Antepartum Nursing Care : Human Reproduction

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ANTEPARTUM NURSING CARE

HUMAN REPRODUCTION

Contraception

Contraception refers to methods or devices that are used to lower the risk of fertilization or implantation in order to avoid pregnancy. 24 hours after ovulation, the human ovum can be fertilized. The capacity of motile sperm to fertilize the ovum lasts 48 to 72 hours on average. A nurse should examine the need, desire, and choice of clients for contraception. Each method’s benefits, hazards, and alternatives should be thoroughly examined. QPCC Sexual partners frequently agree on a de8sired preference (vasectomy or tubal ligation). The discussion of future contraception intentions should be included in postpartum discharge instructions.

Family planning strategies are expected to avoid conception until a certain period. Nurses should assist clients in choosing the best option for their specific circumstances. Natural family planning, barrier, hormonal, and intrauterine techniques, and surgical treatments are all forms of contraception.

NATURAL FAMILY PLANNING (FERTILITY

AWARENESS-BASED METHODS)

Abstinence

Abstinence from having sex eliminates the probability of sperm entering the vagina.

CLIENT EDUCATION: Refrain from having sexual intercourse. Discuss acceptable sexual acts with your partners.

ADVANTAGES

  • The most effective birth control strategy.
  • Abstinence during fertile periods (rhythm technique) is one option, but it requires knowledge of the menstrual cycle and fertility awareness.
  • There is no genitalia touch, hence there is no danger of sexually transmitted diseases (STIs).

DISADVANTAGES:

  • It takes self-control.
  • There are no dangers associated with a high failure rate owing to a lack of adherence.

RISKS: There are no risks if full abstinence is maintained.

Coitus interruptus (withdrawal)

Withdrawal of penis from vagina prior to ejaculation

CLIENT EDUCATION: Pre-ejaculatory fluid may leak from the penis before ejaculation. It may include sperm capable of fertilizing an egg.

ADVANTAGES: Possible option for monogamous couples who do not have access to other contraception.

DISADVANTAGES

  • One of the least effective contraceptive techniques.
  • No protection against STIs.

RISKS: Possible pregnancy.

Calendar rhythm method

It entails following the menstrual cycle to determine the timing of ovulation, which happens around 14 days before the next menstrual cycle begins. This approach can be used to help with conception or as a natural contraception. If the client was attempting to conceive, he or she would have intercourse during the fertile time. If the client is wanting to avoid pregnancy, he or she should avoid sexual activity throughout the fertile time.

CLIENT EDUCATION

  • Keep a record in a book. Record the number of days in each menstrual cycle accurately, beginning with the first day of menstruation and continuing for at least six menstrual cycles.
  • Subtract 18 days from the number of days in the shortest menstrual cycle to determine the start of the fertile period.
  • By subtracting 11 days from the number of days in the longest cycle, the end of the fertile period is determined.

For example:

Shortest cycle, 26-18= 8th day

Longest cycle, 30- 11 = 19th day

Fertile period is days 8 through 19.

Refrain from intercourse during these

days to avoid conception.

ADVANTAGES

  • When paired with the basal body temperature or cervical mucus technique, it is most effective.
  • Inexpensive

DISADVANTAGES

  • This is not a particularly reliable method.
  • Does not provide protection against STIS.
  • Requires careful documentation
  • Adherence to abstinence throughout reproductive times is required.

RISKS

  • Multiple factors can influence and vary the time of ovulation, resulting in irregular menstrual cycles.
  • Possible pregnancy as a result of miscalculating the fertile period or failing to refrain from intercourse during fertile days.

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Standard days method (cycle beads)

A more modern version of the calendar approach uses a fixed number of fertile days for each cycle. The colored cycle beads are strung on a necklace.

CLIENT EDUCATION

  • Begin the first day of the menstrual cycle. Use the rubber ring to move one bead every day.
  • Red bead: the initial bead, representing the first day of the menstrual cycle.
  • Brown beads denote infertile days.
  • White beads denote fertile days.

