Contraception

Introduction - CONTRACEPTION  PURPOSE: prevent conception and implantation  Commonly referred to as Birth Control  Some forms may lower the risk of contracting certain STDs

“Safe Sex”  Many teens have heard the term “safe sex”  This is the idea that using a contraceptive will protect one from the unwanted physical consequences of sex  NO CONTRACEPTIVE IS 100% EFFECTIVE IN PREVENTING PREGNANCY OR STDS

Let’s Review…  Women’s Fertility – hormones cause the release of an egg once per menstrual cycle hormones cause the release of an egg once per menstrual cycle Cervical mucus develops at the same time to help sperm motility Cervical mucus develops at the same time to help sperm motility Lining of the uterus (endometrium) develops so the conceived embryo can implant Lining of the uterus (endometrium) develops so the conceived embryo can implant  Men’s Fertility – produce sperm which fertilize the egg

METHODS OF CONTRACEPTION (GENERAL)  Chemical: Suppressing fertility  Barrier: Preventing sperm/egg from reaching each other  Natural Methods: fertility awareness

Chemical: Birth Control Pills  Chemicals introduced into the body on a daily basis for set # of days during menstrual cycle  Works in 3 ways: Represses ovulation Represses ovulation Reduces lining of uterine wall Reduces lining of uterine wall Changes density of cervical mucus making it difficult for sperm to penetrate Changes density of cervical mucus making it difficult for sperm to penetrate

The Pill: Positives  When taken properly, it is 99% effective.  Can help artificially regulate the menstrual cycle.  Can help treat ovarian cysts

The Pill: Negatives   DOESN’T PREVENT STD’s.   Must take at the same time every day   May cost up to $40 per month   Vaginal bleeding   Spotty darkening of skin   High rate of blood clots (can be fatal)   Loss of sex drive   Irritability   Headaches (migraine- like)   Weight gain or loss   High blood pressure   Vaginal infections   Depression   Anemia   Risk of heart attack   Connections to higher risk for cancers

The Pill: Negatives  Women who use a hormonal contraceptive for at least 4 years before their first full term pregnancy have a 52% higher risk of developing breast cancer  Women who use a hormonal contraceptive for more than 5 years are 4 times more likely to develop cervical cancer

Chemical: Spermacides/Foams  Chemicals inserted into the vagina prior to intercourse – Spermicide: kills sperm  POSITIVE When used in combination with other methods, fairly effective. When used in combination with other methods, fairly effective.  NEGATIVE Do not prevent STDs Do not prevent STDs Failure rate of 21% Failure rate of 21% Messy Messy Can burn vagina or penis Can burn vagina or penis Can have an allergic reaction Can have an allergic reaction

Barrier: Male Condom  Placed over the penis immediately before intercourse  Most effective when used in combination with another method

Male Condom  Positive More effective in preventing STDs than pregnancies More effective in preventing STDs than pregnancies Relatively cheap Relatively cheap Few side effects Few side effects  Negatives Can break or leak Can break or leak Does deteriorate over time and pressure Does deteriorate over time and pressure 12% Failure rate especially among teens 12% Failure rate especially among teens Possible allergies Possible allergies

Barrier: Diaphragm  Flat, rubber-like disc  Must be fitted by doctor  Fits over cervix  Must be inserted before intercourse and left in after (at least six hours)  Must be used with Spermacides

Diaphragm Negatives DO NOT PREVENT STDs If woman gains or loses just a few pounds, it won’t fit properly It can be jarred out of position Risk of TSS It may or may not be inserted properly Possibility of allergic reaction or burns Possible urinary tract infections Positives  Effective Rate 82-94%  Can be used multiple times

Preventing Implantation: IUD (Intrauterine Device), Barrier  Usually a small metal or plastic device  Must be inserted by the doctor  Must have already delivered a child  Irritates lining of the uterus  Prevents sperm motility  Some suppress ovulation

IUD Negatives DOES NOT PREVENT STDs Possible pain Possible puncture of the uterus Possible internal bleeding Increased menstrual bleeding Complications of pregnancy and childbirth where IUD has failed Positives  99% Effective  Fairly low inconvenience

Patch/Ortho Evra  Small patch applied to the skin which releases hormones similar to the Pill Suppresses ovulation, changes cervical mucus and lining of the uterus Suppresses ovulation, changes cervical mucus and lining of the uterus  Patch must be changed the same day every week

