1. Chapter 6: Considering Your Reproductive Choices
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2. Did you PREPARE and did you LEARN?
Explain the process of conception, and describe how the effectiveness of contraception is measured.
Compare and contrast the advantages, disadvantages, and effectiveness of different barrier methods in preventing pregnancy and sexually transmitted infections.
Compare the advantages, risks, and effectiveness of different hormonal methods in preventing pregnancy.
Describe the effectiveness, advantages, and disadvantages of intrauterine contraceptives.
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3. Did you PREPARE and did you LEARN?
Describe emergency contraception and how it is used.
Explain how behavioral methods of contraception work, and compare their effectiveness to other methods of birth control.
Describe surgical methods of birth control, and discuss their advantages and disadvantages.
Identify questions you should consider when choosing a method of contraception.
Summarize the legal decisions surrounding abortion and the various types of abortion procedures.
Discuss key issues to consider when planning a pregnancy
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4. Did you PREPARE and did you LEARN?
Discuss key issues to consider when planning a pregnancy.
Describe fetal development, and explain the importance of prenatal care.
Explain the basic stages of childbirth and the complications that can arise during pregnancy, labor, and delivery.
Review primary causes of and possible solutions to infertility.
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5. Basic Principles of Birth Control
Fertility: A person's ability to reproduce
Conception: The fertilization of an ovum by a sperm
Contraception (birth control): The methods of preventing conception
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6. Basic Principles of Birth Control
The following conditions are necessary for conception:
A viable egg (about 24 hours)
A viable sperm (3 days, up to a week)
Access to the egg by the sperm (in fallopian tube)
1. A sexually mature woman releases an egg roughly every 28 days from one of her two ovaries. The egg is viable for about 24 hours, and if conception occurs, it usually occurs in the fallopian tube.
2. One of the 200 to 500 million sperm ejaculated must penetrate a viable egg. Sperm reach the fallopian tube in about 3 days and are viable for up to a week.
3. To reach the egg, sperm must travel up the vagina, through the cervical opening into the uterus, and from there to the fallopian tubes.
To reach the egg, sperm must travel up the vagina, through the cervical opening into the uterus, and from there to the fallopian tubes.
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7. Basic Principles of Birth Control
Perfect-use failure rate is the number of pregnancies (per 100 users) that are likely to occur in the first year of use of a particular birth control method if the method is used consistently and correctly.
Typical-use failure rate is the number of pregnancies (per 100 users) that are likely to occur in the first year of use of a particular birth control method if the method's use is not consistent or always correct.
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11. Barrier Methods
Barrier methods are contraceptive methods that block the meeting of egg and sperm by means of a physical barrier, a chemical barrier, or both.
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12. Barrier Methods The male condom The female condom
Jellies, creams, foams, suppositories, and film
The diaphragm
The cervical cap
The sponge
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13. How to Use a Male Condom
Latex condoms reduce the risk of STI transmission by between 80 and 90 percent. When used consistently and correctly, condoms can be up to 98 percent effective.
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14. How to Use a Female Condom
Female condoms also provide some protection against STIs. When used consistently and correctly, female condoms can be up to 95 percent effective.
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15. Jellies, Creams, Foams, Suppositories, and Film
Jellies and other spermicides have a 29 percent failure rate in typical use and an 18 percent failure rate with perfect use.
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16. The Proper Use and Placement of a Diaphragm
The diaphragm can be 94 percent effective in preventing pregnancy, if used consistently and correctly.
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17. The Cervical Cap
The cervical cap can be reasonably effective (86 percent) with typical use.
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18. The Sponge
The sponge is fairly effective (91 percent perfect use; 84 percent typical use) when used consistently and correctly.
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19. Hormonal Methods
Hormonal methods of birth control are those that depend on the use of synthetic estrogen and/or progesterone.
Hormones alter a woman's biochemistry, preventing ovulation.
If ovulation does occur, changes occur that make it difficult for a sperm to reach an egg.
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20. Hormonal Methods Oral contraceptives Progestin-only pills
Contraceptive skin patch
Vaginal contraceptive ring
Contraceptive injections
Contraceptive implants
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21. Oral Contraceptives
Oral contraceptives are pills containing synthetic hormones that prevent ovulation by regulating hormones. They can be up to 99 percent effective with perfect use.
Progestin-only pills (minipills) contain only progesterone, no estrogen.
Today, oral contraceptives are the most commonly used birth control method among college women.
Estrogen may pose health risks, including blood clots, which may lead to stroke or heart attack and an increased risk of high blood pressure.
Minipills contain only progestin. Advantages of the minipill include reduced water retention, but women may still ovulate. Progestin produces changes in the cervical mucus that inhibit sperm mobility.
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22. Contraceptive Skin Patch
Ortho Evra is a patch that releases hormones similar to those in oral contraceptives. Each patch is worn for one week.
