We have now discussed conception, pregnancy, and birth this week and although your book briefly mentioned it, we expanded on the topic of remaining child-free or the decision to have children.
– What are some of the positive and negative things you have heard other people/family/friends say about those who choose to remain child-free?
-What are some of the positive or negative things you have heard about those who decide to have children?
– In your opinion, how many children is “too much”? Why? What would be some challenges that could be faced with “too many children”?
– Do you think our society is more pro-children or anti-children? Provide one example of why you believe this is the answer.
Chapter 5:
Contraception: Planning
and Prevention
BY ROGER R. HOCK
Historical Perspectives
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The Politics of Contraception
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Anthony Comstock and the Comstock Act
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Margaret Sanger
?
?
“Family Limitation”
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Planned Parenthood
100 Years Later and it’s Still about Politics
Choosing a Method of Contraception
?
An Individual or Shared Decision?
?
Lifestyle Considerations
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Unreliable Methods – Contraceptive Myths
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Douching
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Cola douche
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Standing up during intercourse
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Plastic wrap In place of male condoms
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Toothpaste as spermicide
?
Pregnancy is not possible the first time
Methods for Preventing Pregnancy
and STIs (STDs)
?
Selective Abstinence
?
?
?
Not to be confused with celibacy
Male Condoms
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How condoms work
?
Effectiveness of condoms
?
Proper use of condoms
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Convincing your partner to use condoms
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In Touch with Your Sexual Health: Using male condoms correctly
The Female Condom
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Create a lining on the inside of the vagina
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Consists of a tube of thin polyurethane
TodayÂ’s condom market offers an amazingly wide selection to satisfy all preferences.
Figure 5.1 The Female Condom
The female condom consists of a tube of thin polyurethane, similar to the polyurethane male
condom, but with a flexible ring at each end, as shown in the photo (a) The three-step
procedure (b) illustrates how to insert a female condom. Care must be taken when removing
the condom to prevent semen from spilling out.
Methods that Prevent Pregnancy
(But Not STIs)
?
Effectiveness of oral contraceptives
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Using birth control pills correctly
?
Advantages and disadvantages of the pill
?
Withdrawal
?
Oral Contraceptives
?
?
?
How oral contraceptives work
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Combination pill
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Minipill
Extended-dosage pill
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90-day Pill
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365-day Pill
Amenorrhea
Numerous brands and formulations of oral contraceptives offer a great many options for
women who choose this form of hormonal contraception.
Methods that Prevent Pregnancy
(But Not STIs)
?
?
?
The Hormonal Implant
?
How an implant works
?
Effectiveness of the implant
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Advantages and disadvantages of the implant
The Injectable Hormonal Contraceptive
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How the injection method works
?
Effectiveness of the injectable contraceptive
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Side effects of the injection method
The Contraceptive Patch
Figure 5.2 The Hormonal Implant
The hormonal implant (Implanon) is a small tube that is implanted under the skin of a
womanÂ’s upper arm. Hormones are slowly released into the womanÂ’s body over several
years, thus preventing ovulation.
The contraceptive patch functions physiologically in basically the same way as other
hormonal contraceptives, but delivers hormones through the skin, preventing pregnancy.
Methods that Prevent Pregnancy
(But Not STIs)
?
The Contraceptive Ring
?
Called NuvaRing
?
Releases a continuous low dose of estrogen-like and progestin-like hormones
Figure 5.3 The Vaginal Ring
The vaginal ring is a colorless, flexible silicone ring (a) about 2 inches in diameter, which
prevents ovulation by secreting hormones through the vaginal walls continuously for three
weeks. The three-step procedure (b) illustrates how to insert a vaginal ring.
Methods that Prevent Pregnancy
(But Not STIs)
?
Emergency Contraceptive Pills
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Plan B One Step, Next Choice, and MyWay
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Should never be substituted for birth control pills
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Provided at little or no cost by most public health clinics and university health
services
Emergency contraception pills offer protection from conception up to five days after
unprotected intercourse. These are not “abortion pills”; they help prevent conception.
