Family Planning (FP)

An effort to increase awareness of the role of society through the maturation age of marriage, birth setting, coaching family resilience, improving the welfare of the family to realize a small family, happy and prosperous. In the post-saline mothers are encouraged to give exclusive breastfeeding for infants from birth until age 6 months. After the baby is 6 months old are given complementary foods, with continued breastfeeding until the child was 2 years old. Do not stop breastfeeding to begin a method of contraception. Contraceptive methods on lactation client selected so as not to affect the breast milk or infant health.

a. Short-Term Contraception Methods  
1. Lactation Amenorrhea Method (LAM) 

 2. Method of Natural Family Planning (NFP)  
3. Barrier methods (condoms, spermisid, diaphragm)  
4. PIL (combination pills and progestin) 

b. Long-Term Contraception Methods  
1. Injection (Injection Combination and progestin)  
2. Contraceptives In Uterus (IUD)  
3. Lower Contraceptive Skin (Implant)  
4. Steady contraception (tubectomy, Vasectomy) 

Contraceptive Injection Method  
These types of contraceptive injections there are 2 kinds, injections and injections of progestin combinations. Here will be discussed progestin only contraceptive injections. Contraceptive progestin injections  
1. Profile  
Very effective, safe, can be worn by all women in reproductive age, the return of fertility more slowly (average of 4 months), suitable for the lactation because it does not suppress milk production.  
2. Type  
There are 2 types of injectable contraceptive containing progestin only, namely: 
 • Depot medroxyprogesterone acetate (DMPA), contains 150 mg of DMPA, which is given every 3 months by IM injection (in the buttocks).  
• Depo noretisteron enanthate (Depo Noristerat), which contains 200 mg noretindron enentat, which is given every 2 months by IM injection.  
3. How it Works  
Prevent ovulation, thicken cervical mucus thereby reducing the ability of sperm penetration, makes the cervical mucous membrane is thin and atrophy, and inhibit the transportation of gametes by the tuba.
4. Effectiveness  
Both injectable contraceptives have high effectiveness, with 0.3 pregnancies per 100 woman-years, provided penyuntikannya done regularly and according to schedule.  
5. Advantages and Limitations 
Profit 
 • Very effective  
• Prevention of long-term pregnancy 
 • No effect on the husband-wife relationship  
• Does not contain estrogen so it is not seriously affected the jnatung disease, and blood clotting disorders  
• Not having an influence on breast milk  
• Few side effects  
• Kilen not need to keep injecting drug  
• Can be used by women aged> 35 years until perimenopause  
Limitation  
• Often found in menstrual disorders 
 • The client is very dependent on the health-care facilities (have to go back to injections)  
• It can not be terminated at any time before the next injection  
• weight problems are common side effects  
• Does not guarantee protection against transmission of sexually transmitted infections, hepatitis B or HIV virus infection  
• Delayed return of fertility after stopping use  
• In the long-term use can cause vaginal dryness, lowered libido, emotional disturbances, headache, nervositos and acne. 

6. Indications and Contra Indications  
Indication  
• Reproductive Age  
• nulliparous and have a child who has  
• require long-term contraception and who have a high effectiveness  
• Breastfeeding and requires an appropriate contraceptive  
• After delivery and not breastfeeding  
• After the abortion and miscarriage  
• Has a lot but do not want tubectomy  
• Smokers  
• Blood pressure <180/110 mmHg, with the problem of blood clotting disorders  
 • Unable to use contraceptive estrogen  
• Often forget to use the contraceptive pill  
• Iron deficiency anemia  

Contra indications  
• Pregnancy or suspected pregnancy  
• vaginal bleeding that has not been clear why
• Unable to accept the occurrence of menstrual disorders, especially amenorrhea  
• Suffering from breast cancer or ovarian cancer  
• DM accompanied kompilkasi 

7. Start Time Using Contraceptives
• At any time during the menstrual cycle, provided the mother is not menstruating 
 • Begin the first day until the 7th day of menstrual cycle
 • In women who are not menstruating, the first injection can be given at any time, provided that only the mother was not pregnant. During the 7 days after injection should not be having sexual relations 
• Women who use hormonal contraception other and want to replace with a contraceptive injection. When the mothers had used contraception previously hormional correctly, and the mother was not pregnant. First injection to be given immediately. No need to wait until the next period to come  
• If the mother is using other types of contraception and want to replace it with another type of injection, which will be given contraception suntuikan initiated during the previous schedule of contraception. 
• Mothers who use nonhormonal contraception and want to replace it with hormonal contraceptives, the first injection of hormonal contraception to be provided can be granted, provided that the mother was not pregnant, and the gift does not need to wait for the next period to come. When mothers were injected after the 7th day of menstruation, the woman diving 7 days after injection should not be having sexual relations • The mother wanted to replace hormonal contraceptives IUD premises. The first injection can be given on the first day until day 7 of menstrual cycle, provided that certain non-pregnant mother. 

8. Warnings for the use of contraceptive progestin injections  
• Any missed a period should consider the possibility of pregnancy  
• Abdominal pain under the weight of possible symptoms of ectopic pregnancy disrupted  
• The emergence of the injection site abscesses or bleeding  
• Migraine headaches, severe recurrent headache or blurred vision  
• heavy bleeding 2 times longer than the period of menstruation or 2 times more in a single menstrual period If there is anything mentioned above, contact your immediate health worker or clinic