NUTRITION AND PAIN MANAGEMENT DURING LABOR
Liston, Nathan - Luke
TERMS AND DEFINITIONS
PURPOSES
5 TYPES OF URINE COLLECTION
FAMILY PLANNING refers to a program which enables couples and individuals to
decide freely and responsibly the number and spacing of their children and to have the
information and means to do so, and to have access to a full range of safe, affordable,
effective, nonabortificacient modern natural and artificial methods of planning
pregnancy (Congress of the Philippines, 2012).
PROGRAMS RELATED TO
FAMILY HEALTH
Republic Act No. 10354
The Responsible Parenthood and Reproductive
Health Act of 2012 {RPRH Act)
• In 2003, there are about 84M Filipinos to grow annually at 2.36% and expected to
double in 29 years.
• The total fertility rate is at 3.5 children/women.
• The use of contraceptive increases gradually from
15.4% (1996), 48.9% (2003), to 57% (2018).
• 44% of women got pregnant with their first child at the age of 20-24.
• In 2003, among married women, 48.8% use any form of contraceptive method and
51.1% do not use any form of contraceptive at all.
PROGRAM
• In 2018, modern Contraceptive Prevalence Rate (mCPR) increased from 53% to
57% (FHSIS). The target mCPR is 65% for married women of reproductive age.
• 43% women of reproductive age have not yet been served and remains to have
unmet need for modern family planning.
• 835,000 unintended pregnancies that could have been avoided, 492,000 possible
abortions prevented, and 440 maternal deaths that could have been averted.
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NATIONAL FAMILY PLANNING PROGRAM (NFPP)
PREVENT PREGNANCY Due to: mother has medical condition, parents have genetic
disorders, achieved directed number of
A national mandated priority public health program to attain the country's national health children, plan spacing
development: a health intervention program and an important tool for the improvement PURPOSE OF FAMILY PLANNING
of the health and welfare of mothers, children and other members of the family. It also
provides information and services for the couples of reproductive age to plan their family
according to their beliefs and circumstances through legally and medically acceptable
family planning methods.
Er
Gaal
r'
BENEFITS OF FAMILY PLANNING
Mother
• Enables her to regain her health after delivery.
• Prevents pregnancy-related health risks
• Gives enough time and opportunity to love and provide attention to her husband and
children.
• Gives more time for her family and own personal advancement.
• When suffering from an illness, gives enough time for treatment and recovery.
Children
• Reduces infant mortality
• Healthy mothers produce healthy children.
• Will get all the attention, security, love, and care they deserve.
PLAN PREGNANCY
Father
• Lightens the burden and responsibility in supporting his family.
• Enables him to give his children their basic needs
(food, shelter, education, and better future).
• Gives him time for his family and own personal advancement.
• When suffering from an illness, gives enough time for treatment and recovery.
PURPOSE OF FAMILY PLANNING
ABSTINENCE
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The only completely effective means of preventing pregnancy.
TYPES OF FAMILY PLANNING
N~URAL
• Standard Days
Method
• Lactational
Amennorhea Method
• Basal Body
Temperature
• Billings Ovulation/Cervical Mucus Method
• Symptothermal
ARTIFICIAL I@HEIST
@THITHET
SIGNS OF OVULATION
• Condom
• Injectables
• Oral Contraceptive Pills
• Intrauterine Device
PERMANENT
• Vasectomy
Increase Body Temperature
• Bilateral Tubal Ligation Mittelschmerz
<;7_;zeE+ ' Unilateral Pelvic Pain
..-1+,>
$
Blooming
CONTRACEPTION
- voluntary prevention of pregnancy
• Natural or Fertility
Awareness Method
- Standard Days Method
(Cycle Beads)
- Lactation Amenorrhea
Mehtod (LAM)
- Basal Body Temp.