Patch Negatives Skin irritation or rashes at site of Patch Patch cannot be moved or fall off Irregular bleeding Fluid retention or raised blood pressure Risk of blood clots doubled from other hormonal methods Nausea, Headache, Breast tenderness, Mood changes Menstrual cramps, Abdominal pain Risk of stroke and heart attack Does not protect against STD’s Positives  99% effective when used correctly  Needs to be changed only once a week

Vaginal Ring/Nuva Ring  Small ring inserted into the vagina each month which releases hormones similar to those in the Pill  Suppresses ovulation, changes cervical mucus and lining of the uterus

Vaginal Ring/Nuva Ring Negatives  Can fall out or move  Bleeding between periods  Breast tenderness  Vomiting, Nausea  Vaginal discharge and irritation  Decreased sex drive  Irregular periods after discontinued use  Heart attack, stroke, blood clots  High blood pressure  Liver tumors Positives  99% effective when used correctly  Change once per month

Shot/Depo Provera  Injection of hormones every three months  Similar to the Pill Suppresses ovulation, changes cervical mucus and lining of the uterus Suppresses ovulation, changes cervical mucus and lining of the uterus

Shot/Depo Provera Negatives  irregular or no menstrual periods  weight gain  Headaches  breast tenderness  depression  Loss of bone density (especially in adolescents)  Decrease in fertility  $35-75 per injection plus exam fees Positives  97% Effective  Fairly Convenient

Plan B/Morning-After Pill  Higher dose of the hormones found in other chemical contraceptives  Suppresses ovulation, changes cervical mucus and lining of the uterus  Positives – 80% Effective Convenient  Negatives nausea vomiting abdominal pain fatigue dizziness menstrual changes

Natural Family Planning  A woman checks her body (temperature, cervix, and cervical mucus) to identify fertile time  A couple will abstain during fertile times (5-12 days per cycle) if trying to avoid pregnancy  Method advocated by the Catholic Faith

What’s the Difference? Contraception  Seeks to sterilize fertile intercourse  Take action to remove the fruitful aspect of sex  Actions display an attitude totally opposed to possibility of conception – contraceptive mentality NFP  Seeks to avoid fertile intercourse  Recognizes the fertility involved in sex  Actions show an openness to the possibility of conception  For NFP to be moral, it cannot be used with a contraceptive mentality

NFP Positives  Inexpensive  95-98% effective  Communication and teamwork  Respect  Learn about your bodies  No physical side effects  Self control and sacrifice  1-3% divorce rate! Negatives  Requires abstinence at times  Must use properly

NFP vs. Contraception  History records people using contraception up to 4,000 years ago  Contraception set Christians apart from the Romans, who used contraception

NFP vs. Contraception  Until 1930 ALL Christian denominations agreed contraception was immoral  In the 1930’s the Anglican Church allowed contraception in certain circumstances  Eventually they caved completely and soon all major Protestant denominations followed

NFP vs. Contraception  Washington Post 1931 – contraception “would sound the death knell of marriage as a holy institution by establishing degrading practices”  Ghandi, Elizabeth Cady Stanton, Theodore Roosevelt, Sigmund Freud, Dr. Elizabeth Blackwell…

NFP vs. Contraception  Humane Vitae – encyclical by Pope Paul VI 1968 which condemned contraception  Society predicted there would be fewer divorces, happier marriages, fewer unwed and unwanted pregnancies, less disease, more respect, less abortions

NFP vs. Contraception  About the pill was widely available

Decrease in Unplanned Pregnancy?  % of white children born out of wedlock 6% of white children born out of wedlock 22% of black children born out of wedlock 22% of black children born out of wedlock  % of white children born out of wedlock 68% of black children born out of wedlock Births to unmarried women increased from 11 to 33 percent of all births from 1970 to 1994, then leveled off through 1999.

Increased Marital Happiness?  1960 Divorce rate – 10% Divorce rate – 10%  1980 Divorce rate – 23% Today Today41-50%

Fewer STDs?

Fewer Abortions?  In the year 2000 – 54% of women who had abortions were using contraception  In 11 years, those numbers have not changed  More than half of women getting abortions are using contraception

Fewer Abortions?

The Natural Family Planning Alternative  NFP boasts a 0-3% divorce rate  Respect  Communication  Teamwork  No harmful side effects  Low cost