Contraception and family planning

Contraception methods

Population growth has many economic consequences, ranging from pressure on educational and health services and high demand for new jobs.In addition to social consequences like increase domestic disputes and divorce rate.In an attempt to control these pressures some countries have implemented family planning programs.

There are several reasons for increased population including wives who have many children to tie their husbands with them for life, families which have many children to make them work and support them financially, families which have many children till they find their desired baby sex. Lack of enough directed awareness on the consequences of population increase and how contraception works is a problem. Lack of efficient family planning programs and difficulty in attaining them is a big drawback. Some countries also encourage having children and constitute it as a national duty in order to supply a large population base for military endeavors.

There is also a religious interaction where some religions and cults prohibit certain contraception methods while allowing others according to their beliefs where some say that sexuality has as its end purpose, procreation; to interfere in this end would be a sin while others do not strictly limit sexual intercourse to procreation; it also constitutes an expression of love, while others assume that procreation within the family as a religious duty.

Some cultures reject family planning methods for fear that contraceptive use will encourage immorality and illicit sex. Feminist commentators have viewed prohibitions on birth control as a means to control female sexuality and independence.

Contraception and family planning are methods to prevent pregnancy.

Natural Methods

Easy to use but has a high percentage of error.

  • Safe period: It depends on identifying the woman’s fertile ovulating days and avoiding sex on those days.
  • External ejaculation: Ejaculating outside the vagina.
  • Lactation: Lactation hormones prevent ovulation thus it can be used as protection

Chemical methods

Found in all pharmacies but they have a high failure rate. E.g. vaginal creams, vaginal suppositories

Mechanical Methods

Condoms

It is a thin sheath made of latex and found in different sizes. It is slipped over the penis during erection to trap the semen when it is ejaculated and prevent it from entering the woman’s vagina. Some kinds have a chemical material that kills the sperms.

Dis-advantages

  • Might tear
  • Decrease sexual feeling

Advantages

  • No need for prescription
  • Cheap

Intrauterine device – Loop

The intrauterine device is inserted inside the woman’s uterus by a doctor. The woman can check the presence of the loop by feeling the threads which are attached to the loop and pass out of the cervix. The Intrauterine device prevents fertilized eggs from implanting in the uterus. Cooper loops kill sperms and impair endometrial formation. Loops are generally made of plastic material and they are shaped according to their kind.

Dis-advantages

  • Not indicated for women who never got pregnant
  • Not advised with pelvic inflammatory diseases.
  • Possible side effects like cramps and increased menstrual blood.

Advantages:

  • It can’t be felt
  • No interference with sex
  • No hormone interference.

Hormonal Methods

Pills

There are lots of kinds in the market. Their primary function is to stop ovulation and to make cervical mucus obstructive for sperms to pass through them.

Dis-advantages

  • Forgetting the pill
  • Side effects like dizziness in some people

Advantages

  • Regulates irregular cycles
  • Has other medical uses.

Patches

Same as pills and easy to use.

Emergency contraception

Used in cases of unprotected sex.

Ring

flexible ring inserted inside the vagina and it releases hormones just like the pills

Injections

stops ovulation but it has many side effects.

Intradermal capsules:

Injected under the skin and is viable for 5 years but have many side effects.

Permanent Methods (Sterilization)

They are used in cases of severe illness and life threatening problems, many children and failure of other methods of contraception.

In males (Vasectomy)

Ligate both spermatic cords either by laparoscope or open surgery.

In Females

Ligate both fallopian tubes either by laparoscope or open surgery.

Caring for your breast

Breast care for lactation

  • Cleaning: You should clean your breasts with warm water at least once daily then dry it out with a clean towel. Put lanolin creams or olive oil or coco butter cream on your areola and nipples at least 3 times per day to avoid nipple cracking. You should clean your hand well before breast feeding and also clean the nipples well before and after breast feeding. If breast cleaning is not done well, it might end in inflammation of the milk ducts.
  • Clothes: Avoid tight bras or bras with wire supports. Simple wide and cottons bras are preferred. No hard contact should be between your nipples and clothes and avoid using any irritating or allergic agents on your breasts.
  • Nipple Cracks and pain: it is caused by the baby not latching on the nipple the correct way or due to inflammation. If the cracks or pain is so severe avoid breast feeding with the affected breast for a period time till your breast heals and in the mean time draw the milk out by gentle massage of the breast and not by suction. If you feel good start breast feeding with the affected side again, but if your healing is slow consult a doctor.
  • Breast congestion: You can gently massage your breast during breast feeding and you can also use warm clothes over your affected side before feeding.  Try to breast feed on close intervals to empty the breast. You can visit your doctor if the situation persists.
  • Breast milk amount: If you feel that your breast milk is not enough you  have to check with your doctor. Milk release depends on repeated sucking of the nipples and breast .When the baby sucks the nipple 2 hormones are released prolactin and oxytocin. The former is  responsible for making milk and the latter is responsible for ejecting the milk.

Bottle feeding

Bottle feeding

Once you have made your choice to bottle-feed don’t let other people make you feel guilty. It is your baby, you body and your choice. Formula fed babies do thrive and you can be reassured that most infant formulas are designed to be as close to human breast milk as possible. Most formulas are fortified with all the necessary vitamins your baby and it is best to use a well-known and recognized brand.

