Chapter 17: Family planning
A woman with implants does not have to do anything before sex to prevent
pregnancy. Implants are very effective, although very fat women may not get the
same protection from pregnancy as thin women. Implants only contain progestin
— so they are safe for women who should not take estrogen. And they can be used
safely while breastfeeding.
Implants have the same risks and side effects as other hormonal methods (see
page 306). Most women who use implants have very irregular monthly bleeding,
with spotting and bleeding between monthly bleeding. This usually gets better after
a year of using this method. And like any hormonal method, implants do not
protect against HIV or other STIs.
A woman cannot remove implants herself. They can only be removed by a
trained health worker. And it may be difficult to find a health worker who knows
how to remove them. Women should understand this before the implants are
put in.
WARNING! Watch women with implants for these signs of
dangerous health problems. Get medical help if you find any
of these signs:
• arm pain near the implant
• pus, redness, or bleeding around the implant
• implant comes out
• m onthly bleeding stops after being regular for
several months
Intrauterine device (IUD, IUS)
The IUD is a small device made of plastic that is put inside
the womb to prevent pregnancy. Different types of IUD
have different names, such as IUCD, copper T, Mirena, or
the loop. Chapter 21 explains more about IUDs and how
to insert them.
the IUD is
put inside
the womb
Once the IUD is put in, it stays inside the womb until it is
taken out by a trained person. IUDs must be replaced every
few years. Different IUDs can be left in for different lengths
of time.
strings hang
out of the
cervix, into
the vagina
Neither the woman nor man feel the IUD while having sex. A woman who uses
an IUD does not have to do anything before having sex. And no one needs to
know that the woman has an IUD inside.
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A Book for Midwives (2010)