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Oral Pills
Oral contraceptive widely known as "pill" has become the most popular spacing method since early sixties. Oral pills are the most effective reversible, safe and convenient form of contraceptives.
Contd..
Decreases risk of ovarian, endometrial cancers and ovarian cysts Protection against PID
Disadvantages/risks
Requires regular and dependable supply. Client dependent Offers no protection against STDs/HIV.
Precautions
Has a suspected pregnancy by history, symptoms, or signs Six weeks to 6 months postpartum Taking anti-seizure drugs for epilepsy or rifampin for tuberculosis
Contraindications
Current or past history of venous thrombo embolic disorders
Breastfeeding Breast cancer Active liver disease
Contd..
Smoking over 15 cigarettes a day and over age 35 High blood pressure Headaches
Timing of initiation
If pills are begun within 5 days of the start of menses, no backup method is needed. If pills are begun after the fifth day of the menstrual cycle, a backup method must be used for 7 days.
Contd..
Postpartum Breastfeeding mothers
Non-breastfeeding mothers (after 3 weeks postpartum) Within 7 days following spontaneous or induced first trimester abortion
Contd
If the woman misses three pills, another form of contraception should be taken immediately If two menstrual periods are missed completely, the woman should be examined for pregnancy.
IUCDs
The copper-bearing intrauterine device (IUD) is a small, flexible plastic frame with copper sleeves or wire around it. A specifically trained health care provider inserts it into a womans uterus.
Contd..
IUDs are a form of long-acting reversible contraception, which is the most effective type of reversible birth control. Types of IUDs Copper-releasing (Copper T 380A) Progestin-releasing
Effectiveness of IUCD
There is less than 1 pregnancy per 100 women using an IUD over the first year Studies have found that the TCu-380A is effective for 12 years.
Mechanisms of Action
Benefits
Highly effective (0.6B0.81 pregnancies per 100 women during the first year of use)
Effective immediately
Long-term method Do not interfere with intercourse
Benefits contd..
Immediate return to fertility upon removal Do not affect breastfeeding
Benefits contd..
Decrease ectopic pregnancy also used as an emergency contraception
Limitations
Pelvic examination required screening for STDs recommended before insertion Require trained provider for insertion and removal
Increase menstrual bleeding and cramping during the first few months
Contd..
May be spontaneously expelled Rarely (< 1/1000 cases), perforation of the uterus may occur during insertion May increase risk of PID and subsequent infertility in women at risk for STIs.
References
1. Park K.Park K. Parks Textbook of Preventive & Social Medicine.
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