- Billings Ovulation/Cervical
Mucus Method
- Symptothermal Method
NFP -- Inexpensive, not hazardous, approved by some religions - Rhythm Method
- Identify fertile periods/unsafe days - Coitus Interruption
• Artificial Methods
0 - Condom (Male & Female)
0 - lnjectibles
- Oral Contraceptive Pills
- Intrauterine Device
• Permanent Methods
- Vasectomy
U t - Bilateral Tubal Ligation
Moder contraception Methods
GEE
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NUTRITION AND PAIN MANAGEMENT DURING LABOR
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p«stout. O t« cry vor period starts, move the rim« to te recd beet
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Traditional Contraceptive A
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© Rhythmic method LACTATIONAL AMENORRHEA METHOD (LAM)
.
• A temporary postpartum method of postponing pregnancy based on the physiological
infertility experienced by breast-feeding
mothers.
N
A • The mother may ovulate but not
T menstruate while breast-feeding.
u Advantage: Easily accomplished by
R all postpartum lactating mothers I4
A I
L • 99.5% effective . A
[ITT: • Use within 6 months after deliver
STANDARD DAYS METHOD • Exclusive Breastfeedin
• No Pacifie
BASAL BODY TEMPERATURE
• Is the most appropriate for women
who usually have cycles between 26 and 32 days long. It is used to identify the fertile and infertile
period of a woman's cycle by daily taking and recording the rise and fall in body
• 95% effective temperature during and after ovulation.
• Uses cycle beads to determine fertile • 99% effective
N days.
A • Based on the fact that:
T N l/, · Before the day of ovulation, a woman's BBT
u A falls about half a degree.
R T ]l! At the time of ovulation, her BBT rises a full
A
L R degree because of the influence of A progesterone.
STANDARD DAYS METHOD This is maintained for the L ' rest of her menstrual cycle.
BILLINGS OVULATION/
CERVICAL MUCUS METHOD
Steps: • Abstaining from sexual intercourse during fertile (wet) days of spinnbarkeit
mucus and 3 days after the peak day.
1. Count the first day of your menstrual bleeding as DAY 1.
• 97% effective
2. On days 1 to 7, you can have unprotected intercourse. N • Advantage: Can be used by
N 3. On days 8 to 19, you should use a A
A barrier method or avoid intercourse. T healthy women with no known
T 4. From day 20 through the end of the u diseases
u cycle, you can have unprotected R • Disadvantage: Not so reliable
R intercourse.
L
L BILLINGS OVULATION /
CYCLE BEADS
CERVICAL MUCUS METHOD
• During ovulation, cervical mucus is copious, thin, watery, transparent, feels
slippery and stretches at least 1 in before strand breaks. The stretchability of
the mucus is described by its spinnbarkeit, having the raw egg white quality that is
easier for sperm to
N penetrate.
A • After ovulation, the character of cervical T mucus changes, and
tt your pvt«t «toss» not start ty tt ctary after yo now ttee rig to tie las»t under the u influence of progesterone it becomes
mow4 peat, vour cycle R thick, scant, and tacky; mucus doesn't
is towar than 32 days td
me RED t
fit decry of your my trl
NUTRITION AND PAIN MANAGEMENT DURING LABOR
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Slippery cervical mucus
(avoid sexual intercourse)
A stretch when pulled between the thumb No slippery crical mucus
L and finger. Sperm typically cannot (he seal iterere)
SYMPTOTHERMAL METHOD
• It is the combination of Basal Body
Temperature and Billings method.
COITUS INTERRUPTUS
• 98% effective
• Method of contraception where couple
proceeds with coitus until moment of ejaculation and the man withdraws so that the
The Symptothermal Method spermatozoa are emitted outside the vagina.
