1. Copyright © 2011 Pearson Education, Inc. All rights reserved. Chapter 13 Preventing Pregnancy: Contraceptives and Abortion

2. Copyright © 2011 Pearson Education, Inc. All rights reserved. Preventing Pregnancy and Protecting Your Sexual Health Almost half of all pregnancies in the U.S. are unintended. Almost half of all pregnancies in the U.S. are unintended. Approximately one-third occur in women 18-25. Approximately one-third occur in women 18-25. Half of all sexually active people acquire an STI by the age of 25. Half of all sexually active people acquire an STI by the age of 25. Knowledge helps minimize the risks associated with sexual behaviors. Knowledge helps minimize the risks associated with sexual behaviors.

3. Copyright © 2011 Pearson Education, Inc. All rights reserved. Contraceptive Behavior Birth Control Birth Control Any action, method, or practice that controls the number of children born by preventing or reducing the likelihood of conception.Any action, method, or practice that controls the number of children born by preventing or reducing the likelihood of conception. Contraception Contraception Prevents the fertilization of the ovum by sperm.Prevents the fertilization of the ovum by sperm. Contraceptive Behavior Contraceptive Behavior How men and women utilize methods to prevent pregnancy.How men and women utilize methods to prevent pregnancy.

4. Copyright © 2011 Pearson Education, Inc. All rights reserved. College Students and Birth Control

5. Copyright © 2011 Pearson Education, Inc. All rights reserved. Contraceptives: Then and Now Past and present methods work in a number of ways for pregnancy prevention: Past and present methods work in a number of ways for pregnancy prevention: Block the sperm form reaching the egg.Block the sperm form reaching the egg. Kill or damage sperm.Kill or damage sperm. Keep eggs from being released each month.Keep eggs from being released each month. Change the lining of the uterus so the fertilized egg cannot attach to it.Change the lining of the uterus so the fertilized egg cannot attach to it. Thicken the mucus in the cervix so sperm cannot easily pass through it.Thicken the mucus in the cervix so sperm cannot easily pass through it.

6. Copyright © 2011 Pearson Education, Inc. All rights reserved. Contraceptives: Then and Now With the exception of the birth control pill introduced in the 1960s, there are no new contraceptive methods—all of the techniques available today were practiced in ancient times. With the exception of the birth control pill introduced in the 1960s, there are no new contraceptive methods—all of the techniques available today were practiced in ancient times. Ancient Society—Biblical Days Ancient Society—Biblical Days 1350-1200 BCE 1350-1200 BCE Ancient Greeks Ancient Greeks Ancient Barrier Methods Ancient Barrier Methods Abortion: Ancient Times—1800s Abortion: Ancient Times—1800s 1800s 1800s Early 1900s Early 1900s Mid-1900s Mid-1900s Late 1900s/Early 2000s Late 1900s/Early 2000s

7. Copyright © 2011 Pearson Education, Inc. All rights reserved. Barrier Methods: Preventing Sperm from Reaching the Ova These provide a chemical or physical barrier between the sperm and the ovum: These provide a chemical or physical barrier between the sperm and the ovum: CondomsCondoms DiaphragmsDiaphragms Cervical CapCervical Cap SpongeSponge

8. Copyright © 2011 Pearson Education, Inc. All rights reserved. Condoms: “No Glove, No Love” Thin sheath of latex, polyurethane, or animal intestine that is worked over an erect penis or inside the vagina during intercourse. Thin sheath of latex, polyurethane, or animal intestine that is worked over an erect penis or inside the vagina during intercourse. It is used to prevent pregnancy and to protect against STIs. It is used to prevent pregnancy and to protect against STIs. Male rubber condoms were first made in 1850. Male rubber condoms were first made in 1850. Female condoms, made of polyurethane, became available in 1994. Female condoms, made of polyurethane, became available in 1994.

9. Copyright © 2011 Pearson Education, Inc. All rights reserved. Diaphragms Small, latex, dome- shaped cup inserted into the vagina. Small, latex, dome- shaped cup inserted into the vagina. Covers the cervix. Covers the cervix. Use in conjunction with spermicide. Use in conjunction with spermicide. Insert up to 6 hours before; leave in at least 6 hours after. Insert up to 6 hours before; leave in at least 6 hours after. Must be fitted by health care provider. Must be fitted by health care provider.

