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 Essure9

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)