointain synthetic progestrogen. These are commonly known by the name
MINI PILLS. These are best contraceptive for breast feeding women.
• It must be taken at the same time every day as the hormone dose is small and
forgetting one day pills can cause the method to be ineffective.
• It’s often called the “Mini-Pill” because it doesn’t contain estrogen.
• It may be prescribed for young and adult women who can’t take estrogen due
to an underlying medical condition, sensitivity or because of an unwanted side
effect.
• These are better than COCs as these do not affect lactation or increase BP. And
also do not cause headache.
• But the failure rate high as compared to COCs.
• Contraindication –
I. Breast cancer
II. Liver cirrhosis
III. Benign and malignant liver tumors
IV. history of ischemic heart disease

101. DESOGESTREL 75 µG (E.G.,
CERAZETTE)

102. • Ones a week pills called SAHELI Can also used to prevent pregnancy.
• It is non steroidal and is available in the market at Rs. 1.5 per tablet
• . Saheli is world’s first and only oral non Steroidal contraceptive pill.
‘Saheli’ (ormeloxifene 30mg)
• zero side effects
• The only non – steroidal pill with no side effects with ormeloxifene as the
active ingredient.
• Most convenient and safest mode of contraception with a dosage of one
pill a week.

104. DEPO-PROVERA
(DMPA)
NORSTRAT
(NET-EN)

105. DEPO-PROVERA(DMPA)
• A long acting hormone injection
• Female is given a shot one time every 3 months
• Not reversible- once the injection occurs, the hormones are in the
woman for at least 3 months. It may take a long time to get pregnant
after the shot.
• More chance of weight gain than any other method
• Clinic / doctor visit needed every 3 months
• Effectiveness: 94-99.8%
SIDE EFFECTS
• Extremely irregular menstrual bleeding and spotting for 3-6 months!
• NO PERIOD -after 3-6 months
• Weight change
• Breast tenderness
• Mood change
*NOT EVERY WOMAN HAS SIDE-EFFECTS!

106. DEPO-PROVERA(DMPA)
DOSE- 150Mg/3month
Route- intramuscular (IM)
Composition- DMPE (Depot-
Medroxyprogesteron Acetate)

107. • The Noristerat injection is a reversible, progestin-only method of
prescription birth control.
• Noristerat is a contraceptive injection that contains the progestin
hormone, norethisterone enantate.
• The effectiveness, advantages, and disadvantages of Noristerat are
similar to Depo Provera but its duration of action is shorter for 2
months.
• Effectiveness-Noristerat is 97% to 99.7% effective. This means that
with typical use, 3 out of every 100 women who use Noristerat
become pregnant in one year.
• DOSE- 200Mg/2month
• Route- intramuscular (IM)
• Composition- NET-EN (Norethisterone Enantate)

108. CYCLOFEM: 25 mg of DMPA and 5 mg of estradiol cypionate
•MESYGYNA: 50 mg NET-EN and 5 mg estradiol valerate
•Administered by deep IM every month.
•The contraceptive efficacy is similar to (DMPA) and OCs, an estimated
failure rate of 0–0.1 per 100 woman-years.
•The most common side effect: irregular bleeding during the first
three months. Over the longer term, however, most women (83%)
have regular menses

109. • A soft rod 1 ½ inches(size of paper matchsticks)
Plastic capsules inserted under the skin in the arm.
• it consist of six small , slender silicon rubber, flexible, non biodegradable
capsules filled with the synthetic progestin (210mg levonogrestrel) each
capsule containing 35 mg LNG.
• under the skin in your upper arm
• Implants are placed in the body filled with hormone that Slowly released
into your system and prevents pregnancy
• Physically inserted in simple 15 minute outpatient procedure
• 99.95% effectiveness rate.
• Prevents pregnancy for 3 years, but can be taken out at any time.
• Clinic / doctor visit needed every 3 years

110. NORPLANT I vs NORPLANT II
• Six capsules • Two capsules
• Five years • Three years

112. Common side effects include
• weightgain,
• nervousness,
• anxiety, nausea,
• vomiting,
• mastalgia,
• dizziness,
• dermatitis/rash,
• hirsutism,
• scalp-hair loss,
• headache,
• depression, and
• Sometimes, pain, itching or
• infection at the site of the implant will occur.

113. ADVANTAGES and DISADVANTAGES
ADVANTAGES DISADVANTAGES
Effective even in heavier women
Provides long term pregnancy
protection
It is reversible
No change in the quality and
quantity of the breast milk.
Prevent pregnancy up to five year.
No estrogen side effect
No interference with sexual
enjoyment.
DO Not provide protection against sexually
transmitted disease.
Specially trained practitioner is required for
implant and removal. it is not start or stop its
use by self.
Discomfort for several hours
Removal is painful.