ADVANTAGES

  • Increased adherence by employing a visual aid
  • A mobile app is now available.
  • Simple to comprehend

DISADVANTAGES

  • Unreliable for menstrual cycles that last more than 32 days or less than 26 days.
  • Can lose track of the days

RISKS/POSSIBLE COMPLICATIONS

  • Use with caution if menstrual cycles are irregular or prolonged.
  • likely pregnancy
  • IUD, breastfeeding, and hormonal contraception all have lower effectiveness

Basal body temperature (BBT)

The BBT is the body’s resting temperature. The temperature falls just before ovulation and rises as it happens. A symptom-based technique for facilitating or preventing pregnancy is to determine the timing of ovulation.

CLIENT EDUCATION

  • Take your temperature as soon as you wake up and before you leave bed. When working at night, take your temperature after the longest cycle of sleep. Make use of a thermometer that can measure temperature down to the tenths. On a customized graph, note the temperatures.
  • The first day with a change in temperature is regarded as the first fruitful day. Three days of increasing temperatures in a row prolong fertility.
  • To increase efficacy, use this approach with the calendar approach.

ADVANTAGES: Inexpensive, convenient, and noadverse effects

DISADVANTAGES

  • Numerous factors (stress, exhaustion, illness, alcohol, and the warmth of the sleeping environment) might have an impact on reliability and lead to an incorrect interpretation of temperature changes.
  • Does not protect against STIS.

RISKS: Possible pregnancy.

Cervical mucus ovulation detection method

The Billings method, often known as the fertility awareness approach, is a symptom-based technique in which the client examines cervical mucus to identify ovulation.

  • Under the influence of estrogen and progesterone, the cervical mucus thins and stretches after ovulation to promote sperm viability and motility.
  • The mucous can extend the farthest between the fingers during ovulation. This is an indication of spinnbarkeit.When the cervical mucus is thin and slippery, the fertile period starts, and it lasts until four days following the last day that the cervical mucus had this appearance.

CLIENT EDUCATION

  • Use it with the calendar technique to maximize effectiveness.
  • Practice good hand hygiene both before and after the assessment.
  • Start looking at mucus on the final day of your period.
  • Vaginal introitus is the source of mucus. The cervix need not be reached through the vagina.
  • The cervical mucous can be examined using your fingers or tissue paper.
  • Egg whites’ elastic texture serves as an excellent analogy for cervical mucous during ovulation.
  • Don’t be a douche before the evaluation.

ADVANTAGES

  • A client can learn to recognize the characteristics of their own mucus at ovulation, and self-evaluation can be extremely accurate.
  • Cervical mucus self-evaluation can be diagnostically useful in figuring out when ovulation begins during breastfeeding and in preparing for a planned pregnancy.

DISADVANTAGES

  • Some clients find this procedure uncomfortable since they don’t like having their mucous and genitalia touched.
  • Cervical mucus might be challenging to analyze internally.
  • Does not offer protection from STIS.

RISKS/POSSIBLE COMPLICATIONS

  • When cervical mucus is mixed with semen, blood, contraceptive foams, or infectious discharge, it can be difficult to accurately assess its characteristics.
  • The look and accuracy of cervical mucus can be changed by sexual stimulation or intercourse (which thins secretions), or by using deodorants, douches, medications, or lubricants.
  • Possibly pregnancy.

2-day method

An approach based on symptoms that entails daily vaginal secretion checks without any secretion analysis. The reproductive period has ended after two days without any secretions.

CLIENT EDUCATION: Avoid sex without protection if vaginal secretions are present two days in a row to avoid getting pregnant.

ADVANTAGES: Simple and easy to use

: Daily evaluation of vaginal secretions is necessary.

RISK: Possible pregnancy

BARRIER METHODS

Male condom

A thin shealth that is placed over the penis during sex to prevent infection or serve as a method of birth control. The material of male condoms can range from natural membrane to polyurethane to latex rubber.

CLIENT EDUCATION

  • On the erect penis, place a condom, leaving a gap at the tip for a sperm reservoir.
  • After ejaculating, remove the penis from the vagina while grasping the condom’s rim to stop any semen from dripping onto the vulva or vaginal region.
  • To maximize effectiveness, use with spermicidal gel or cream.
  • Before using, verify the expiration date.
  • Natural skin condoms (made of lamb cecum) do not protect against STIs due to their narrow pores, unlike latex and polyurethane condoms. Condoms made of polyurethane may not be as effective as those made of latex since they are more likely to slip or lose their shape.
  • To prevent condom breaking, only water-soluble lubricants should be used with latex condoms.

