CHAPTER I Preliminary

I.I Background Range of 1800-1900 Indonesian population increased three times as much. 1900 -2000 occurred while the population of five-fold from 40.2 million to 205.8 million people. 1900 -2000 occurred while the population of five-fold from 40.2 million to 205.8 million people. During the 1900-2000 span, the program as Family Planning (KB) successfully prevented the birth of 80 million people. Without population planning program through 2000 predicted 285 million people.

Family Planning (KB) is one of the preventive health care of the most basic and major for women, although not always recognized as such. Improvement and expansion of family planning services is one of the efforts to reduce maternal morbidity and mortality is so high due to pregnancy experienced by women. Many women have to make a choice of contraception difficult, not only because of the limited number of methods available but also because of certain methods may
1

not be accepted in relation to the national family planning policy, individual health and female sexuality or the costs of obtaining contraceptives (MOH, 1998) . Purpose 1. Knowing the meaning KB 2. Knowing the purpose of family planning 3. Knowing the benefits of family planning 4. Methods of contraception Target The expected results of this research are: 1. At least readers know about family planning 2. Readers know about family planning 3. Readers can spread the word about this program to people who lack knowledge about the importance of family planning programs.

CHAPTER 11 LITERATURE REVIEW

2.1 Defenition According to the World Health Organisation (WHO) expert committee 1997: family planning is an action that helps couples to avoid unwanted pregnancies, births are indeed getting very desirable, set the interval between pregnancies, birth control time in relation to the age of the husband and wife determine the number of children in the family. Family planning under the Act No. 10 of 1992 (concerning population development and construction of a prosperous family) is an effort to increase awareness and community participation through the maturing age of marriage (PUP), birth control, fostering family resilience, improving the welfare of a small family, happy and prosperous . Family planning is an attempt to thin out the number and spacing of pregnancy by using contraception. In general, family planning can be interpreted as an attempt to set the number of pregnancies in a way that positively impacts for mothers, babies, fathers and families concerned will not result in
3

losses as a direct result of the pregnancy. Hopefully with the careful family planning pregnancy is something that is highly desirable so that it will avoid the deed to terminate a pregnancy by abortion. 2.2 The purpose of Family Planning Family planning and contraceptive services movement has a purpose: 1. Regulate pregnancy by delaying marriage, delaying first pregnancy and spacing of pregnancy child after the first child and terminate the pregnancy if the child has felt enough. 2. Treating infertility or infertility for couples who have been married more than one year but not yet have children, it is possible to achieve a happy family. 3. Counseling Married or marriage advice for teenagers or couples who will marry in the hope that the couple will have the knowledge and understanding that is high enough to form a happy family and quality. 4. The final goal is the achievement NKKBS KB (Small Family Norms Happy and Prosperous) and form a quality family, family means the quality of a harmonious family, healthy, adequate clothing, food, shelter, education and economically productive.
4

5. Increase the number of people to use contraceptives. 6. The decline in the number of birth rate. 2.3 The scope of family planning program According to Handy (2010:29) the scope of family planning programs, including: a. Communication of information and education. b. Counseling. c. Infertility services. d. Sex education. e. Pre-wedding consultation and wedding consultation. f. genetic counseling 2.4 Benefits of family planning efforts in the field of public health point of view. Improvement and expansion of family planning services is one of the efforts to reduce maternal morbidity and mortality are higher in women due to pregnancy. 2.5 Terms - Terms of Contraception In an effort to prevent pregnancy should have the requisite contraception - following requirements: a. safe use and reliable.
5

b. adverse side effects do not exist. c. five works can be set as desired. d. not interfere with intercourse. e. does not require medical assistance or strict control over the its use. f. how to use simple. g. cheap price in order to reach the wider community. h. can be received by married couples.

2.6 Contraception Mechanical Named because of its nature as a mechanical protector. That is, this contraceptive prevents meeting of sperm and egg in the uterus. Well, there are several contraceptives that are included in the mechanical group, namely condoms and diaphragms. Condoms

First condoms made of animal skin or gut. Each will be used soaked first. Then made of linen. Now condoms are made of thin material and elastic rubber. Shaped like a pouch. Condom use is actually to hold the sperm so it does not get into the vagina. The effective protection of 90 per cent. Especially when used together with a spermicide (sperm killer). "On average, 100 couples a year, about 4 women who are pregnant," said Andon. Condoms are cheap, easy to come by, do not need a prescription, does not need supervision and can also prevent the spread of venereal disease. But it is not always suitable, especially if the wearer is allergic to rubber. And may be a leak, because the material is very thin. Diaphragm