As with other hormonal methods, there is less room for user error than there is with barrier methods.
Ortho Evra is 99.7 percent effective with perfect use.
A back-up method is required during the first week of use
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23. Vaginal Contraceptive Ring
NuvaRing contains both progestin and estrogen and is inserted into the vagina for three weeks.
It is 99.7 percent effective with perfect use.
NuvaRing also exposes the user to a lower dosage of estrogen than the patch and some combination pills, so it may have fewer estrogen-related side effects.
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24. Contraceptive Injections
Depo-Provera is an injectable method of birth control that lasts for 3 months
It takes effect within 24 hours of the first shot and is 99.8 percent effective with perfect use.
Users may experience irregular bleeding or may stop bleeding altogether. It may also take a woman up to one year to return to a pre-use fertility state after the last shot.
Side effects may include weight gain, loss of bone density, dizziness, nervousness, and headache. These may continue for up to 6 months after the last shot.
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25. Contraceptive Implants
Implanon is a single-rod implantable contraceptive that is inserted into the skin on the inner side of a woman's upper underarm.
It releases a low, steady dose of progestin for up to three years, suppressing ovulation during that time.
It is percent effective.
It may cause irregular bleeding patterns, have a higher initial cost, and may not be covered by all health plans.
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26. Intrauterine Contraceptives
An intrauterine device (IUD) is a device, often T-shaped, that is implanted in the uterus to prevent pregnancy.
ParaGard, Mirena, and Skyla (a lower dose and smaller-sized version of Mirena) are the three IUDs currently available in the United States.
ParaGard can be left in place for 10 years; Mirena is effective for five years, and Skyla for three years.
IUDs are 99% effective.
IUDs can be used by breast-feeding women and are very environmentally friendly.
ParaGard must be replaced every 10 years, while Mirena is replaced every 5 years. IUDs can be used by breast-feeding women and are very environmentally friendly.
An IUD can be removed at any time, after which fertility returns to the pre-use state.
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27. See It! Video: New Support for IUDs
Discussion Questions
What are the risks associated with using IUDs?
Do you think the changes in the IUD will have a positive impact on its use?
Analyze the pros and cons of using the IUD in contrast to other forms of birth control. When is the IUD indicated for use? When is it contraindicated for use? What impact do the hormones have on the body?
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28. Emergency Contraception
Emergency contraceptive pills (ECPs) are drugs taken within three days after unprotected intercourse in order to prevent fertilization or implantation.
Plan B One-Step, Take Action, Next Choice One Dose, and My Way, are progestin-only pills taken as soon as possible (but not later than 72 hours or three days) after unprotected intercourse.
Ella, the newest ECP, is only available by prescription.
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29. Behavioral Methods
Withdrawal: A method of contraception that involves withdrawing the penis from the vagina just before ejaculation
Abstinence: Abstinence means deliberately avoiding intercourse.
Outercourse: Oral–genital sex and mutual masturbation are referred to as "outercourse."
Fertility awareness methods:
Cervical mucus method
Body temperature method
Calendar method
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30. The Fertility Cycle
Fertility awareness methods (FAMs) can combine the use of a calendar, the cervical mucus method, and body temperature measurements to identify the fertile period. It is important to remember that most women do not have a consistent 28-day cycle.
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31. Surgical Methods Female sterilization
Tubal ligation is a form of sterilization that involves the cutting and tying off or cauterization of the fallopian tubes.
Hysterectomy is the surgical removal of the fallopian tubes and sometimes also the ovaries and uterus.
Male sterilization
Vasectomy is a form of sterilization that involves the cutting and tying off of both vasa deferentia.
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32. Female Sterilization: Tubal Ligation
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33. Male Sterilization: Vasectomy
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34. Choosing a Contraceptive Method
Consider how comfortable you will be using a particular method.
Consider whether the method will be convenient for you and your partner.
Consider your risk for STIs.
Consider whether you eventually want to have biological children.
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35. Choosing a Contraceptive Method
Consider how an unplanned pregnancy would affect your life.
Consider your religious and moral values.
Consider how much the birth control method will cost.
Consider any health factors that could limit your choice.
Consider any additional benefits you'd like from your contraceptive.
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36. Abortion
Women have abortions for a variety of reasons. The vast majority of abortions occur because of unintended pregnancies.
Abortion is a highly charged and political issue in the United States. Pro-choice individuals feel that it is a woman's right to make decisions about her own body and health. Pro-life individuals, on the other hand, believe that the embryo or fetus is a human being with rights that must be protected.
