Transcript Chapter 5 Reproductive Health Birth Control vs. Contraception Percentage of U.S.

Chapter 5
Reproductive Health
Birth Control vs. Contraception
Percentage of U.S. Women Ages 15–44
Using Major Contraceptive Methods
Legal Perspectives of Birth Control
• Griswold v. Connecticut (1965)
• Mandated coverage for contraception for federal
employees via an act of Congress (1998)
• Private insurance companies: oral contraception
coverage
Race and Religion Also Influence
Contraception Use
Choosing a Contraceptive
Kaiser Family Foundation Study
Women found the following “very important”:
• Prevents pregnancy (90%)
• Protects against STIs (77%)
• No health risk (77%)
• Is easy to use (51%)
• Requires no advance planning (45%)
Failure Rates
A failure rate is the chance that the average couple using
a given birth control method will become pregnant in a
given year.
• Failure rates can be either for “perfect use” (ideal
conditions) or “actual use” (failure rate in the real
world)
• Failure rates range from less than 1% to 30%.
• Condoms, sponges, and diaphragms have the
largest difference between these rates.
Contraceptive Failure
• High rates of effectiveness—oral contraceptives,
hormone injectables and implants, IUDs,
condoms, vaginal hormonal ring, hormone patch,
sterilization
• Lower rates of effectiveness—diaphragms,
cervical caps, sponges, spermicidal agents,
fertility awareness methods, rhythm method,
withdrawal.
Birth Control Pills
• Most commonly used
form of contraceptive
• 99% effective
• Suppresses a
woman’s reproductive
hormone cycle
Oral Contraceptives
Used by 19% of women aged 15–44 years
Pros
 Lighter and less painful
periods
 Lower PMS symptoms
 Improved skin
 Protect against breast,
ovarian, and endometrial
cancers and PID
 Increased bone density
with long-term use
Cons
 Mood changes
 Spotting
 Weight changes
 Drug interactions
 Decreased libido
 Headaches
 Fluid retention
 Health risks for some
women
Fertility Awareness Methods
“Free, no equipment necessary, but not reliable”
Calendar method
• Avoidance of intercourse during fertile time of month
by calculating time of ovulation
Basal body temperature
• Fertility cycle related to changes in basal body
temperature
Cervical mucus or ovulation method
• Fertility cycle related to variations in type of cervical
mucus
Pros vs. Cons of Fertility
Awareness Methods
Pros
 No side effects
 Used by anyone
 Cost-effective
Cons
 Limited effectiveness
 Need to abstain from
sexual intercourse
certain days/month
 No protection from
STIs
Hormone Delivery Methods
Depo-Provera
• Injectable progestins every three to four months
Ortho Evra
• Patch worn on skin for one-week intervals; fourth
week is patch-free
NuvaRing
• Vaginal ring worn for three weeks and removed
during week of menstruation
Barrier Methods
Spermicides
Barrier Methods
Condoms
Barrier Methods
Female condoms
Polyurethane sheath lining entire vagina and external
genitals
Barrier Methods
Diaphragm, cervical cap
Dome-shaped latex cup sealing cervix
Pros:
Barrier Methods
• Condoms offer protection from STIs
• Can be used as backup for pill users (or with other
methods)
• Can be used for the short or long term
Cons:
• Small risk of bacterial infection or toxic shock
syndrome for diaphragm, sponge, and cervical cap
• Must be used properly
• May have higher long-term costs
Permanent Methods
Female sterilization
• Tubal ligation = fallopian tubes cut and tied
–Laparoscopic sterilization
–Minilaparotomy
Male sterilization
• Vasectomy = vas deferens cut and tied
Other Forms of Contraception
Abstinence
• No penis-in-vagina intercourse
Withdrawal
• Coitus interruptus
Breastfeeding
• Lactational amenorrhea method (LAM)
Intrauterine device (IUD)
• Small plastic object placed in uterus for 1–10
years
Emergency Contraception
• NOT the same as RU-486, otherwise known as
“the abortion pill”
• Use of high-dose birth control pills taken within
72 hours of unprotected sex
• Brands = Ovral, Alesse, Preven
• Plan B = progestin-only form of emergency
contraception
Handling an Unplanned Pregnancy
• Adoption—can be “open” or “closed”;
private or public
• Abortion
Abortion
A controversial issue of debate or a very common
medical procedure?
…Both, actually
Perspectives on Abortion
Why do women choose abortions?
• Pregnancy would reduce a woman’s ability to
work, finish school, or care for others
• Can’t afford a(nother) baby
• Relationship issues or not wanting to be a single
mother
• Completed childbearing
• Not ready for a(nother) child
• Didn’t want people to know she had gotten
pregnant or had sex
Global Perspectives
Motherhood continues to be a major risk to life and
health in the developing world (most of Asia, Africa
and Latin America)
Abortion Procedures
Surgical abortion
• Vacuum curettage
• Dilation and curettage (D&C)
• Dilation and evacuation (D&E)
Medical abortion (“abortion with pills”)
• Mifepristone, misoprostol
• Misoprostol alone
Informed Decision Making
If you want to prevent pregnancy…
• Review your and your partner’s needs
• Personal medical history
• Review failure rates
• Risks and benefits of method
• Reevaluate periodically
Discussion
• Where can people respectfully agree/disagree
about when and how women should be able to
end their pregnancies?
• How should unsafe abortion be addressed as a
public health issue?
• What are some ways to promote public health
and reduce the number of abortions?