Women are like condoms contraception. Shaped like a hat that covers the cervix. Made of rubber and a bit thick. Contraception is inserted into the vagina, a kind of insulation can prevent the entry of sperm into the uterus. Diaphragm will be used if intercourse. Once again it can be removed or left in place. Because the material is thicker than condoms, contraception is not possible leak. Contraceptives In The Womb

Contraception in Rahim / IUD / IUD better known as spiral. Shaped small tools and a lot of stuff. Some are made of plastic like the shape of the letter S (Lippes Loop). Some are made of copper metal shaped like the number seven (Copper Seven) and resemble the letter T (Copper T). In addition, there is a horseshoe-shaped (Multiload). "The most famous Copper T and Multiload. Contraception is an
8

option because of its convenience. Recent modifications Copper T, the Nova T has a softer edge, "said Andon. The intrauterine device inserted into the uterus by a doctor with the help of tools. Foreign body in the uterus will cause reactions can prevent breeding the fertilized egg in the uterus. This tool can survive in the uterus for 2-5 years, depending on the species and can be opened before the time if you want to get pregnant again. As a user, you can check the existence of the tool itself. The trick with fingering yarn contraceptives in the cervix. If you've done this installation contraception, do not forget to do the re-examination. Is it 2 weeks, 1-2 months, or every six months to one year after installation. Contraceptive use without the active ingredient Copper can continue until menopause. While the active ingredient Copper Contraceptive, 3-4 years should be replaced. To keep in mind this is not a contraceptive perfect tool. Still a weakness. For example, pregnancy can still occur, bleeding, or infection. Probably due to the thread of the device can stimulate the cervix causing injury and interference in the sexual intercourse. IUD use also makes it easier to discharge. Contraception should therefore not be used if there is an infection or bleeding genetalia are not clear.
9

The advantage, this tool can be used for long term. Even completely disrupt production of breast milk, if the mother is mmenyusui. "Effectiveness of contraceptive use in the womb, a thousand couples, about 5 women will become pregnant in a year," said Andon.

Spermicides

Contraception is a chemical compound that can be crippling to kill sperm. The form can be foam, jelly, cream, vaginal tablets, tablets, or aerosols. Before sexual intercourse, this tool is inserted into the vagina. After about 5-10 minutes of sexual intercourse can be done. The use of spermicide are less effective if not combined with other instruments, such as a condom or diaphragm. "Of the 100 couples a
10

year, there are three women who are pregnant. But as is often wrong in its use, there can be up to 30 of pregnancy, "said Andon. Admittedly, many women felt uncomfortable using spermasida. "His complaint, bad and allergies arise," said Andon later. In addition, its use is rather troublesome relationship before intercourse. Pair was difficult to achieve satisfaction. Hormonal contraception The use of hormonal contraceptives, progesterone through a combination of estrogen and progesterone. Contraceptive use is done in the form of pills, injections, or implants. In principle, the mechanism of action of the hormone progesterone is to prevent spending the egg from the ovary, cervical secretions thicken so sperm impenetrable, making the uterine lining being thin and unfit for the growth of the products of conception, fallopian tubes running so slow that it interferes with sperm when meeting and egg cells.

11

Pills or Tablets

Pill aims to improve effectiveness, reduce side effects, and minimize complaints. Most women can receive contraception without difficulty. In Indonesia, this species occupied the second highest number after the injection is used. This pill is available in different variations. There were only contains the hormone progesterone alone, there is also a combination of progesterone and estrogen. How to use it, taken every day on a regular basis. There are two ways to drink the system 28 and system 22/21. For system 28, a pill taken on without ever stopping (21 tablet combination pills and 7 placebo tablets). While the system is 22/21, taking the pill continuously, then stop for 7-8 days for the chance to menstruation. So, arrangements were made with the pattern of menstruation
12

(sequential). In the comparative strength of each pill contained estrogenic or progesterogenik, through assessment menstrual pattern. Women who menstruate less than 4 days requiring oral contraceptives with high estrogen effect. Whereas women with menstrual require more than 6 days pills with low estrogen effect. Distinctive properties that berkomponen estrogen hormonal contraceptives cause irritability, tension, weight gain, cause headache, bleeding a lot during menstruation, while the berkomponen progesterone cause breast tension, decreased menstruation, feet and hands are cramping, dry hole intercourse. The use of the pill regularly and for extended periods may suppress ovarian function. Other losses, may gain weight, also nausea to vomiting, dizziness, forgetfulness, and there are spots on the skin such as black spots. Also can affect the liver and kidney function. In addition, the content of the hormone estrogen can interfere with milk production. The advantage, these pills can increase libido, as well as for the treatment of endometriosis. Periods become irregular, reducing menstrual pain and regulate menstrual bleeding.
13