To prepare bottles and nipples

  • you must first wash them in hot soapy water and scrub the inside of the bottle with a brush
  • Nipples must be washed inside and out with detergent then rinsed off thoroughly
  • You have three choices of sterilization, boil them in a pot, soak them in an antimicrobial solution or a microwave bottle sterilizer
  • You will need to use boiled water to make up the formula. Measure the formula out carefully and don’t compress the powder in the scoop.
  • Scrape excess powder off the scoop level with a knife. Once you have prepared the bottle shake it thoroughly.
  • Cradling your baby in your arms is the easiest position for feeding. To protect your clothes and your baby’s clothes, remember to put a bib on the baby.
  • When your baby finishes his bottle tip any left over milk out because Bacteria from your baby’s mouth can be introduced into the milk and multiplies quickly.

Breast feeding directions

Breast feeding

  • Hold your baby in a way that his abdomen faces yours and his face towards your nipple. You can lift him by one hand where his head lies in your elbow and his bottom with your other hand.

Or You can also lie on your side and hold the baby head towards your breast. The last two are good for women who delivered by cesarean section.

Or You can also place the baby on a pillow and rest your elbow on the same pillow and lift the baby head with your hand.

  • Surround your areola and nipple with index and thumb fingers.
  • Make the baby open its mouth as if yawning by rubbing his lips or mouth with your nipple.
  • As soon as he opens his mouth pull him towards the nipple with your hands and don’t bend yourself towards him.
  • Latching: make sure that your baby took in the whole nipple and most of your areola. If you feel pain then the latching is not correct. Put your finger at the side of his mouth to open it and pull your your nipple and repeat the steps again.
  • After the first few gulps your baby will develop a rhythm of his own. Sometimes the baby sleeps in the middle for a while then continues. If you pull out your nipple and he objects then he wants to continue feeding. If done correctly, it can be a beautiful experience. Younger babies need to be burped after each feed so sit your baby up and support him on your chest or sit him on your legs or lay him across on your legs abdomen down.
  • Rub your baby’s back gently in round circular movements until he burps. If your baby is gaining weight then you must be feeding him or her correctly.

Bathing your new born

Baby bath

  • Preparing the changing area: You have to choose a place that is safe and clean. Then you have to prepare the tools that you will use because it is not safe to leave the baby un-attended to go get a tool that you forgot to prepare. You can use a baby tub or a regular tub. Water should be warm and not hot, you can measure it with special water thermometers or with your elbow or wrist.
  • Take off the baby’s clothes slowly while holding him closely to give him a sense of security.
  • Put the baby in the tub slowly while holding him firmly with one hand and holding the bathing cloth or towel with the other hand. Start by washing from top first to bottom last. You can use special shampoos and soaps.
  • When you finish lift the baby out and cover him well with his towel and leave the bathing tools for a later time.
  • Put a new diaper and dress him well.
  • When the baby sleeps you can clean the bathing tools and the bathroom.

Diapering your new born

Changing baby’s diaper

  • Preparing the changing area: you have to choose a place that is safe and clean. Then you have to prepare the tools that you will use because it is not safe to leave the baby un-attended to go get a tool that you forgot to prepare.
  • Unfasten the old diaper but leave it in place because air can make the baby let go one more time.
  • Hold the baby from his heels and raise the bottom a little bit, then wipe all over the bottom and inside of legs with wipes. After you make sure everything is clean remove the old diaper and set it aside and put a new diaper under the baby
  • Use anti rash cream between the legs and buttocks and at the genitals.
  • Fasten the sides well. For a newborn you can tilt the upper part of the front side down a little bit to give room for the umbilical cord and clamp. Take the old diaper and make it into a small ball and toss it in the garbage pin.

What happens after delivery

After delivery

Puerperium period (return to pre pregnancy time) is usually from 6- 8 weeks after labor. It involves body organs returning to their original state.

  • Emotional changes: Some mothers experience post delivery depression or stress. It is usually due to the sense that they are now responsible and life won’t be the same again. Responsibility can sometimes be heavy but on the other side a baby in your life is something cheerful for sure. Your husband can help you by giving you time to sleep and rest and help with house work. He can even encourage you and also take you out every now and then.
  • General care: You will start to loose weight after labor. You need extra  calories and certain nutrients to maintain successful lactation and for your body to heal. You are also advised to do some walking as early as possible.
  • Uterus: After labor the uterus starts to return to its original size  before pregnancy. It might be associated with minor contractions and it will reduce in frequency by time.
  • Urine: There will be frequency of urination as the body is trying to get rid of extra fluids, and at the same time urine will be constipated. A woman is encouraged to urinate every 6 hours.
  • Intestine and bowel: you will be viable to constipation in the first period of time, you can overcome that by eating vegetables and fruits and some laxatives.
  • Skin care and stretch marks and cholasma (skin darkening): the stretch marks change color from red to bright silver and cholasma lightens up.
  • First menstrual period after labor: It differs from one woman to another. It can extend from few weeks to a whole year. A lactating woman can have her periods later than a non-lactating woman.
  • Sexual relations: Sometimes after labor there would be a wound  (especially if episiotomy is made) and some pain and vaginal discharges. The mother also would not be psychological ready to resume her sexual life again. With time those symptoms heal and then she can try the first relation. Till that happens continue sharing your support with your husband.
  • Family planning: family planning and contraception are discussed with the doctor in the first visit after delivery.
  • Post delivery exercises: You are advised to start exercising early.
    • Sleep on your back with your knees bent , raise your head and shoulders with your arms towards your knees then come back (Repeat 5-10 times )
    • Sleep on your back with your knees bent , raise your hips up and keep it for 30 seconds then return back ( Repeat 5-10 times)
    • Sleep on your back with your knees bent , push your leg forward then up and move your sole front and back then return it again , repeat with your other leg( Repeat 5-10 times)