10. Copyright © 2011 Pearson Education, Inc. All rights reserved. Cervical Cap Small, thin, cup- shaped device made of plastic or latex. Small, thin, cup- shaped device made of plastic or latex. Fits tightly over cervix Fits tightly over cervix Use in conjunction with spermicide. Use in conjunction with spermicide. Offers protection for up to 48 hours. Offers protection for up to 48 hours. FemCap available in U.S. FemCap available in U.S.

11. Copyright © 2011 Pearson Education, Inc. All rights reserved. Sponge The Today sponge is a 2-inch plastic foam disc that contains spermicide. The Today sponge is a 2-inch plastic foam disc that contains spermicide. Moisten with water and insert into vagina to cover cervix. Moisten with water and insert into vagina to cover cervix. Intercourse can take place immediately. Intercourse can take place immediately.

12. Copyright © 2011 Pearson Education, Inc. All rights reserved. Spermicide A chemical contraceptive. A chemical contraceptive. It works by killing sperm or making them inactive. It works by killing sperm or making them inactive. Place directly into the vagina, or on the diaphragm or cap. Place directly into the vagina, or on the diaphragm or cap. Suppositories need time to melt before sex. Suppositories need time to melt before sex.

13. Copyright © 2011 Pearson Education, Inc. All rights reserved. Hormonal Methods: Preventing Ovulation These methods use artificial hormones (estrogen and progesterone) to prevent ovulation: These methods use artificial hormones (estrogen and progesterone) to prevent ovulation: Birth control pillsBirth control pills Skin patchSkin patch Vaginal ringVaginal ring InjectionsInjections implantsimplants

14. Copyright © 2011 Pearson Education, Inc. All rights reserved. Birth Control Pills: “The Pill” Oral contraceptives are used by 30% of women Oral contraceptives are used by 30% of women Widely used by women in their teens and 20sWidely used by women in their teens and 20s Combination pill Combination pill Contains both estrogen and progestinContains both estrogen and progestin Mini-pill Mini-pill Contains progestin-onlyContains progestin-only Continuous-dose pills Continuous-dose pills Breakthrough bleedingBreakthrough bleeding

15. Copyright © 2011 Pearson Education, Inc. All rights reserved. Getting the Facts: Birth Control Pills Do birth control pills affect my sex drive? Do birth control pills affect my sex drive? Yasmin and Yaz Yasmin and Yaz Most pills come in packs of 28. Most pills come in packs of 28. What are the side effects associated with the pill? What are the side effects associated with the pill?

16. Copyright © 2011 Pearson Education, Inc. All rights reserved. Skin Patch A 2-inch adhesive patch that a woman wears on her buttocks, chest, back, arm, or abdomen. A 2-inch adhesive patch that a woman wears on her buttocks, chest, back, arm, or abdomen. Artificial estrogen and progesterone are released. Artificial estrogen and progesterone are released.

17. Copyright © 2011 Pearson Education, Inc. All rights reserved. Vaginal Ring The NuvaRing is a flexible plastic ring that is placed monthly in the upper segment of the vagina. The NuvaRing is a flexible plastic ring that is placed monthly in the upper segment of the vagina. About 2 inches in diameter, the ring continuously releases low doses of estrogen and progestin. About 2 inches in diameter, the ring continuously releases low doses of estrogen and progestin.

18. Copyright © 2011 Pearson Education, Inc. All rights reserved. Implants and Injections Implants Implants Norplant is a single rod, the size of a match stick, that contains progestin.Norplant is a single rod, the size of a match stick, that contains progestin. Implanted under the skin in the upper arm.Implanted under the skin in the upper arm. Effective for 3 years.Effective for 3 years. Injections Injections Depo ProveraDepo Provera Administered every 3 months.Administered every 3 months. The “shot” is injected into the woman’s arm muscle or buttock.The “shot” is injected into the woman’s arm muscle or buttock.