ADVANTAGES

  • Protects against most STIs
  • Involves males in the birth control method
  • No adverse effects
  • Readily accessible

DISADVANTAGES

  • Very high rate of non-adherence.
  • can make communication less spontaneous.
  • Sensibility is reduced.
  • In order to apply a condom, the penis must be upright.
  • Sexual activity may be impeded by withdrawing the penis while it is still erect.
  • does not provide defense against STIs like HPV, HSV, or syphilis that are spread through sores on the skin or mucous membranes.
  • Since condoms are only used once, replacement costs are incurred.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • Condoms have the potential to leak or rupture, which could lead to pregnancy.
  • People who are sensitive to latex or have a latex allergy shouldn’t use condoms comprised of the substance.

Female condom

Nitrile, a synthetic rubber that is non-latex and has flexible rings on both ends and is pre-lubricated with a spermicide, is used as the vaginal sheath.

CLIENT EDUCATION

  • Prior to sexual contact, the client places the closed end of the condom pouch into the vagina and secures it around the cervix. The labia are covered by the condom’s open ring. Each act of sexual activity is followed by the removal and disposal of the condom.
  • Use just on its own; never with a male condom.

ADVANTAGES

  • Offers protection against pregnancy and STIS
  • Provides some protection against STIS (HPV, HSV, syphilis) and STIS spread through skin-to-skin contact.

DISADVANTAGES

  • Complicated to use
  • Bulky
  • Noisy during intercourse
  • More expensive than male condoms

Spermicide

There are various types of chemical barriers that keep sperm from reaching the cervix. As a result, the vaginal flora becomes more acidic, which is bad for sperm survival.

CLIENT EDUCATION

  • The spermicide should be injected 15 minutes before sexual activity. Although spermicide has a one-hour shelf life, it shouldn’t be used again for six hours after a sexual encounter.
  • Before use, films should be folded and placed in the vagina where they will dissolve.

ADVANTAGES

  • No prescription needed
  • when used with other contraceptive treatments, improves their effectiveness.
  • Multiple preparation (suppositories, foams, creams, gels, films)

DISADVANTAGES

  • Messy
  • must reapply after each sexual encounter.
  • Does not offer protection from STIS

RISKS/CONTRAINDICATIONS

  • Patients with cervical infections should not take this medication.
  • Using spermicides that contain nonoxynol-9 (N-9) more than twice per day can result in lesions and raise your chance of contracting HIV. Customers who are highly susceptible to STIs shouldn’t utilize N-9-containing products.

Diaphragm

A silicone cup in the form of a dome with a flexible silicone rim that fits tightly over the cervix. Use of a spermicidal cream or gel inside the dome and around the rim improves effectiveness. There are several sizes of diaphragms.

CLIENT EDUCATION

  • Get a provider to correctly equip you with a diaphragm.
  • Replace every two years, re-fit for weight changes of 20%, following pelvic or abdominal surgery, and after each pregnancy.
  • The diaphragm needs to be inserted and removed correctly. Before coitus, spermicidal jelly or cream is placed to the cervical side of the dome and all over the rim before the diaphragm is put vaginally over the cervix. The diaphragm can be placed up to 6 hours before sexual activity and must remain in place for at least 6 hours afterward, but not longer than 24 hours.
  • Each act of coitus requires a fresh application of spermicide.
  • To relieve pressure on the urethra before inserting the diaphragm, empty the bladder first.
  • Make sure the diaphragm is washed with mild soap and warm water after each use.

ADVANTAGES

  • Client should be given more control over contraception
  • Very easy to insert.

DISADVANTAGES

  • For spermicidal gel, cream, or foam to be successful, reapplication with each act of coitus is necessary, which is inconvenient, interferes with spontaneity, and is time-consuming.
  • Needs a doctor’s prescription and a visit to the hospital
  • For it to work, it must be inserted properly.
  • Does not offer STIS defense

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • For patients who have a history of toxic shock syndrome (TSS), cystocele, uterine prolapse, or frequent, recurrent urinary tract infections, this treatment is not advisable.
  • TSS, which is brought on by a bacterial infection, is now more likely to develop. High fever, feeling dizzy, drop in blood pressure, diarrhea that is watery, headache, macular rash, and muscle aches are some clinical findings.
  • The removal of the diaphragm as soon as possible, six to eight hours after coitus, also helps to prevent TSS.
  • Both allergic response and UTI risk.