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37. When Women Have Abortions (in weeks from the last menstrual period)
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38. Methods of Abortion Surgical abortions Suction curettage
Dilation and evacuation (D&E)
Induced abortion
Intact dilation and extraction (D&X)
Medical abortions
Mifepristone
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39. Suction Curettage Abortion
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40. Planning for a Pregnancy and Parenthood
Emotional health
Maternal health
Paternal health
Financial evaluation
Delivery can cost anywhere from $15,000 to $35,000+ in a hospital
Average fulltime daycare in N. Seattle is around 1800 a month. Also consider stroller, crib, clothing, diapers, food, time off from work (maternity and sick leave)
Contingency planning
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41. Preparing for Pregnancy
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42. Pregnancy
Pregnancy is an important event in a woman's life. The actions taken before pregnancy, as well as behaviors engaged in during it, can significantly affect the health of both infant and mother.
Pre-conception health focuses on the conditions and risk factors that could affect a woman if she became pregnant. It also looks at factors that could affect a fetus or infant.
The process of pregnancy begins the moment a sperm fertilizes an ovum in the fallopian tubes.
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43. Fertilization
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44. Changes in a Woman's Body during Pregnancy
This slide covers development from early signs through all three trimesters.
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45. Series of Fetoscopic Photographs Showing Development in the First, Second, and Third Trimesters of Pregnancy (NOTE: these are not the same scale!!!)
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46. Prenatal Care Nutrition and exercise Drugs and alcohol Smoking
Other teratogens
Maternal age
Prenatal testing and screening
Ultrasonography
Chorionic villus sampling
Triple marker screen
Amniocentesis
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48. Childbirth Labor and Delivery
Painkilling drugs given to the mother during labor can cause sluggish responses in the newborn as well as other complications, but it is important to keep a flexible attitude about pain relief because each labor is different.
The Lamaze method is the most popular technique of childbirth preparation in the United States—it focuses on proper breath control during contractions.
A cesarean section (C-section) is a surgical procedure in which the baby is removed through an incision made in the mother's abdomen and through the uterine wall.
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49. The Birth Process
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50. Complications of Pregnancy and Childbirth
Preeclampsia and eclampsia
Miscarriage
Rh factor
Ectopic pregnancy
Stillbirth
AND many others not mentioned in the book
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51. The Postpartum Period
The postpartum period typically lasts for 4 to 6 weeks after delivery. During this period, many women experience fluctuating emotions.
Many new mothers experience what is called the "baby blues," characterized by periods of sadness, anxiety, headache, sleep disturbances, and irritability.
About 1 in 7 mothers experience postpartum depression, which is a syndrome characterized by energy depletion, anxiety, mood swings, and depression. Counseling and sometimes medical therapy are the most common types of treatment.
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52. Breast-Feeding Breast-fed babies:
Have fewer illnesses and a much lower hospitalization rate
Recover more quickly from illness
Are less likely to be obese than babies fed on formulas
Have fewer allergies
Based on a new study, also have a higher IQ in adulthood
Breast-feeding has scientifically proven advantages over bottle-feeding. Breast-fed babies have fewer illnesses and a much lower hospitalization rate because breast milk contains maternal antibodies and immunological cells that stimulate the infant's immune system.
When breast-fed babies do get sick, they recover more quickly. They are also less likely to be obese than babies fed on formulas, and they have fewer allergies. They may even be more intelligent: A new study finds that the longer a baby was breast-fed, the higher its IQ is in adulthood.
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53. Infant Mortality
In the United States, the unexpected death of a child under one year of age for no apparent reason is called sudden infant death syndrome (SIDS).
It is the leading cause of death among children aged one month to one year and is responsible for about 2,500 deaths each year.
A SIDS death is sudden and silent; death occurs quickly, often during sleep, with no signs of suffering.
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54. Infertility
Infertility is the inability to conceive after a year or more of trying.
Ten percent of infertility cases have no known cause.
Causes in women
Endometriosis
Pelvic inflammatory disease (PID)
Causes in men
Low sperm count
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55. Other options for conception
Fertility drugs
Alternative insemination
Assisted reproductive technology
In vitro fertilization
Intracytoplasmic sperm injection
Gamete intrafallopian transfer
Zygote intrafallopian transfer
Nonsurgical embryo transfer
Surrogate motherhood
Adoption
Discuss with your students the cost involved with each method, and note that drug therapy is not guaranteed to bring results.
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56. See It! Video: What are the Reasons for Infertility?
Discussion Questions
What method is used to bypass tubal infertility?
A couple in their 30s is having difficulty conceiving over the course of a year. Describe the steps in the process this couple should take when determining infertility.
When do you recommend a couple consult a fertility specialist if they suspect they are having difficulty conceiving?
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57. Assessing Yourself—A Personal Inventory
Go online to MasteringHealth to take the "Are You Comfortable with Your Contraception?" assessment.
Do you think you now know enough about birth control options to be sure that you can prevent an unplanned pregnancy?
If you are not yet a parent, are you now prepared to consider what parenthood entails before choosing to start a pregnancy?
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