Why don ’ t teenagers use contraception?

1. Why don’t teenagers use contraception? • Despite education, availability/access, and affordability, why don’t teenagers who are sexually active regularly use contraceptives?

2. Contraceptive Review for Test

3. Contraceptive Review • Product Name • Product Type: Barrier, Hormonal, Surgical, or miscellaneous • Product Effectiveness • Advantages • Disadvantages • Cost

4. Contraceptive Design Project

5. Contraceptive Design Project • Design/create a new contraceptive method • All products must be realistic, cost effective and prevent pregnancy (STIs) • All products should be eco-friendly :-)

6. Contraceptive Design Steps 1. Decide on a new contraceptive method 2. Illustrate your new product – place all notes on the back of your illustration 3. Build the prototype 4. The Sales Pitch - Present your idea/product to the class 5. Class votes on the best product

7. Contraceptive Design Rubric • Critical Thinking 20% • Reality 20% • Model/Prototype 20% • Creativity 10% • Presentation/Sales Pitch 20% • Question & Answer Period 10%

8. Contraceptive Design (Day 2) • Project approval • Completion of illustration and all notes • Prototype development • Presentation style & order

9. What can this couple do? List all possible options. Given the alternatives, what’s your group’s advice?

10. Emergency Contraception & Abortion

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

12. 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)

13. 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

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

15. Contraceptive History History

16. Ancient Birth Control MethodsBeaver-Testicle Tea

17. Dances, Amulets, Rituals & Myths • Squatting or kneeling to provoke sneezing • Jumping backwards seven times • Leather pouch containing a cat’s liver on the left foot • Spitting in a frogs mouth three times • Inserting a finger into the vagina and “swishing it around” after intercourse

18. Dances, Amulets, Rituals & Myths • Soranus - Ancient Greek Doctor of Gynecology • Determined that women were fertile during ovulation and promoted the rhythm method. Unfortunately, he assumed that ovulation occurred during menstruation.

19. Spermicides, IUDs, Pessaries, & Douches • Dried cow, elephant, & crocodile dung mixed with honey • Ground dates, acacia tree bark, & honey blended into a paste • Dried fish or cotton soaked with lemon • Half lemons with the juice squeezed out • Glass or metal diaphragms

20. Spermicides, IUDs, Pessaries, & Douches • IUDs invented by Arabs would placed pebbles in the uteruses of their camels • 1920 – German gynecologist Ernest Grafenberg developed the first IUD for humans, which was made from silkworm gut and coiled wire. • Seaweed, leaves, wooden blocks, and apricot pits were also used to block the cervix • Vinegar injected into the vagina

21. Douche French term for soak or wash Douche Bag Douche Can

22. Coitus Interruptus • “Pull out” or withdrawal method • When a man withdraws his penis from a woman prior to ejaculation • 80% Effective • Couples in monogamous relationships who do not have to worry about STIs or caring for a child.

23. Breastfeeding • Suppresses fertility • Breastfeeding can provide up to 98% effective contraception if three criteria are met: - The mother has not experienced the return of her menstrual periods - The mother is fully or nearly fully breastfeeding - The baby is less than six months old.

24. Alfred Trojan • 1921 – Alfred Trojan, a factory worker in Akron, Ohio, accidentally dunked his erect penis into a vat of vulcanized rubber

25. 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

26. 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”

27. Contraceptive Museum • History of Contraception Museum at Case Western Reserve University in Cleveland • Phone: 216-368-364811000 Euclid Ave.Cleveland, OH 44106-1714

28. 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

29. 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

30. Nonoxynol-9 Information

31. What You Need to Know About Nonoxynol-9 • N-9 is the active ingredient in all of the over-the-counter (OTC) spermicidal products available in the U.S. and has been used for pregnancy prevention since the 1950s. An Advisory Review Panel of the Food and Drug Administration (FDA) has deemed N-9 a safe and effective contraceptive.

32. WHAT IS N-9? • N-9 is the active ingredient in all OTC spermicidal products in the U.S. N-9 is a chemical detergent that damages sperm cell membranes, killing the cells. • N-9 is marketed and sold as a spermicidal contraceptive product in several different formulations, including: • Suppositories - Foam – Film (VCF) - Gel - Cream

33. N-9 • Diaphragms and cervical caps are FDA approved for use in conjunction with spermicidal gels and creams. Also, some condoms include a spermicidal lubricant.

34. N-9 USE RECOMMENDATIONS FROM WHO & CDC • N-9 can be used as a contraceptive, alone or in combination with a cervical barrier method, and among women at low risk of HIV/STI infection (Use the product no more than once daily.) • N-9 should not be used for the purpose of HIV/STI prevention. • N-9 should not be used for contraception by women at high risk of HIV infection.

35. N-9 USE RECOMMENDATIONS FROM WHO & CDC • Condoms with N-9 should not be promoted for disease prevention. (However, it is better to use N-9-lubricated condoms than no condoms at all.) • N-9 should not be used rectally.

36. Contraceptives Methods

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

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

39. 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

40. 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

41. 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

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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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%