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Family Planning 101: Key Concepts in Adolescent Health Care

April 2010 Meera Beharry, MD Division of Adolescent Medicine University of Rochester Medical Center ACT for Youth Center of Excellence

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Family Planning 101: Key Concepts in Adolescent Health Care

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  1. April 2010 Meera Beharry, MD Division of Adolescent MedicineUniversity of Rochester Medical Center ACT for Youth Center of Excellence Cornell University Family Life Development CenterCornell University Cooperative Extension of New York CityNew York State Center for School SafetyUniversity of Rochester Medical Center Div. of Adolescent Medicine Family Planning 101: Key Concepts in Adolescent Health Care

  2. Objectives • Define family planning • Describe methods of contraception • Identify resources for adolescents

  3. Family Planning • The use of education and birth control to limit the number of offspring and the population of a country. American Heritage® New Dictionary of Cultural Literacy, 3rdEd, 2005 by Houghton Mifflin Company

  4. Legal Issues • Distributing information and counseling patients about contraception was illegal under federal and state laws. AP Margaret Sanger, 1914

  5. US fertility rates: 1917-1997 and Key Family Planning Events Title X established Birth Control Pills, IUD approved by FDA Timing of ovulation established MMWR, Dec 03, 1999 48(47);1073-1080

  6. Ring Patch Cap Implant Diaphragm Condoms Spermicides Abstinence Pills Injection (“shot”) IUD Myriad of Methods

  7. How do you choose?

  8. Decision 1 Hormonal, Non-hormonal or both?

  9. Condoms Non-Hormonal/Barrier • Condoms

  10. Spermicide Cervical Cap Spermicides Diaphragm Non-Hormonal/Barrier • Condoms • Diaphragm • Cervical Cap

  11. Non-Hormonal/Barrier • Condoms • Diaphragm • Cervical Cap • Copper IUD

  12. Non-Hormonal/Barrier • Condoms • Diaphragm • Cervical Cap • Spermicide • Copper IUD • Abstinence1 • Period abstinence/fertility awareness1 • “Withdrawal”, coitus interruptus 1 Society for Adolescent Med., J Adolesc Health 2006;38:83–87

  13. Hormonal • Pill • Daily • Emergency (not recommended as a regular form of birth control)

  14. Patch Hormonal • Pill • Patch

  15. Hormonal • Pill • Patch • Injection

  16. Hormonal • Pill • Patch • Injection • Ring

  17. IUD Hormonal • Pill • Patch • Injection • Ring • Progesterone IUD

  18. Hormonal • Pill • Patch • Injection • Ring • Progesterone IUD • Implantable device

  19. Advantages/Disadvantages

  20. Advantages No hormones Fewer or no medical contraindications* Can prevent STD Disadvantages Event based use Some need a doctor’s visit Non-Hormonal/Barrier

  21. Advantages Not event dependent Additional health benefits Menstrual symptoms Acne Lower cancer risk Less blood loss Disadvantages Require use as prescribed Some medical contraindications Hormonal

  22. Quick Quiz Does a young woman need to have a pelvic exam before starting birth control?

  23. NO!

  24. Decision 2: if hormonal method Any contraindications?

  25. Blood clotting problems Stroke Very high blood pressure Some cancers Some liver diseases Major surgery with prolonger immobilization Migraine headaches with aura W.H.O. Absolute Contraindications to Estrogen Containing Products http://whqlibdoc.who.int/hq/2008/WHO_RHR_08.19_eng.pdf

  26. Decision 3: if hormonal method, How often do you take it?

  27. How Often Do You Take It?

  28. How Often Do You Take It?

  29. How Often Do You Take It?

  30. How Often Do You Take It?

  31. How Often Do You Take It?

  32. How Often Do You Take It?

  33. Quick Quiz: Match the method

  34. Match the Frequency & the Method

  35. Match the Frequency & the Method

  36. Emergency Contraception

  37. What if…. …the condom broke or slipped off... …you forgot your regular birth control... …you were forced to have sex... Association of Reproductive Health Professionals

  38. Emergency Contraception • What is it? • A method for preventing implantation • A method for preventing fertilization • There are three types available in the U.S.

  39. Association of Reproductive Health Professionals

  40. Emergency Contraception Pills • What they are not: • They are not the “abortion pill” • They are not a form of family planning

  41. Resources • Internet: • http://youngwomenshealth.org/ • www.plannedparenthood.org • http://ec.princeton.edu/ • Current health care provider • www.adolescenthealth.org • Family Planning Benefit Program • www.nyhealth.gov/community/pregnancy/family_planning/program_sites.htm

  42. ACT for Youth Center of Excellence • Was this presentation useful? Please give us your feedback: • http://www.zoomerang.com/Survey/WEB22AEZWMYJH3 • The ACT for Youth Center of Excellence connects positive youth development resources and research to practice in New York State and beyond. The Center provides: • Technical support, training, and evaluation for youth-serving programs funded by the NYS Department of Health. • Youth Development resources: www.actforyouth.net, publications, training and events, and the e-letter ACT for Youth Update. Email act4youth@cornell.edu to subscribe. • A home base for the ACT Youth Network. Visit the network at www.nysyouth.net act4youth@cornell.edu • 607-255-7736•http://www.actforyouth.net

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