Methods that Prevent Pregnancy
(But Not STIs)
?
The Diaphragm
?
Thin latex membrane attached to a flexible ring, forming a shallow cup
?
Must be left in place at least six hours after intercourse
Figure 5.4 The Diaphragm
The diaphragm is a thin latex membrane attached to a flexible ring, forming a shallow cup,
as shown in (a) It can be inserted up to two hours prior to intercourse and must be left in
place for at least six hours (but not more than 24 hours) after. For effective contraception,
the diaphragm must always be used with spermicide. The three-step procedure (b) illustrates
how to insert a diaphragm.
Methods that Prevent Pregnancy
(But Not STIs)
?
The Cervical Cap
?
Designed to fit more snugly over the cervix itself
?
FemCap
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Must be left in place at least six hours after intercourse
Figure 5.5 The Cervical Cap
The cervical cap (FemCap), shown in (a), is used with spermicidal cream and inserted much
like the diaphragm. It is designed, however, to fit more snugly over the cervix itself (b).
Methods that Prevent Pregnancy
(But Not STIs)
?
A One-Size-Fits-All Diaphragm
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Contraceptive Sponge
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Spermicides
?
Fertility Awareness Methods
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The Standard Days Method
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Technique for tracking fertile and infertile days during a womanÂ’s menstrual cycle
Figure 5.6 The Average Window of Fertility
This is an example of the average window of fertility in a womanÂ’s monthly cycle, calculated
on the assumption that ovulation occurs on day 14 and that sperm may live as long as seven
days. Note that the exact fertile days vary among women and, for many women, from cycle
to cycle.
Methods that Prevent Pregnancy
(But Not STIs)
?
Fertility Awareness Methods
?
The Two Day Method
?
?
Relies on careful observation of secretions from the cervix to predict ovulation
Fertility Awareness Methods
?
The Symptothermal (Basal Body Temperature) Method
Figure 5.8 The Two Day Fertility
Awareness Method of Contraception
Source: Based on Institute for
Reproductive Health (2008).
Figure 5.9 Charting Your Basal Body Temperature
Careful monitoring of basal body temperature allows a woman to determine when ovulation
occurs. The process involves taking her temperature first thing every morning using a special
thermometer and graphing the changes on a chart. A sharp rise in BBT indicates that
ovulation is imminent.
Methods that Prevent Pregnancy
(But Not STIs)
?
?
Fertility Awareness Methods
?
Ovulation Predictor Kits
?
Effectiveness of Fertility Awareness Methods
?
Advantages and Disadvantages
Intrauterine Methods
?
Advantages and Disadvantages of an IUD
?
How the IUD works
Figure 5.10 The IUD
The intrauterine device (IUD) is inserted into the uterus by a health care professional and may
remain in place up to ten years, depending on the type of IUD.
Methods that Prevent Pregnancy
(But Not STIs)
?
Surgical Methods
?
Sterilization (VSC)
?
?
Female
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Tubal Ligation
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Essure
Surgical Methods
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Male
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Vasectomy
?
Effectiveness of VSC
?
Advantages and Disadvantages
?
Reversibility
Figure 5.11 Tubal Sterilization
Voluntary surgical sterilization for women involves the cutting, tying, or blocking of the
fallopian tubes.
Figure 5.13 Vasectomy Procedure
A vasectomy severs each vas deferens tube so that sperm will no longer be able to pass
through and be ejaculated with semen.
Methods that Prevent Pregnancy
(But Not STIs)
?
Experimental and Future Methods
of Birth Control
?
?
Possible Future Methods for Men
?
A male hormonal contraceptive
?
Vas injection
?
Immunocontraceptives
Future Methods for Women
?
Antimicrobial, spermicidal gel
Abortion is Not Contraception
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Occurs after conception
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Termination of a pregnancy
?
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Never an easy decision
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Very emotional and psychologically painful experience
As contraception use rises, abortion rates decline
