Family Planning and Related Nursing Care

Family planning refers to methods used to plan when pregnancy occurs, and includes natural family planning methods, contraceptive devices and medications, and surgical procedures.

Natural family planning involves fertility awareness methods to predict fertile and infertile days to either avoid pregnancy or to conceive when pregnancy is desired. One method involves using a basal thermometer to monitor basal temperature, which is the body’s temperature first thing in the morning before getting out of bed. During ovulation, the temperature will rise around 0.4 degrees F, or 0.2 degrees C, and stay elevated until menstruation. The temperature is tracked for several months until a pattern is established, which helps predict when ovulation is likely to occur.

Next, the Billings method involves monitoring changes in cervical mucus. A few days before ovulation, the amount of mucus increases, and it changes from thick and sticky to thin and slippery.

Lastly, the calendar method, sometimes called the rhythm method, is used for those with regular menstrual cycles. It involves charting monthly cycles on a calendar for up to 12 months to estimate when ovulation is likely to occur, which is usually around the 14th day before the next menstrual cycle.

Contraceptive devices are reversible methods of contraception. First, there are barrier methods, like male condoms, cervical caps, and contraceptive sponges that prevent sperm from entering the uterus.

Male condoms are a thin stretchable sheath, commonly made of latex, that’s applied over the erect penis. They are single use and applied immediately prior to intercourse. The effectiveness of condoms is enhanced when used together with spermicides, which are chemical-based formulations that destroy sperm cell membranes and reduce sperm motility, reducing their ability to reach the cervix.

Spermicides can come pre-applied to condoms and are also available as foams, tablets, suppositories, vaginal films, creams, or gels. These formulations should be inserted deep into the vagina about 15 minutes before intercourse and must be reapplied before repeat intercourse since they're only effective for about an hour.

Cervical caps are soft silicone cups that are inserted deep into the vagina to cover the cervix. They are most effective when used with a spermicide.

There are also vaginal sponges, which are circular pieces of foam that contain spermicide, which trap and immobilize sperm. The sponge is moistened with water and then inserted against the cervix prior to intercourse.

All barrier method devices have advantages and disadvantages. The advantages are that they’re inexpensive, relatively easy to use, and effective when applied properly. In terms of disadvantages, male condoms offer effective protection against sexually transmitted infections, or STIs, while other barrier devices and spermicides offer no protection.