Effectiveness of using this pill 95-98 percent. So, there are about 7 women who become pregnant than 1,000 couples a year. Injections

Contraceptive injections contain synthetic hormones. Inoculation is done 2-3 times a month. Injections every 3 months (Depo-Provera), every 10 weeks (Norigest), and each month (Cyclofem). One advantage of injections is not intrusive milk production. Use of this hormone can also reduce pain and menstrual blood comes out. Unfortunately, it can make the body fat because of increased appetite. Then the mucus lining of the uterus to become thinner so little menstruation, spotting or no period at all. Erratic bleeding. Failure rate of only 3-5 out of every 1,000 pregnant women couples a
14

year. Implant

Called contraceptives under the skin, due to be installed under the skin on the upper left arm. The shape is kind of small tubes or wrapping silastik (hollow plastic) and the size of a matchstick. Implant mounted in a fan with six capsules. Now being tested implant one kapsulimplanon). It contains the active substance or form of the hormone levonorgestrel. The implant releases hormones that little by little. Thus, the concept works blocking ovulation and blocking the sperm migration. Use of implants can be replaced every 5 years (Norplant) and 3 years (Implanon). Now some are replaced every year. The cost of contraceptive use light.
15

Revocation can be done ahead of

time if you really want to get pregnant again. Effectiveness, of the 10,000 couples, there are 4 women who become pregnant in a year. Side effects such as menstrual disorders, irregular menstruation, spotting or no period at all. Unless it can lead to obesity, breast tension, and feels dry hole intercourse. Other constraints in the revocation of the implant that is difficult to remove because the installation time may be too deep. This can lead to infection. If you are newly married and do not plan to have children, use simple methods to delay pregnancy. What is it? 1. Condoms Sperm that comes out will be accommodated by a condom, so it does not get into the uterus. Failure may occur. Usually because the condom was torn and leaking. 2. Periodic Abstinence To avoid pregnancy, do intercourse in the past only when the wife is infertile. This can be done in couples whose wives have regular menstrual cycles. Cooperation and understanding husband desperately needed in this regard. 3. Intercourse Disconnected This method may be able to avoid pregnancy. The concept,
16

issuing genitals before ejaculation. But, this way is rather disturbing satisfaction of both parties. The failure rate is quite high, 30-35 percent. "It's more due to the husband can not control, so that the sperm still spilled in the cervix and vagina can still enter." Said Andon. Not suitable if: Unstable Body Weight Does the body become thin or fat? If there is a change of normal weight, the possibility of contraception used is not suitable. Pain Occur Can headache, muscle aches, abdominal cramps. Changes in Emotions Appear anxious, depressed, and so on. Pattern Haid Bothered Blood comes out to be a lot, a little, or none at all. Incurred Whitish Numerous and contain odors.

17

2.7 Permanent Contraception Method Sterilization Fallopian tubes in women blocked by tied, cut or dilaser. Sterilization in women can also be done with the removal of the uterus. This is a permanent contraceptive method. Whereas in men, sterilization is done by cutting the vas deferens. If we want to live this contraceptive, should age of your youngest child has gone through the toddler years. this just in case someday you still intend to get pregnant again.

18

CHAPTER III CLOSING A. CONCLUSION Almost all couples planning pregnancy and the need to limit the number of children at the same time. Therefore, contraception is needed. Reason contraceptive use can vary, of delaying pregnancy, pregnancy spacing distances, up to stop the pregnancy.

"Each partner has a reason. Perhaps because of school affairs, employment, age, health and all sorts. It could also be because they have children and want to delay their next pregnancy. Or, yes, want to stop because the child had a lot, "said dr. Andon Hestiantoro, Sp.OG, from Cipto Mangunkusumo.

As we know, there are so many contraceptives. Broadly speaking, contraception is divided into three major sections. Namely mechanical contraceptives, hormonal, and permanent contraception.

19

B. SUGGESTIONS Before choosing contraception couples should first consult your midwife or doctor to be the mainstay pick tool and type of contraception that suits your needs and comfort of husband and wife. any contraception has the durability and distinct side effects, this should also consult in order to know which pair is best for them.

20

REFERENCES 1.http://medicastore.com/penyakit/575/Keluarga_Berencana_KB.html 2. http://repository.usu.ac.id/bitstream/123456789/27190/4/Chapter% 20II.pdf 3. http://healthiskesehatan.blogspot.com/2011/06/macam-macam-alatcontraception-and-efek.html 4. http://poemofjava.blogspot.com/2012/12/pengertian-cara-kerjajenis-keuntungan.html

21