Cervical cap

Silicone rubber cap that encircles the cervix’s base securely. This acts as a physical deterrent for sperm trying to enter the cervix. Its efficiency is increased when combined with a spermicide. There are three sizes of cervical caps.

CLIENT EDUCATION

  • Place up to 6 hours before intercourse and leave for at least 6 hours afterward, but not for more than 48 hours at a time.
  • After any big weight change, pregnancy, or gynecological surgery, replace every two years and refit.

ADVANTAGES

  • Extended period of use
  • No more spermicide application is necessary.

DISADVANTAGES

  • Possibility of developing TSS
  • Allergic reaction potential
  • does not offer STI protection

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

Not for clients with TSS history or those who have had abnormal Pap test results.

Contraceptive sponge

Sponge made of polyurethane that is small, spherical, and concave and is filled with spermicide. It is designed to fit over the cervix and functions as a physical and chemical barrier to stop sperm from entering the vagina.

CLIENT EDUCATION

  • One size fits all.
  • Moisten with water prior to insertion in the vagina.
  • After the final act of sexual contact, should be remained in place for six hours. It offers protection for up to twenty-four hours.

ADVANTAGES

  • Can have repeated acts of intercourse
  • Easy to insert

DISADVANTAGES: Does not protect against STIS

RISKS/COMPLICATIONS: TSS is a possibility if the substance is kept in the vagina for longer than 24 hours.

HORMONAL METHODS

Combined oral contraceptives (COCs)

Using estrogen and progestin, hormonal contraception suppresses ovulation, thickens cervical mucus to block semen, and changes the uterine decidua to prevent implantation.

CLIENT EDUCATION

Medication needs a prescription and follow-up doctor’s appointments.

  • It may be necessary to get routine breast exams and Pap tests.
  • To be successful, medications must be used consistently and correctly.
  • The previous seven days should have seen regular menstrual cycles.
  • Keep an eye out for and report any signs of problems, such as chest pain, breathing difficulties, and leg pain from hypertension.headache, visual changes, and [thromboembolism] [stroke],
  • If you skip a dosage, take the missed pill as soon as you can. If you miss two or three pills, follow the manufacturer’s instructions. Until regular dosing is resumed, advise the client to use alternative methods of contraception or abstain from sexual activity to prevent pregnancy.
  • Take before bedtime if you feel queasy.

ADVANTAGES

  • Highly effective if taken properly and consistently, especially at the same time each day.
  • Low-dose estrogen hormone contraception (less than 35 mcg) provides additional therapeutic effects, such as reducing menstrual blood loss, iron deficiency anemia, controlling menorrhagia and irregular cycles, and lowering the frequency of dysmenorrhea and premenstrual symptoms.
  • decreases the risk of benign breast illness, treats acne, and provides defense against the emergence of functional ovarian cysts. It also offers protection against endometrial, ovarian, and colon cancer.

DISADVANTAGES

  • Does not offer protection from STIS and may even raise your risk of thromboembolism, stroke, heart attack, hypertension, gallbladder disease, and liver tumors.
  • Aggraves diseases including kidney or heart illness, epilepsy, migraine, or epilepsy that are worse by fluid retention.
  • Headache, nausea, breast soreness, and breakthrough bleeding are some of the negative side effects. (Estrogen can lead to fluid retention, nausea, and painful breasts. Increased hunger, lethargy, depression, breast sensitivity, oily skin and scalp, and hirsutism are all possible side effects of progesterone.)

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • It is not recommended for clients to use oral contraceptives if they have a history of thromboembolic disorders, stroke, heart attack, coronary artery disease, gallbladder disease, cirrhosis, or liver tumors, headache with focal neurologic findings, uncontrolled hypertension, diabetes mellitus with vascular involvement, breast or estrogen-related cancers, pregnancy, lactation, less than six weeks after childbirth, or smoking (if they are over 35 years old).
  • Anticonvulsants, antifungals, and certain antibiotics all have a negative impact on the effectiveness of oral contraceptives.

