Contraception & Family Planning

1. Contraception & Family Planning

3. Contraception Three general strategies: Prevent ovulation Prevent fertilization Keep sperm & ovum away from each other Prevent implantation 22 April 2010 Contraception.ppt 3

4. Prevent Ovulation “The Pill” Synthetic hormones mimic effect of progesterone. Inhibits FSH & LH, and their effects on follicle development Hormonal Implants Norplant Hormonal Injections Depo-provera Vaginal Implant NuvaRing 22 April 2010 Contraception.ppt 4

5. Birth Control Pills • 99.5% effective • Lighter, predictable periods • Milder cramps • Protects against uterine, ovarian cancer • Protects against benign breast disease • Low risk of side-effects • Must take a pill each day

6. Hormonal Injections - Depo-provera • 99% effective • Lasts 3 months • IM injection • Amenorrhea, spotting • Weight gain • Ovulation returns in 4.5 months • Average 10 months to conception

8. Prevent Fertilization Celibacy (Is this contraception, or non-participation?) Condom Male and Female Spermicide Foam, cream, gel Film Diaphragm Cervical Cap • Sterilization • Vasectomy • Tubal ligation • Rhythm • Withdrawal 8

9. Condom • 98% effective • Protects against some STDs

10. Female Condom • 95% effective • Protects against some STDs • Noisy • Use extra lubrication

11. Foam • 80-85% effective • Works immediately • Effective for an hour • Over the counter • No douching for 6 hours after intercourse • 20% have burning (reaction)

12. Film • 80-85% effective • Works 10 min after insertion • Effective for an hour • Over the counter • No douching for 6 hours after intercourse • 20% have burning (reaction)

13. Diaphragm • 95% effective • Requires fitting, manual dexterity • Leave in place 6 hours after intercourse • Use with contraceptive jelly/cream

14. Cervical Cap • Small latex thimble • Must remain in place for 8 hours • Increased risk of infection

15. Tubal Ligation & Vasectomy • Surgical sterilization • Permanent, irreversible • >99% effective • Male • Minor outpatient surgery • Female • Major surgery

16. Prevent fertilization Rhythm – Natural Family Planning Avoid intercourse during woman’s likely fertile period ~ 1 week before ovulation to ~ 4 days after ovulation 22 April 2010 Contraception.ppt 16

17. Rhythm – Natural Family Planning • Avoid unprotected intercourse day #9-19 • 70-80% effective • Assumes ovulation about day #14

18. Withdrawal • 80-90% effective • Always available • Requires motivation, sense of timing • Some sperm present in pre-ejaculatory fluid

19. Prevent implantation Intrauterine Device (IUD) “Morning-after pill” High dose progestins Immunize woman against embryo 22 April 2010 Contraception.ppt 19

20. IUD • 98-99% effective • Lasts 10 years • Heavier, crampier periods • Risk of infection/PID • Risk of ectopic pregnancy • Good candidate: • multiparous • monogamous

22. Effectiveness Rates

24. Finish these Sentences… • I hope my children will wait to be married until…… • I hope my children wait to have sex until…. • I hope my children will wait to have children of their own until….