OUTLINE
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INTRODUCTION
EPIDEMIOLOGY
METHODS OF CONTRACEPTION
CONCLUSION
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Family planning
The planning of when to have children
Choosing the number children to have in a
family
Determine the length of time between their
birth.
Involves use of techniques like
Sexual education
Use of contraception
Preconception counseling and
management
Infertility management
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Family planning services
Educational, comprehensive medical and
social activities
To determine freely the number and spacing
of children
To select the means of achieving these
Has direct impact on health and wellbeing.
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Benefits of family planning
Prevents pregnancy related health risks in
women.
Allows to determine number and spacing
More than 4 children - sharp increase in
maternal mortality.
Reduces unintended pregnancies and the
need for unsafe abortion.
Prevents HIV/AIDS and other STIs
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Helps to reduce infant mortality
Reduces adolescent pregnancies
Empowering people and enhancing education
Reduces population explosion.
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Use of various methods and devices to
prevent conception/impregnation
May be inform of sexual practices, drugs or
surgical procedures.
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Current contraceptive
Nigeria
2008
2009
2010
2012
prevalent rate in
14.6%
11.0%
13.0%
10.0%
Fertility rate in Nigeria is 5.6
UNFPA(2012)
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Life expectancy in Nigeria is 47.2years at
birth
Maternal mortality ratio (600 ->800) in the
last decade.
Globally 13% of maternal death are due to
unsafe abortion (WHO 2011)
Infant mortality rate – 88 in every 1000
births. (UNICEF, WB Indices 2012)
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For every death 20 others suffer morbidities
such as obstetric fistulas , infections and
other disabilities.
Two-third of unintended pregnancies occur
in women not using contraception.
75% of unintended pregnancies can be
prevented by meeting family planning
needs(Singh, S. 2009)
Contraception can reduce maternal death by
44%(Cleland J, Peterson H. 2012)
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Natural family planning methods
Barrier methods
Hormonal methods
Intrauterine devices
Permanent methods (female and male)
Emergency contraception
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Natural family planning
Rhythm method (calendar method)
Basal body temperature
Cervical mucus(Billings method)
Symptothermal method(combined method)
10-20% failure rate
Lactational amenorrhea(0.9-1.2% first
6months 7.4% at 12months)
Withdrawal method(5-25% FR) not in
premature ejaculation
Post coital douche
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Barrier methods
Male condom (10-30% FR first year)
Female condom(15% FR)
Vaginal diaphragm(7%)
Cervical cap
Spermicides(Vaginal jellies, creams, sponge,
gels, suppositories and foam nonoxynol-9,
active for about 2hours).
10-30%FR
Hormonal methods
 Oral contraceptive pills
Combined pills
Sequential
Mini pills(progesterone only)
Reduces incidence of ovarian and
endometrial cancer, benign breast diseases,
Also protects against development of
colorectal cancer and progression of
rheumatoid arthritis.
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Contraindications;
Thromboembolic phenomenon
Breast cancer
Myocardial infarction
Hypertension
Active liver disease
Smoking
Pregnancy
Failure rate between 1-2% if taken
appropriately.
Non contraceptive uses of OCPS
 Menorrhagia
 DUB
 PCOS
 Dysmenorrhea
 Hirsutism
 Acne
Injectables
 Progesterone only( DMPA, NET-EN)
 Combined contraceptive injections(cyclofem,
mesigna)
 Given monthly.
Progestogens
 Suitable for sickle cell disease patients
 Protects against the risk of endometrial and
cancers, endometriosis and PID.
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Irregular vaginal bleeding
Weight gain
Amenorrhea
Return to fertility may take few months
Failure rate 1%
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Implants
Norplants
Jardelle
Implanon
Nexplanon
Failure rate < 1%
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Vaginal ring
Transdermal patch
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Intrauterine contraceptive devices
Cu T 380A, 380S multiload Cu-250, 375.
Heavy menstrual flow and abdominal
cramps
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Hormone releasing e.g progestasert(1year)
mirena IUS LNG20(5-7years)
More suitable in a patient with
menorhagia
Less abdominal cramps
Effectiveness 95-98%
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Sterilisation
Permanent
Male - Vasectomy
Female – Bilateral tubal ligation
Minilaparotomy, per vagina or laparoscopy
Essure (Sterilisation implant).
> 99% effective
Regret 5% >35years
20% <35years
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Emergency contraception
After unprotected sexual intercourse
Failure of contraceptive method
In cases of rape or incest
Following a single act of sexual exposure in
young girls.
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Standard regimen (Yuzpe regime)
IUCD insertion
Failure rate 10%
Family planning is a right of every individual
and there is need to improve on the shortage of
its services and also on the high unmet need
for contraception.
Contribute to improvement in our health
indices and the path to MDG.
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