Progestin-only pills (minipill)

Oral progestins have combined oral contraceptive effects, which reduce the likelihood of fertilization and implantation.

CLIENT EDUCATION

  • To ensure effectiveness in addition to a modest progestin dose, take the pill at the same time every day.
  • Don’t skip a pill.
  • In order to prevent pregnancy during the first month of use, you might require another method of birth control.

ADVANTAGES

  • less efficient than combined oral contraceptives at preventing ovulation.
  • Regarded as safe to use when breastfeeding.

DISADVANTAGES

  • less effective at preventing ovulation than combined oral contraceptives.
  • No protection against STIS.
  • The most frequent and often mentioned side effects are breast soreness, irregular vaginal bleeding, headaches, and nausea.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • The efficiency of oral contraceptives declines when liver enzyme-affected drugs (anticonvulsants,
  • Bariatric surgery, lupus, severe cirrhosis, liver tumors, and active or previous breast cancer are all contraindications.

Emergency oral contraceptive

Morning after pill that inhibits ovulation and sperm transport to stop fertilization from happening.

CLIENT EDUCATION

  • Within 72 hours of an unprotected coitus, the pill is taken.
  • To counter the negative effects of nausea that might develop with high doses of estrogen and progestin, a provider will advise taking an over-the-counter antiemetic 1 hour prior to each dose.
  • If your period doesn’t start in the next 21 days, you should get checked for pregnancy.
  • Think about getting counseling on contraception and changing dangerous sexual habits.
  • Although a prescription is needed, a copper IUD can be used for up to 5 days after the procedure.

ADVANTAGES

  • This method is not taken on a regular basis.
  • At a pharmacy, emergency oral contraceptives may be purchased by anyone, regardless of age.
  • Directions are easy to understand.

DISADVANTAGES

  • Nausea, menstrual blood that is heavier than usual, lower abdomen pain, exhaustion, and headache.
  • Does not provide long-term contraception
  • Does not terminate an established pregnancy
  • Does not protect against STIS

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS:

If a client has untreated abnormal vaginal bleeding or is pregnant, the method is contraindicated.

Transdermal contraceptive patch

  • Contains progesterone, also known as progestin, which is continuously released into subcutaneous tissue through the skin.
  • Inhibits ovulation by thickening cervical mucus.

CLIENT EDUCATION

  • The buttock, abdomen, upper arm, or torso, except the breast area, should be covered with the patch.
  • Requires patch replacement once a week.
  • Apply the patch every week on the same day for three weeks, skipping the fourth week.

ADVANTAGES

  • Maintains consistent blood levels of hormone.
  • Avoids pharmaceutical metabolism in the liver since it is not absorbed in the digestive system.
  • Decreases risk of forgetting a daily pill
  • Can be used when swimming in water.

DISADVANTAGES

  • Method does not protect against STIs.
  • Same negative effects as those of oral contraceptives. Because the hormones from the patch enter the bloodstream and are metabolized by the body differently than hormones from OCPS, there may be a modest increase in the risk of deep-vein thrombosis and venous thromboembolism in clients using the patch.
  • Skin reactions can occur from patch application.
  • Can cause breast discomfort.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • Same as those of oral contraceptives
  • Avoid applying the patch to skin rashes or lesions
  • Less effective in clients greater than 198 lb

Injectable progestins

Every 11 to 13 weeks, a female client receives an intramuscular or subcutaneous injection of medroxyprogesterone. It thickens cervical mucous and prevents ovulation.

CLIENT EDUCATION

  • Injections should begin during the first five days of the menstrual cycle and continue for the next 11 to 13 weeks. Within five days of delivery, postpartum nonbreastfeeding clients should start receiving injections. Injections for customers who are still nursing should begin in the sixth postpartum week.
  • Keep your follow-up appointments.
  • To reduce the risk of osteoporosis, keep your calcium intake adequate and do weight-bearing exercises.
  • After IM injections, avoid massaging because this reduces the medication’s absorption and effectiveness.

