Emergency Contraception

1. Emergency Contraception • Morning After Pills • Preven ($60.00) • Plan B (Sliding Scale Costs)

2. Plan B • 1-888-not-2-late or 1-800-230-plan • Progestin pill only • Cost- unknown, price differs • Lowers risk of pregnancy by 75%

3. Preven • 1-888-PREVEN2 or www.PREVEN.com • 90%-99% effective • Estrogen and Progestin pills • Pills can be taken up to 72 hours after intercourse • Must remember to take daily • Some side effects (ex. nausea, gain weight) • Only works if implantation hasn’t taken place • 2nd pill must be taken 12 hours after the first pill • Cost $60.00 • Reversible • Continuous protection against pregnancy

4. Medical Abortion • RU-486 • Mifepristone (1st pill) • Inhibits progesterone • 3 Days later • Misoprostol (2nd by mouth or vaginal suppository) • Promotes uterine contractions * May be used up to seven weeks after implantation (95% effective)

5. Surgical Abortions • Early Vacuum Aspirations /Suction (D&C) • 90% of all abortions • Performed 4-6 weeks • Dilation & Evacuation • 7% of all abortions • Performed 12-20 weeks • Insertion of a medical drug, which dilates the cervix

6. Surgical Abortion • Induction Method • Major Procedure • Insertion of a saline solution, which starts contractions • 1% of all abortions • Medical Extraction • Rare procedure

7. Evolution of the Condom • Latin word "condus" which means "vessel” • Oiled silk paper, linen sheaths, sheep intestine, snake skin leather, or very thin hollow horn

8. Condoms Today • Condoms can be found in a variety of shapes, sizes, colors, flavors and textures. Many condoms also contain lubricants, spermacides and a reservoir tip. • Condoms that play music when they break • “Dixie,” “The Anniversary Waltz,” “Happy Birthday to You,” & the “1812 Overture”

9. Male Condom • Made of latex or polyurethane • Single use barrier method that blocks sperm from entering the female • Approximately 86%-97% effective • Some protection against STIs • Over the counter • Inexpensive • May leak, break, or interfere with spontaneity

10. Female condom • Rubber sheath with a flexible ring that is inserted in to the female • Single use barrier method that blocks sperm from entering the female • 79%-95% effective • Some protection against STIs • Over the counter • May leak, break, or interfere with spontaneity • More difficult to use

11. Spermicide • A foam, cream, jelly, film, suppository or a tablet that contains Nonoxynol-9 • 20-50 out of 100 pregnancies • No protection against STDs

12. Contraceptive foam, film, suppositories • Available over the counter • Must be inserted close to time of intercourse • Limited STD protection • 74%-94% effective

13. IUD (Intrauterine device) • A T-shaped device inserted into the uterus by a doctor • Can last from 1 to 10 years • About 2 in 100 pregnancies a year • Pregnancies usually end up in fallopian tubes

14. Diaphragm • Dome-shaped rubber disk that covers the cervix so sperm cant reach the uterus • Best if used with a spermicide • 80%-94% effective • Inserted before intercourse, left in for at least 6 hours • Can be used multiple times • Uncomfortable to use • Has to be fitted • Limited protection against STDs

15. Cervical Cap • Soft rubber cup with a round rim which fits around the cervix • 80%-94% effective • Hard to insert • Can remain in place for up to 48 hours without being removed

16. Combination Pill • Effectiveness • Adult Users 99.7% • Actual effectiveness: 92 % • Forget a pill or two • Not following directions • Certain antibiotics • Vomiting or diarrhea

17. Combination Pill • Benefits – regular cycle every 28 days, reduces cramps and flow, reduces risks of uterine and ovarian cancer and other diseases • Side Effects – nausea, headaches, weight gain, fluid retention, bleeding between periods, depression, mood changes, changes in vision, dizziness, yeast infections, and smokers increase chances of stroke and heart attack • Who should not use it – heavy smokers, suffer from severe depression, get migraines, have had blood clots, CVS, cancer or blood diseases • Cost - $10 to $35 a month

18. ABSTINENCE • 100% EFFECTIVE • ADVANTAGES • No medical or hormonal side effects • Easy to use • Prevents sexually transmitted infections • 100%FREE • POSSIBLE DISADVANTAGES • many people find it difficult to abstain from sex • many people fail to use protection when abstinence ends • A commitment required by both people • Peer pressure

19. Extended Cycle Pill • Prevents ovulation, changes lining, difficult for fertilized ovum to implant, thickens the cervical mucous • Only four period per year • 99% effective • Advantage for women who suffer from severe cramping or PMS • Side Effects – irregular bleeding, fluid retention (hands and feet), raise blood pressure, nausea, vomiting, headache, vision, appetite, depression infections and allergic reactions • Who should not use it – smokers, CVS, cancer • Cost - $100 to $120 for three months

20. Facts To Know • Other Benefits from correct use: benefits from the birth control method that are in addition to its use to prevent pregnancy • Side Effects: unwanted changes, including health risks, that might occur when the birth control method is used • Who should not use: a list of cautions that identify users who should not use the birth control method because it might cause health risks or might be inappropriate • Cost: an estimate of how much money the birth control method will cost

21. Facts to Know About Birth Control Methods • How it works: the way the birth control methods works to prevent pregnancy • Instructions for correct use: directions for using the birth control method the right way • Effectiveness: • Theoretical Effectiveness: % that tells how well birth control works if adult users use it the correct way every time and have no preexisting conditions that reduce how well it works • Actual user Effectiveness: % that tells how well birth control works if adult users do not use it in the correct way and have no conditions that reduce how well it works