N • Disadvantages:
Smptoens A • Presence of few spermatozoa in pre•
NAT T ejaculation fluid
u
R R • Lack of control
AL AL
Calendar Method
Safe Times Using the Calendar Method
(1 2 • ) s s 1
ABSTINENCE
8 11 M
24 25 26 27 28
29 30 1 (2) 4
Irregular menses +aO II +rX
N
A Determine shortest and longest cycle for 6 to 12 months
T A ► Most effective
u Shortest -18 Example T > Difficult compliance
R Lon est- 11 u
A R
A
23-18=5th L
35-11= 24
L No sexual intercourse from 5th to 24" of the cycle
RHYTHM METHOD
• Calendar method
• It is abstaining from coitus 3 or 4 days before ovulation until 3 or 4 days after • A thin sheath of latex rubber made to
ovulation. fit on a man's erected penis, it prevent
the passage of sperm into the internal
• The woman determines the number of days A vagi• na
R •
Calculation: T ADVANTAGES
N • Subtract 18 from the shortest cycle - first fertile day I • Safe and has no
A • Subtract 11 from the longest cycle - last fertile day F hormonal effect
T Ex. Range from 25 to 29 days I • Protects against
25 29 C mi croorganims
- 18 - 11 I • Easily accessible
R 7 to 18" day - fertile days (12)
A 1to 6" day; 19to 29" day - non-fertile DISADVANTAGES
L d~~s----------------~ • May cause allergy to latex
- • May decrease sensation
er • Interrupts the sexua ct
bihros • Requires cooperation
INTERRUPTUS! ! D A • Used in managing
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L premature ejaculation
INJECTABLES
• A long term birth control method that is a small, T• shaped plastic device that is
• It contains synthetic hormone, progestin which suppresses ovulation; thickens the wrapped in copper or
cervical mucus thus making it difficult for sperm to pass through A contains hormones.
A • Advantages: R
T Reversible and no daily inta T • A plastic string is tied to
I • No sexual inference I the end of the IUD hangs
F • No estrogen related effects F down through the cervix
I • Doesn't affect breastfeeding I into the vagina.
C • 99.95% effective C • 99.4% effective and can
I last up to 10 years.
A A
L L
INTRAUTERINE DEVICE
• DepoProvera, DMPA, MedroxyProgesterone
• IM every 3 months
• Can be used in breastfeeding
ORAL CONTRACEPTIVE PILLS
• Pill contains hormones: estrogen and progesterone, taken daily to prevent conception. P.oats delayed
• 99. 7% effective
A • Advantages:
R • Safe, convenient and easy to use, 3%
T failure
I • Reduces gynecological symptoms like
F painful menstruation and reduce the risk of #\aominal pain
I ovarian and endometrial cancers A
C • Disadvantages: R
I • Has side effects like: nausea, dizziness, T Increased temperature
A breast tenderness, blurring of vision I
L • Suppresses lactation F ]Vaeeeable vaginal discharge
I
C bting periodically checked
I
A
L
VASECTOMY
CJ • The vas deferens is
blocked or cut, to prevent
the passage of sperm.
~,~ w • 99.9% effective
A s p • Birth control should be E used until two negative R
. •3' , sperm reports have been
I .%• "' M examined
A
N
E
«....d....e....e.
.=f='
N rt
~~ T
7 BILATERAL TUBAL LIGATION (BTL)
• Involves the cutting or blocking of the 2 fallopian tubes.
• 99.5% effective
p • Advantages:
Contraindications: Smokers, DVT, CVD, DM, HPN, Estrogen-dependent cancers E • Permanent method of
ORAL CONTRACEPTIVE PILLS M contraception
A • No repeated clinic visit° ,
N • Does not interfere with
E result to increase enjo
N • No known side effects Cauterized Tei d and cut
A bdominal pain
. 0% to 70% successful reversal rat
Ces«oam .. ~
A But with high percentage of ectopic pregnanc
R POSTPARTUM CONTRACEPTION CONSIDERATIONS
T la%ache (severe)
I
F Fe(lurans of vision)
I
C S harp leg pain
I
A • Breastfeeding - Lactation Amenorrhea Method
L
INTRAUTERINE DEVICE • Fertility Awareness:
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- Not reliable until menstrual cycles are re-established
- Not breastfeeding: Menses returns at 4-6 weeks
• IUD - wait 6-8 weeks for complete involution
• Pharmacologic Methods - Minipills
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