1. Pre-service Education on FP and AYSRH
Session II, Topic 5 Female Condoms

2. What is the Female Condom?
Effective barrier method that can be used for both prevention of pregnancy and protection against HIV and other sexually transmitted infections (STIs)
A transparent sheath that fits loosely inside a woman’s vagina
Most made of thin, soft, synthetic film
Female Condom 2
Illustration credit: Salim Khalaf/FHI
The female (and male) condom is an effective barrier method that can be used for both prevention of pregnancy and protection against HIV and other sexually transmitted infections, or STIs.
The female condom is a transparent sheath that fits loosely inside a woman’s vagina.
Most female condoms are made of thin, soft, synthetic film.
Plastic female condoms can be used by anyone, and latex female condoms can be used by anyone except those with severe allergic reaction to latex. However, severe allergic reactions to latex are extremely rare.
Most common type is the Female Condom 2 (FC2), made of thin, soft, synthetic rubber film, with flexible rings at both ends.
Natural latex female condoms are available in some countries.
Describe and discuss the types of female condoms that are available in your country or region.
Ask students: What are some words that clients use to refer to condoms?
Discuss the common words for female condoms that students have heard their clients use. Inform students that knowing common terms can help them communicate more effectively with clients.
Display samples of locally available condoms (latex and plastic) and distribute them among the group for students to examine.
Family Planning Training Resource Package for Pre-service Education 2

3. Female Condom: Key Points for Providers and Clients
Protects against both pregnancy AND STIs including HIV/AIDS
Client needs condom when:
Client is unsure whether he/she or his/her partner has an STI including HIV.
Client has other sex partners or is not sure if current partner has had other sex partners.
Effective when used EVERY TIME you have sex
When condoms are used correctly every time, they are very effective in preventing pregnancy, HIV and other STIs.
May be less effective than the male condom in preventing pregnancy, HIV and other STIs.
Best if inserted before any sexual contact.
Adapted from WHO’s Decision-making tool for family planning clients and providers.
Use slides 3 and 4 to provide an overview of the key points about female condoms.
Family Planning Training Resource Package for Pre-service Education

4. Female Condom: Key Points for Providers and Clients
Can be used alone or with another family planning method
May be more effective against pregnancy when combined with another method, but cannot be used with the male condom.
Also used as back-up for another method of family planning (for example, missed pills, late for injection).
May be expensive
More expensive than the male condom and may not be as easily available.
Inserted by the woman, but usually need to discuss with partner
If partner does not want to use condoms,
“We can discuss and practice what you might say.”
Adapted from WHO’s Decision-making tool for family planning clients and providers.
Family Planning Training Resource Package for Pre-service Education

5. Contraceptive Effectiveness
In this progression of effectiveness, where would you place female condoms?
Less effective
More effective
Implants
Male Sterilization
Female Sterilization
Intrauterine Devices
Progestin-Only Injectables
Combined Oral Contraceptives
Standard Days Method
Spermicides
Ask participants: Where would you put female condoms on this list? <After participants respond, click the mouse to reveal the answer>.
The list on this slide categorizes contraceptive methods from most effective to least effective as commonly used. In this list, spermicides are the least effective method and the most effective methods are sterilization and IUDs.
Conclude by emphasizing that condoms would be in the third tier of methods, with Standard Days Method.
Female condoms
Family Planning Training Resource Package
for Pre-service Education

6. How to Use a Female Condom
To remove, twist the outer ring and gently pull
Throw away condom properly
Gently insert the inner ring into the vagina
Place the index finger inside condom, and push the inner ring up as far as it will go
Make sure the outer ring is outside the vagina and the condom is not twisted
Be sure that the penis enters inside the condom and stays in it during intercourse 
Inner ring
Open end 
Choose a comfortable position― squat, raise one leg, sit or lie down
Open package carefully
Make sure the condom is well-lubricated inside
Squeeze the inner ring at the closed end
Outer ring   
Adapted from WHO’s Decision-making tool for family planning clients and providers.
Review the steps for inserting the female condom
Step 1: Open package carefully. Make sure the condom is well-lubricated inside
Step 2: Choose a comfortable position―squat, raise one leg, sit or lie down
Step 3: Squeeze the inner ring at the closed end
Step 4: Gently insert the inner ring into the vagina
Place the index finger inside condom, and push the inner ring up as far as it will go
Make sure the outer ring is outside the vagina and the condom is not twisted
Be sure that the penis enters inside the condom and stays in it during intercourse
Step 5: To remove, twist the outer ring and gently pull
Throw away condom properly
Family Planning Training Resource Package
for Pre-service Education

7. Correcting myths, misperceptions, fears How to use; demonstration
Key Counseling Topics
Characteristics
Correcting myths, misperceptions, fears
How to use; demonstration
Importance of correct and consistent use
Common problems; practices to avoid
Lubricants
Where to get more condoms
Use of ECPs, if needed
How to talk with partner about condoms
Users of female (and male) condoms are more likely to be successful when they receive thorough counseling. When counseling clients about condoms, providers should explain their characteristics, including dual protection and effectiveness. It is also important to respond to and correct any misconceptions, myths or fears about condoms that the client expresses.
After a client has decided to use female condoms, demonstrate how to use a female condom and allow clients to practice using a model or other item. Emphasize the importance of consistent and correct use.
Clear and practical information on how to avoid common mistakes in use and how to get more supplies is also essential. Advise clients that emergency contraceptive pills (ECPs) may be available in case a condom slips or breaks or was used incorrectly. Give clients ECPs in advance if possible, or advise them where to go for ECPs.
Because partner communication and cooperation is required for effective use of condoms, explore partner negotiation techniques as needed. If culturally appropriate, it is also helpful to talk to clients about how to make the use of condoms a part of sexual activities.
Family Planning Training Resource Package
for Pre-service Education

8. Follow-Up Visits
Ask how the client is doing with the method. Ask about questions or concerns.
Ask if they are having any problems using condoms correctly and every time they have sex.
Give the client more condoms, and ask them to return before supply runs out. Remind them of other places they can get condoms.
Ask a long-term client about major life changes that may affect her needs; plans for having children or STI/HIV risk.
Ask students what questions they would ask a client who has returned for a follow up visit. Allow students to answer, then click the mouse to reveal the list on the slide.
Present and discuss follow up visits for clients who are using condoms.
Ask students if they have any questions and answer or clarify points as needed.
See Session Plan for Roleplays
Family Planning Training Resource Package
for Pre-service Education

9. Female Condom: Summary
Safe and easy to use
Protect from both pregnancy and STIs/HIV
Female condom can be initiated by woman
Require partner’s cooperation
Summarize the main points about the female condom, using slide #9
Thank the students and explain that the next session will be on male condom.
Family Planning Training Resource Package
for Pre-service Education