Family Planning/Contraception Methods

Family planning concept is based on the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their birth. The eligible couples consists of married couples where the wife is in the reproductive age group (15-49) years of age. This term was previously used as target couple. Eligible couple register is maintained by ANM at the sub-center. There are few terms used for family planning, these are:

• Couple Protection Rate- It is the percentage of eligible couples protected against childbirth by one or other approved family planning methods. It is a good indicator of prevalence of the contraceptive practice in the community.

Couple protection Rate= No. of couples using the contraceptive method/Total no. Of eligible couples multiply by 100

• Effective Couple Protection Rate- It is the percentage of eligible couples effectively protected against childbirth by one or other approved family planning methods.

Also Read: National TB Elimination Programme (NTEP)

Family planning methods under National Family Welfare Program ( NFWP)

1. Condoms: Male condoms are provided( Nirodh)
2. Mala-N
3. IUD
4. Antara
5. Chaya
6. Sterilization

Also Read: Intrauterine Device: Types, Uses, Function, Procedure, Advantages, Risks and Complications

Contaceptive Efficacy

It can detect the  number of unwanted pregnancies occuring in a specific period or use of contraceptives.

• Evaluation of Contraceptive efficacy:
  • Pearl Index- It is defined as No. of accidental pregnancies/ Total months of exposure multiply by 1200.
  • Life Table analysis - It is considered as a better method than Pearl Index. It calculates the cummulative failure rates over a specified time frame.

Also Read: Epidemiology: Ideas, Models, Definitions, Morality, Morbidity Rate, Analytical and Descriptive

Methods of contraception

1. Spacing methods - Spacing between two pregnancies ( atleast of 3 years) and It is a temporary method. It constitutes of:

• Barrier methods : Physical methods, chemical methods 
• Intrauterine devices
• Hormonal methods
• Post conceptional methods

Barrier methods: Condoms- It comes for both males and females. 

1. Male condoms- It is made up of latex and the most famous brand name is NIRODH. It is freely available under NFWP. It is provided under a social marketing scheme and failure rate is 2-14/HWY. It is non-reusable.
2. Female condoms- It is identified by presence of two rings(Inner ring covers cervix and outer ring lies outside vagina). It is sold under brand name FEMIDOM. It is made up of Polyurethane or Nitrile. It is not provided under NFWP but provided freely under NACP. It is reusable.

Diaphragm

1. It is inserted into vagina and pushed to place over the cervix but requires expertise.
2. It should be fitted properly and not damaged.
3. Cervical cap, Vault cap are its some other variations.

Vaginal sponge

1. It must be wet under water till thoroughly wet before insertion and should be gently pushed towards the cervix.
2. The chemical used is Nonoxynol-9.

Spermicides

1. It includes Foams, Pastes , Jellies and Suppositories.
2. These are best used along with condoms.
3. These are surface active agents that binds to sperms and inhibits oxygen uptake by sperms which kills them

Intrauterine Devices

It is a temporary method of contraception and is essential in spacing pregnancies. There is a great importance of the tail of IUD because it gives reassurance that IUD is in place. The types are:

• 1^st generation- Includes Lipples Loop, Grafenberg containing ring
• 2^nd generation- includes Copper containing devices like CuT380A, Nova-T and Multiload.
• 3^rd generation-  includes Hormone containing devices like MIRENA ( LNG-20) and Progestasert.

Also Read: Accessibility, Functions, Obligations, Compensation, Benefits And Facilitators of Asha

The ideal time for insertion of an IUD is during menses or first 5 days of menstruation. Most preferred timing is Immediate Postpartum or Late postpartum that is within 48 hours of delivery upto 1 week.

• Hormonal contraceptives:
• NUVA Ring- Once a moth self administered use. It has both estrogen and progesterone.
• Depot formulation- It is an injectable and most common is DMPA. It is now available under the name ANTARA.
• NET-EN(Norethisterone Enanthate )- It is highly effective and is an injectable hormone.
• Implants- Contains only progesterone. Most common is Norplant which is a subdermal implant contraceptive.
• Patch- It is a transdermal patch which contains both progesterone and estrogen. It inhibits Ovulation.
• Centchroman (Saheli)-  It is available under the name CHAYA. Mechanism of action is Selective estrogen receptor modulator.
• Oral Contraceptive pills ( OCPs): The typpes of OCPs are 
  • MALA-N - Contains Levonorgesterol 0.15mg and ethinylestradiol 0.03mg.( Free supply under NFWP)
  • MALA-D - Contains Ethinylestradiol 0.03mg and Levonorgesterol 0.15mg. It is Rs. 3 per strip under NFWP. 

• Male only pill (Gossypol): It is dervied from a chinese cotton plant and its adverse effect is permanent sterilization.

2. Terminal methods- This is a permanent method . This includes Male sterilization( vasectomy) and Female sterilization(Tubectomy).

Eligibility criteria of male sterilization:

• <60 years of age
• Married
• Sound minded
• At least one child of more than 1 year of age

Eligibility criteria of female sterilization

• Age 22-49 years
• At  least one child of more than 1 year of age
• Sound minded
• Married

Also Read: Screening of Disease

Download the PrepLadder app now to access high-yield content with 24-hr Free Trial. Explore premium study resources like Video Lectures, digital notes, QBank, and Mock Tests for a seamless exam preparation. Start your NEET PG online coaching journey with PrepLadder.