MiMi – Health Project With Immigrants for Immigrants Intercultural Health in Germany

1. MiMi – Health Project WithImmigrantsforImmigrants InterculturalHealth in Germany THEME: Pregnancy & FamilyPlanningSpeaker: Chris EzehBA Mass Communication Founder/CEO & MD EuroAfricaCentral Networkwww.euroafricacentral.com

2. Pregnancy and Family Planning 1. Why Family Planning? 2. Contraceptives 3. Natural Family planning 4. Sterilisation 5. AIDS 6. Other Sexually Transmitted Diseases 7. Pregnancy

3. 1. Why Family Planning? If one does not want to get any (-more) children (at the moment). If one has already but would like to wait to get another one. If one has already children and does not want to get any more. It is important to know which possibilities of family planning are available. • Not every possibility is suitable for every couple • Most contraceptives have to be applied by women

4. 2. Contraceptives 2A) „Pill“ (birth-control pill) • Pills containing hormones which inhibit ovulation and therefore also a pregnancy • Birth control pills have to be prescribed by a doctor:  High security  Easy to use  But has to be taken every day, it is not allowed to forget about it! • Some women’s systems cannot tolerate the pill well

5. 2. Contraceptives 2B) (Hormonal) Loop • Especially suitable for women which are already mothers already • Gynaecologist implants it • It lasts up to three years • Loops with hormones even last up to five years 2C) Diaphragm • Has to be prescribed by a doctor • Is not a safe as birth control pill or loop

6. 2. Contraceptives 2D) Hormonal implants... • are very safe! • are pushed under the upper arm’s skin and secures for up to three years against an unwanted pregnancy • may be removed at any times if one wants to get pregnant

7. 2. Contraceptives Gynaecologist informs about disadvantages and benefits of different contraceptives. In emergencies he might evenprescribe ´the morning-after pill` if a female patient had unsecured intercourse or if any problems with contraceptives took place. That is a contraceptive of a high dosage of hormones accompanied by uncomfortable side effects.

8. 2. Contraceptives 2E) Condomes • So far the only contraceptive for men. Only condoms secure both against unwanted pregnancy and sexually transmittable diseases like AIDS • Available at pharmacies, drugstores, super markets and machines • Better not to get condoms out of machines because often there are stored for quite a long while and therefore possibly insecure • After their expiry date condoms are insecure!!! All in all, condoms are less safe than birth control pills, loop or hormonal implants.

9. 3. Natural Family Planning • One who does not want to take contraceptives may make use of natural ways of family planning • It just works for women which have a regularly cycle and do know their bodies very well • Using a natural way of family planning a woman has to determine time of ovulation and therefore her fertile days on the basis of her morning temperature or structure of her vaginal slime

10. 3. Natural Family Planning Disadvantage: At fertile days, no sexual intercourses are permitted! Further disadvantages: Due to stress, illnesses or irregularities (house moving, travelling) cycles may be delayed. That is way natural family planning cannot ever be as safe as birth control pills or mechanical contraceptives. Family advisory services and gynaecologists inform about natural family planning

11. 4. Sterilisation • If a couple family planning is completed, both man or woman may decide to get sterilised • Spermatic cord or tube are thereby excised

12. 4. Sterilisation Operation: Woman have to be under full anaesthetic and men under local treatment while intervention takes place. Afterwards, the couple may have sexual intercourses as before but cannot conceive children. Sexual feelings are not impaired. Disadvantage: Sterilisation is hard to reverse or even irreversible. That is why this treatment has to be well reconsidered by both partners.

13. 5. AIDS AIDS: Final stage of am infectious disease caused by HIV. It is still incurable and everyone may be infected. The virus destroys one's immune system step by step, so that originally harmless illnesses may end fatal.

14. 5. AIDS 5A) Transmission of HIV • By insecured sexual intercourses • By blood-to-blood contacts (e. g. by sharing medical shots) BUT NOT by social contacts (kissing, hugging) • Transmission caused by anal intercourses is extremely high because HIV transmits over lesions of mucous membranes. • Heterosexual and homosexual sex are dangerous to the same extend. • Infected mothers may transmit HIV to their children by giving birth or breastfeeding.

15. 5. AIDS 5B) How can I protect myself against AIDS? • By using condoms when having sexual contacts with persons whose state of health is not to 100 percent clear. • Untouched women starting a partnership should make sure that their partners (who possibly had some prior sexual experiences) are healthy and if necessary insistence on an AIDS-test. Until that test has proved to be negative, couple should use condoms.

16. 5. AIDS • In permanent relationships, sexual faithfulness is the best guaranty against AIDS • If one partner has sexual contacts besides his permanent partner (e.g. prostitution) there are always condoms to be used • That is the only possible way to make sure that neither oneself not one's partner will be infected

17. 5. AIDS 5C) Why conducting an AIDS-test? • Someone may have a healthy look but nevertheless be HIV-positive • Only someone who let oneself be tested can be sure not to transmit HIV to other persons • If diagnosed of being HIV-positive at an early stage, the disease’s breakout may be delayed for years or even decades

18. 6. Other Sexually Transmitted Diseases Condoms not only protect against AIDS but also against other sexually transmitted diseases. • Examples: gonorrhoea, syphilis, hepatitis B These illnesses do not have to end up fatal but may cause permanent impairment if not treated properly. • Examples: skin rash, infertility, impairment of unborn children

19. Other Sexually Transmitted Diseases • One who fears being infected with a sexually transmitted disease should overcome one’s shame and call the doctor immediately • Also local health authorities offer anonymous tests (in some regions for (partly) free) • All physicians are bound to professional discretion. Nobody but the patient will get to know about one's illness

20. 7. Pregnancy 7A) Pregnant or not? • Women which assume to be pregnant because of missing their period or because of feeling sick or whose breast changed should conduct a pregnancy test as soon as possible. In this way, they are able to care for their unborn´s health most effectively. • At best, conduct a pregnancy test at your gynaecologists practice, which will tell the test's results only to the woman (professional discretion) • Pregnancy tests are also available at pharmacies

21. 7. Pregnancy 7B) Preventive medical checkups and medical care • In Germany, pregnant women have the right to get medical care (by a gynaecologist) and a midwife´s help during pregnancy and childbirth) • All results of preventive medical checkups are enlisted in ´Mutterpass´ (a mother's special passport) • Preventive medical checkups: e.g. ultrasonic testing

22. 7. Pregnancy 7B) Preventive medical checkups and medical care • Always ask your doctor if something seems unclear to you. Also let someone explain all information written down in your `Mutterpass` to you! • All preventive check-ups should be attended because they are important for your and your child´s health. • Costs of preventive medical checkups are fully covered by your health insurance.

23. 7. Pregnancy 7C) Behaviour during pregnancy? • Midwife or gynaecologist inform about development of pregnancy and about suitable behaviour during pregnancy, e.g. nutrition • Pregnant women should not drink any alcoholic drinks and not smoke cigarettes. Consumption of nicotine and alcohol may strongly harm the unborn Risks of alcohol consumption during pregnancy:  Brain damages Speech and visual disorder Cardiac defect  Malformations

24. 7. Pregnancy 7C) Behaviour during pregnancy? (continuation) • Gynaecologist and midwife also inform about pregnancy courses, different ways of giving birth and about where the childbirth may take place (at home or at hospital) • They also provide information about nursing

25. Thank you for your attention!