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Contraception and Birth Control

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1 Contraception and Birth Control
Chapter Eleven Contraception and Birth Control

2 Risk and Responsibility
In the United States, half of all pregnancies are unintended Half of unintended pregnancies occur in couples who do not use contraception Those who discuss preventing pregnancy are most likely to use contraceptives 2

3 Men, Women, and Birth Control: Who Is Responsible?
Women may have a greater interest than male partners in controlling fertility Traditionally been seen as the woman’s job Male-controlled methods now account for 35% of reversible contraceptive use

4 Adolescents and Contraception
Adolescents are less likely than older individuals to use contraction Condoms are preferred method Condom use may be stigmatized

5 Birth Control and Contraception: What’s the Difference?
Birth control: any means of preventing a birth from taking place; includes contraception and abortion Contraception: birth control that works specifically to prevent conception 3

6 Choosing a Method Best method is the one you will use correctly and consistently Theoretical effectiveness assumes consistent and correct usage User effectiveness: Actual statistical effectiveness incorporating those who use method but do not do so consistently and correctly

7 Sexual Abstinence Most reliable form of birth control
Involves refraining from sexual activity that could cause pregnancy Abstinence doesn’t necessarily rule out affection or non-coital sexual activities Practitioners’ definitions of abstinence vary From a contraceptive perspective, abstinence from vaginal intercourse is required

8 Hormonal Methods Oral contraceptives
“the pill”; the most widely used form of reversible contraceptive in the U.S. Highly effective in preventing pregnancy Contains progestin and (usually) estrogen How they work: Suppress ovulation Thicken cervical mucous Thin the lining of the uterus Slow the rate of ovum transport 4

9 Hormonal Methods Oral contraceptives
Effectiveness rates Suppresses ovulation Multiple types Advantages Disadvantages Possible problems

10 Other Hormonal Methods
Injectable contraceptives: Depo - Provera The Patch: Ortho Evra Effectiveness rates Advantages Disadvantages The vaginal ring: Nuva Ring

11 Other Hormonal Methods
The vaginal ring: Nuva Ring Effectiveness rates Advantages Disadvantages Implants: Jadelle

12 Barrier Methods of Contraception
Condom Spermicide: nonoxynol – 9 Latex vs. polyurethane Women and condom use Effectiveness and advantages Possible problems The female condom 5

13 Barrier Methods of Contraception
Diaphragm and Cervical Cap Both cover the cervical opening to prevent entry of semen Both are filled with spermicidal jelly and cream Different shapes and style of fit Effectiveness Advantages Possible problems

14 Barrier Methods of Contraception
Contraceptive sponge The FemCap Spermicide Foam Film Creams, jellies, and vaginal suppositories

15 Intrauterine Device (IUD)
Tiny plastic or copper device inserted into uterus Multiple types currently available 10-12 years Not an abortifacient Projections for increased popularity 7

16 Fertility Awareness Based Methods
Calendar (rhythm) method Basal body temperature (BBT) method Ovulation method Symptothermal method 8

17 Sterilization Men: Women: Vasectomy Tubal ligation Laparoscopy Essure

18 Emergency Contraception
Taken within 120 hours of unprotected sex Plan B Concentrated doses of progestin and/or estrogen Stops ovulation, fertilization, and implantation Will not abort an established pregnancy Different from “abortion pill” Copper IUD Less common method; interferes with implantation 10

19 Abortion Medical definition: expulsion of the conceptus
Can happen naturally (miscarriages) Can be medically or surgically induced Abortions are not all the same Circumstances of pregnancy vary Differences by stage of pregnancy 11

20 Abortion Under safe, clean, legal conditions abortion is a safe medical procedure Self-administered or illegal abortions can be very dangerous, sometimes fatal

21 Methods of Abortion Medical Abortion
A two-drug regimen (mifepristone with misoprostol) that can terminate early pregnancy. Most effective up to 49 days after the beginning of the pregnant woman’s last period

22 Mifepristone/Misoprostol

23 Methods of Abortion Surgical Abortion
Vacuum Aspiration Used in first trimester Dilation and Evacuation (D&E) Used in second trimester Only 1.5% of US abortions Hysterotomy Used in later stages of pregnancy Like a cesarean section; extremely rare

24 Prevalence of Abortion
About half of unintended pregnancies end in abortion Highest rates: Ages 18-29, unmarried, Black or Hispanic, and/or economically disadvantaged women Number of abortions decreased between 1994 and 2000 Emergency contraception accounts for as much as 43% of decrease

25 Three Factors Leading to Abortion
Failure to practice contraception Incorrect or inconsistent use of contraception Failure of contraceptive method Emotional issues for women Reevaluation of relationships Examination of childbearing plans A search to understand role of sexuality An attempt to clarify life goals

26 Women, Men, and Abortion Emotional issues for men
Experience of guilt and anxiety Ambivalence about parenthood Powerlessness May experience erectile or ejaculatory difficulties Effect on relationships Stress, conflict, and guilt sometimes lead to break-up Clinics now provide counseling for both men and women

27 The Abortion Debate Pro-life Argument Pro-choice Argument
Human life begins at fertilization Same rights in utero as after birth Abortion is moral equivalent of murder Pro-choice Argument Women should be able to choose whether or not they will have children Abortion should be available as a back-up birth control method Women will get illegal and unsafe abortions if the procedure is made illegal

28 The Abortion Debate Abortion and Religion
The Bible is silent on abortion Scriptural basis for or against is a matter of interpretation The debate about when human life begins is theological American religious organizations take both pro-choice and pro-life stances

29 The Abortion Debate Constitutional Issues U.S. Supreme Court
Roe v. Wade (1973) Webster v. Reproductive Rights (1989) Planned Parenthood v. Casey (1992)

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