114. • A bandage-like patch that sticks to your skin
• Changed weekly, no patch on 4th week.
• Hormones are absorbed through the skin
• Less effective if you weigh over 198
• May cause skin irritation.
• Prescription needed
• Effectiveness: 91-99.7%

117. • Emergency contraception pills Often called the morning-after
pill, can reduce the chance of a pregnancy by 75% if taken
within 72 hours of unprotected sex!
• Must be taken within 72 hours of the act of unprotected
intercourse or failure of contraception method.
• Contains a higher dosage of the same hormones
(levonorgestrel) found in regular birth control .
• Available at pharmacy for girls
• Available at pharmacy for girls 17+, prescription is needed if
less than 17
• Must receive ECP from a physician
• 75 – 84% effective in reducing pregnancy

120. • These procedures are permanent, and are
usually done by people 35+ years
• Both procedures are done in hospital

121. PERMANENT FAMILY PLANNING
MALE
STERILISATION
FEMALE
STERILISATION
VASECTOMY TUBAL
LIGATION
LAPROSCOPY
NO SCALPEL
VASECTOMY

123. DEFINITION:
• A Permanent birth control method which involves the blocking of a
man’s Vas deferens tubes.
HOW IT WORKS: -
• The vas deferens from each testicle are clamped, cut, or otherwise
sealed which prevents sperm from mixing with the semen that is
ejaculated from the penis.
• effectiveness of a vasectomy is 100% but in reality it is only 99.85%
effective.
• After a vasectomy, a male will still ejaculate, but there won’t be any
sperm present
MALE STERILISATION

124. During a vasectomy (“cutting the vas”) a
urologist cuts and Ligates (ties off) the ductus deferens.

125. Advantages Disadvantages
Permanent method of
birth control.
Safer and cheaper
procedure than tubal
ligation in women.
It does not interfere the
ability to have sex.
 Requires no daily
attention.
Does not affect pleasure
Not immediately effective.
 Does not protect against
STD’s
Requires minor surgery in
a clinic.
Reversal surgery is difficult
Bleeding or blood clot or
infection at the incision site.

126. • No scalpel vasectomy (also called keyhole vasectomy or NSV) is
a vasectomy procedure variant in which a sharp hemostat is used to
puncture the scrotum.
• This offers several benefits, there is no need for surgical sutures to
close the skin.
• vasectomy was developed and first performed in China by Dr. Li
Shunqiang with the aim of reducing men's fear related to the
incision.
• No scalpel vasectomy was introduced in India in 1998. A team of
Indian surgeons lead by Dr RCM Kaza.

127. Anaesthesia
 No scalpel vasectomy is performed under local anaesthesia.
Usually lidocaine 2 percent is infiltrated into the vas deferens and
the puncture site on the scrotum.
 This makes the procedure pain free.
Eligibility criteria in India.
 The Government of India stipulates more stringent criteria:[6]
 Should be married
 Should be above 22 years of age and less than 60 years of age
 Should have at least one living child above 1 year of age (to pass the
age of infant mortality)
 Should be mentally sound to understand and give consent
 Should not be coerced or under any pressure

129. • Surgical procedure performed on a woman Fallopian tubes
are cut, tied, cauterized, prevents eggs from reaching
sperm
• A small incision is made in the abdomen to access the
fallopian tubes. Fallopian tubes are blocked, burned, or
clipped shut to prevent the egg from travelling through the
tubes
• Recovery usually takes 4-6 days
• Failure rates vary by procedure, from 0.8%-3.7%
• May experience heavier periods
FEMALE STERILISATION
TUBAL LIGATION (MINI LAP,
TUBECTOMY)

132. ADVANTAGES DISADVANTAGES
Tubal ligation is considered a
permanent method of
sterilization and birth control.
 Reduces the risks of pregnancy
Reduces the Pelvic
inflammatory disease (PID)
 Protection against ovarian
cancer.
Infection or abscess of wound
Injury to the internal organs
Pain can occur for several days
after the procedure.
Death, due to the procedure or
anaesthesia, is extremely rare.

133. ’
• A LAPAROSCOPY is used for sterilisation purpose. The abdomen is
inflated with carbon dioxide or nitrous oxide and laparoscopy is
introduced to visualize the fallopian tubes. Then the clips are applied to
occlude the tube.
• It is not advisable 6 weeks after delivery.
• The client is kept under observation in hospital for 48 hours.
• Women having heart disease
• Respiratory disease
• Diabetes
• Hypertension
• Hb not less than 8mg/dl

134. ’

135. ANY QUESTION ?
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136. THANKYOU