ADVANTAGES

  • Very effective and requires only four injections per year
  • Does not impair lactation
  • The possible absence of periods and decrease in bleeding
  • Decreased risk of uterine cancer if used long-term

DISADVANTAGES

  • Reduced bone mineral density, increased depression, weight gain, amenorrhea, headaches, and irregular vaginal spotting or bleeding are some of the negative consequences.
  • fails to offer STI protection.
  • Up to 18 months after stopping treatment, return to fertility may take place.
  • Should only be used as a long-term (greater than two years) birth control technique if all other birth control options fail.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • After administering the injection, avoid massaging the injection site to prevent increasing drug absorption, which will reduce the duration of the medication’s effectiveness.
  • Breast cancer, signs of ongoing cardiovascular illness, undiagnosed liver tumors, impaired liver function, and unexplained vaginal hemorrhage are also contraindications.
  • This approach can reduce glucose tolerance in patients with diabetes mellitus and raise the chance of developing diabetes in patients without the disease.

Contraceptive vaginal ring

A flexible silicone ring that delivers etonogestrel and ethinyl estradiol continuously through the vaginal canal.

CLIENT EDUCATION

  • Place the ring intravaginally.2
  • Replace the ring after three weeks and install a fresh vaginal ring within seven days. Insertion should take place every month on the same day of the week.
  • Replace with a new ring and utilize a barrier method of contraception for 7 days if removed for more than 4 hours.

ADVANTAGES

  • Does not have to be fitted
  • Decreases the risk of forgetting to take the pill
  • Hormone bioavailability is increased by the vaginal method of delivery, allowing for lower doses and less side effects.

DISADVANTAGES

  • Method does not protect against STIS.
  • Method has the same adverse effects as oral contraceptives.
  • Some clients report discomfort during intercourse.For up to three hours, the ring can be taken off without losing any of its potency.
  • Prescription is required.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • Blood clots, hypertension, stroke, heart attack.
  • Vaginal irritation/discomfort, increased vaginal secretions.

Implantable progestin

  • The provider inserts tiny, thin progesterone rods beneath the skin on the inner upper side of the arm.
  • Suppresses ovulatory cycle and thickens cervical mucus to prevent conception.

CLIENT EDUCATION

  • Avoid trauma to the area of implantation.
  • Wear condoms for protection against STIS.

ADVANTAGES

  • Effective continuous contraception for 3 years
  • Can be inserted right away following an unplanned or spontaneous abortion, childbirth, or while breastfeeding.
  • Reversible

DISADVANTAGES

  • Does not protect against STIs.
  • The most frequent negative effects include unpredictable and irregular menstruation, along with depression, mood swings, headaches, acne, and weight gain.
  • Scarring at the place of insertion may necessitate removal.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • If pregnancy develops, the method carries a higher risk of ectopic pregnancy.
  • The presence of unexplained vaginal bleeding is a contraindication.
  • The location may become infected.

Intrauterine device (IUD)

A T-shaped device with chemical components that the provider inserts through the cervix and places in the uterus. emits a toxin that harms sperm while it is traveling to the uterine tubes and hinders conception. The long-acting reversible contraceptive (LARC) techniques, including implants and IUDs, are the most successful at preventing conception. Female clients who are nulliparous or multiparous can use IUDs.

CLIENT EDUCATION

  • In order to rule out migration or expulsion of the device, clients must check the device once a month after menstruation to make sure the small string that hangs from it is in the upper part of the vagina.
  • Prior to implantation, sign a consent document.
  • Cervical cultures, Pap smears, and pregnancy tests should all be negative before insertion.
  • A ultrasound may be required if pregnancy is suspected following IUD installation in order to rule out ectopic pregnancy.

ADVANTAGES

  • For 3 to 10 years, an IUD can be effective (hormonal IUD 3 to 5 years, copper IUD 10 years).
  • The procedure can be inserted right away following a spontaneous or voluntary abortion, childbirth, or breastfeeding.
  • With an instantaneous restoration to fertility, contraception can be stopped.
  • doesn’t get in the way of spontaneity.
  • IUDs that include hormones lessen menstrual pain and heavy bleeding.
  • Since the copper IUD doesn’t contain any hormones, it is safe for those who have been advised against hormonal birth control techniques.