19. Copyright © 2011 Pearson Education, Inc. All rights reserved. Intrauterine Methods: Blocking Sperm and Preventing Implantation Creates Mild Infection in Uterus Creates Mild Infection in Uterus Hormonal IUSHormonal IUS Contains progestin Contains progestin Replace every 5 years. Replace every 5 years. Copper IUDCopper IUD Copper Copper Replace every 10-12 years Replace every 10-12 years

20. Copyright © 2011 Pearson Education, Inc. All rights reserved. The Symptothermal Method: Fertility Awareness Natural Family Planning Natural Family Planning Predicting ovulation and avoiding intercourse during this fertile time.Predicting ovulation and avoiding intercourse during this fertile time. There are three methods:There are three methods: Basal Body Temperature Basal Body Temperature The Calendar Method The Calendar Method Cervical Mucus Method Cervical Mucus Method

21. Copyright © 2011 Pearson Education, Inc. All rights reserved. Basal Body Temperature

22. Copyright © 2011 Pearson Education, Inc. All rights reserved. Withdrawal and Abstinence Withdrawal Withdrawal Coitus interruptus is one of the oldest methods of birth controlCoitus interruptus is one of the oldest methods of birth control Effectiveness depends on man’s ability to withdraw prior to ejaculationEffectiveness depends on man’s ability to withdraw prior to ejaculation Abstinence Abstinence Refraining from sexual intercourse.Refraining from sexual intercourse. 100% effective in preventing pregnancy and STIs100% effective in preventing pregnancy and STIs Outercourse is an alternative.Outercourse is an alternative.

23. Copyright © 2011 Pearson Education, Inc. All rights reserved. Advantages and Disadvantages of Outercourse

24. Copyright © 2011 Pearson Education, Inc. All rights reserved. Permanent Contraceptive Methods: Surgical Sterilization Female Sterilization Female Sterilization Tubal ligationTubal ligation Surgical procedure in which the fallopian tubes are severed; this prevents sperm from meeting egg.Surgical procedure in which the fallopian tubes are severed; this prevents sperm from meeting egg.

25. Copyright © 2011 Pearson Education, Inc. All rights reserved. Permanent Contraceptive Methods: Surgical Sterilization Male Sterilization Male Sterilization VasectomyVasectomy In-office procedure that removes all or part of the vas deferens, the duct which transports sperm from testes to the penis.In-office procedure that removes all or part of the vas deferens, the duct which transports sperm from testes to the penis. Post vasectomy pain syndrome Post vasectomy pain syndrome

26. Copyright © 2011 Pearson Education, Inc. All rights reserved. Emergency Contraception Aka Morning-after pill or Plan B Aka Morning-after pill or Plan B Prevents pregnancy by keeping woman’s ovaries from releasing an egg and also by thickening a woman’s cervical mucus to keep sperm from joining an egg. Prevents pregnancy by keeping woman’s ovaries from releasing an egg and also by thickening a woman’s cervical mucus to keep sperm from joining an egg. Take within 72 hours of unprotected sex. Take within 72 hours of unprotected sex. Available without prescription for those 17 and older. Available without prescription for those 17 and older.

27. Copyright © 2011 Pearson Education, Inc. All rights reserved. Abortion: A Personal Choice Therapeutic Abortion Dates Back to Ancient Times Therapeutic Abortion Dates Back to Ancient Times Historical Timeline of Abortion: Historical Timeline of Abortion: 5 th Century5 th Century 9 th -18 th Century9 th -18 th Century 19 th Century19 th Century 20 th Century20 th Century 21 st Century21 st Century

28. Copyright © 2011 Pearson Education, Inc. All rights reserved. Abortion Trends

29. Copyright © 2011 Pearson Education, Inc. All rights reserved. The Abortion Pill: Medication Abortion Use Within 63 Days of Pregnancy Use Within 63 Days of Pregnancy Three Step Procedure: Three Step Procedure: The abortion pill (Mifepristone, or RU-486)The abortion pill (Mifepristone, or RU-486) This pill blocks progesterone, the lining of the uterus breaks down and pregnancy cannot continue. This pill blocks progesterone, the lining of the uterus breaks down and pregnancy cannot continue. MisoprostolMisoprostol This pill is taken up to 3 days later, causing cramping and bleeding. This pill is taken up to 3 days later, causing cramping and bleeding. Follow-upFollow-up To ensure the abortion was complete. To ensure the abortion was complete.

30. Copyright © 2011 Pearson Education, Inc. All rights reserved. Abortion In-clinic Abortion In-clinic Abortion AspirationAspiration D&CD&C Induction abortionInduction abortion Dilation and ExtractionDilation and Extraction Feelings After an Abortion Feelings After an Abortion Wide range of feelingsWide range of feelings

31. Copyright © 2011 Pearson Education, Inc. All rights reserved. Sexual Life Education Concluding Points Concluding Points