22. Kinds of Birth Control methods • Abstinence from Sex • Oral Contraceptives - Combination Pill, Progestin Only Pill, Extended-Cycle Pill • Vaginal Ring • Injectable Contraceptives – injectable Progestin • Skin Patch • Barrier Methods – Spermicides, Diaphragm, Cervical cap, Male and Female Condom • Fertility Awareness Methods – basal Body Temperature Method, The Calendar Method, The Mucous Method • Sterilization – Tubal Ligation (Female), Vasectomy (Male) • Unreliable Methods – The Douche and Withdrawal

23. Norplant (Implant) • 6 matchstick sized rubber rods implanted under skin of the upper arm • Steadily releases a contraceptive steroid levonorgestrel • Very effective. About 1 in 100 pregnancies • Lasts for 5 years until person needs to replace them • Reversible • Very expensive • No STD protection

24. Depo-Provera (injection) • Injectable progestin that prevents ovulation • Prevents sperm from reaching egg and keeps egg from implanting in the uterus • Less than 1 out of 100 pregnancies • 1 injection every 3 months • Not safe against STDs • Fertility may take a few months to get back to normal

25. Lunelle (injection) • Injectable form of Progestin and Estrogen • Less than 1 out of 100 pregnancies • Could change menstrual cycle, cause to gain weight • Given 1 time a month • Prescription given from doctor • No STD protection

26. WITHDRAWAL • Effectiveness varies: Increases if male doesn’t predict when to pull out • pregnancy is possible if sperm are spilled on the vagina • not effective against sexually transmitted infections — use latex or female condoms to reduce the risk

27. WITHDRAWAL • ADVANTAGES • can be used when no other method is available • POSSIBLE DISADVANTAGES • requires great self-control, experience, and trust • not for men who ejaculate prematurely • not for men who don’t know when to pull out • not recommended for teens

28. Fertility Awareness Methods • Nothing to purchase • Permitted by some religious groups that don’t allow other methods • Requires commitment to other person • No intercourse during menstrual cycle • 80%-99% effective if done correctly

29. No MethodNo Protection • Only 15% effective • Free • No protection against pregnancy • No protection against STDs

30. STERILIZATION • ADVANTAGES • permanent protection against pregnancy • no lasting side effects • no effect on sexual pleasure • protects women whose health would be seriously threatened by pregnancy • POSSIBLE DISADVANTAGES • risks of minor surgery if incision is made • some people later regret not being able to have children • not usually reversible if you change your mind • rarely, tubes reopen, allowing pregnancy to occur

31. STERILIZATION • Tubal sterilization — intended to permanently block woman's tubes where sperm join egg • Vasectomy — intended to permanently block man's tubes that carry sperm • 99.5-99.9% EFFECTIVENot effective against sexually transmitted infections — use latex or female condoms to reduce the risk.

32. STERILIZATION • Tubal sterilization • bruising if incision is made • very rare injury to blood vessels or bowel • pregnancies that rarely occur are more likely to be ectopic (in a fallopian tube) • Vasectomy • infection or blood clot in or near the testicles • temporary bruises, swelling, or tenderness of the scrotum • sperm leakage may form temporary small lumps near testicles

33. STERILIZATION • COST$2,000-$6,000/ tubal sterilization240-$520/ vasectomy(Vasectomy costs less because it is a simpler procedure that can be done in the clinician’s office.)

34. Skin Patch • Hormones are released to prevent ovulation from occurring, mucus thickens, ovulation returns three months after the patch is last used • Effectiveness – 99% in women who weigh 198 pounds or less • Other benefits – menstrual cycle regular, shorter and lighter flow • Side effects – bleeding between periods, nausea, headaches, weight gain or loss, mood changes • Who should not use them – Same as others, include history of blood clots • Cost - $30-$35 a months

35. Ortho Evra (patch) • Patch worn on the lower abdomen or on the upper body • Releases progestin and estrogen into the bloodstream • Less effective for women weighing more than 198 pounds • New patch applied once a week for 3 weeks, 4th week no patch is worn so female can have her menstrual period

36. Vaginal Ring • Small, flexible, plastic ring that is about 2 inches wide • Placed in the vagina each month and releases hormones similar to those in birth control pills • Prevents ovulation, removed after three weeks, after having a menstrual period insert a new one • Effectiveness – 98-99% • Benefits – regular menstrual period, shorter and lighter flow • Side effects – bleeding between period, nausea, headaches, weight gain or loss, mood changes

37. Vaginal Ring • Who should not use it • Smokers, High Blood Pressure, CVD, liver disease, cancer • Cost - $30-35 a month

38. Nuva Ring • It is a small, flexible ring that is inserted into the vagina once a month • It is left in place for three weeks and taken out for the remaining week • The Ring releases synthetic estrogen and progestin to protect against pregnancy for one month. • Two woman out of every 100 who use the ring become pregnant

39. Cost of the Nuva Ring • The cost of the first visit and/or examination, if needed, ranges from about $35-$125 • At some family planning clinics, the cost may depend on your income. • The Ring costs between $30 and $35 a month. • The cost is usually lower at a clinic and is covered by Medicaid.

40. OUTERCOURSE • NEARLY 100% EFFECTIVE • pregnancy is possible if sperm are spilled on the vagina • reduces the risk of many sexually transmitted infections — unless body fluids are exchanged through unprotected oral or anal intercourse. • Latex or female condoms can reduce risk of infection.

41. Outercourse • ADVANTAGES • no medical or hormonal side effects • may prolong sex play and enhance orgasm • can be used when no other methods are available

42. Outercourse • POSSIBLE DISADVANTAGES • many people find it difficult to abstain from vaginal intercourse • many people fail to use protection from pregnancy or infections if intercourse takes place