DISADVANTAGES

  • This procedure can result in expulsion and raise the risk of pelvic inflammatory illness, uterine perforation, or ectopic pregnancy.
  • Clients should notify the physician if they experience irregular or late spotting or bleeding, pain in the abdomen or during sexual activity, unusual or foul-smelling vaginal discharge, fever, chills, a change in string length, or if their IUD cannot be found. This approach does not offer STIS protection.
  • Spotting, irregular bleeding, headache, nausea, depression, and breast soreness are all symptoms of hormonal IUD. An increase in menstrual discomfort and bleeding is a side effect of copper IUD.

RISKS/CONTRAINDICATIONS

  • Due to the dangers of STIS, it is best utilized by clients in monogamous relationships.
  • Able to result in irregular menstrual bleeding.
  • Risk of PID, uterine perforation, bacterial vaginosis, or uterine ejection
  • When pregnant, it must be removed.

: Active pelvic infection, abnormal uterine bleeding, severe uterine distortion.

TRANSCERVICAL STERILIZATION

  • The insertion of tiny, flexible substances into the fallopian tubes via the cervix and vagina. Due to the formation of scar tissue in the tubes, pregnancy is prevented.
  • After three months, an examination is required to check for obstructed fallopian tubes.

CLIENT EDUCATION: Most patients can return to their regular routines a day after the treatment.

ADVANTAGES

  • A quick process that does not call for general anesthesia
  • Birth control methods without hormones
  • Effective in preventing conception by 99.8%
  • Rapid return to regular daily activities

DISADVANTAGES

  • Not modifiable.
  • Not recommended for usage in postpartum clients.
  • 3 month delay in the effectiveness. Use a different method of birth control up until a blocked fallopian tube is confirmed.
  • modifications to menstrual patterns.
  • Does not offer STIS protection.

RISKS/POSSIBLE COMPLICATIONS/CONTRAINDICATIONS

  • Perforation is possible.
  • If a client engages in unprotected sexual activity within the first three months after the surgery, an unwanted pregnancy may result.
  • increased chance of an ectopic pregnancy if it happens.

SURGICAL METHODS

Female sterilization (bilateral tubal ligation)

A surgical technique that involves cutting, burning, or restricting the fallopian tubes to stop fertilization.

PROCEDURE: The fallopian tubes are cut, burned, or blocked in order to stop the sperm from fertilizing the ovum.

ADVANTAGES

  • Contraception that is immediate and permanent.
  • After giving birth, this procedure can be performed 24 to 48 hours afterwards.
  • No changes are made to sexual function.
  • Ovarian cancer is less common as a result of this technique.

DISADVANTAGES

  • A surgical technique that entails risks for anesthesia-related issues, infection, bleeding, and trauma
  • If a customer wants conception, it is believed that the process is irreversible.
  • Does not offer protection from STIS

RISKS: If pregnancy develops, there is a risk of ectopic pregnancy.

Male sterilization (vasectomy)

A surgical treatment to block sperm from passing via the vas deferens by cutting and ligating it.

PROCEDURE: Cutting the male vas deferens in order to permanently sterilize him.

CLIENT EDUCATION

  • For a few of days after the treatment, it is advised to engage in light exercise and scrotal support to lessen pain.
  • Once all sperm has been removed from the proximal vas deferens (after around 20 ejaculations), sterility will not occur.
  • Until the vas deferens is free of sperm, alternative methods of birth control must be employed.
  • Inquire about sperm count testing from the provider. Sterility is proven when the sperm count is 0 on two separate occasions.
  • Reversal may be accomplished by a time-consuming and costly surgery.
  • Sperm can be saved in advance of the procedure for potential use.

ADVANTAGES

  • Method is permanent.
  • Procedure is short, safe, and simple.
  • Sexual function is not impaired.

DISADVANTAGES

  • Surgery is required.
  • Reversal is possible but not always successful.
  • This method does not protect against STIS.
  • Granulomas can occur due to accumulation of sperm.

COMPLICATIONS: Infections that bleed, anesthetic reactions, site hematomas, kidney stones, and chronic pain (which may require reversal) are uncommon but possible..

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