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Explore the key methods and legal aspects of contraception versus birth control, failure rates, popular contraceptive options, and global perspectives on reproductive health decisions.
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Chapter 5 Reproductive Health
Birth Control vs. Contraception Birth Control Contraception
Percentage of U.S. Women Ages 15–44 Using Major Contraceptive Methods
Legal Perspectives of Birth Control • Griswold v. Connecticut (1965) • Mandated coverage for contraception for federal employees via an act of Congress (1998) • Private insurance companies: oral contraception coverage
Choosing a Contraceptive Kaiser Family Foundation Study Women found the following “very important”: • Prevents pregnancy (90%) • Protects against STIs (77%) • No health risk (77%) • Is easy to use (51%) • Requires no advance planning (45%)
Failure Rates A failure rate is the chance that the average couple using a given birth control method will become pregnant in a given year. • Failure rates can be either for “perfect use” (ideal conditions) or “actual use” (failure rate in the real world) • Failure rates range from less than 1% to 30%. • Condoms, sponges, and diaphragms have the largest difference between these rates.
Contraceptive Failure • High rates of effectiveness—oral contraceptives, hormone injectables and implants, IUDs, condoms, vaginal hormonal ring, hormone patch, sterilization • Lower rates of effectiveness—diaphragms, cervical caps, sponges, spermicidal agents, fertility awareness methods, rhythm method, withdrawal.
Birth Control Pills • Most commonly used form of contraceptive • 99% effective • Suppresses a woman’s reproductive hormone cycle
Oral Contraceptives Used by 19% of women aged 15–44 years
Fertility Awareness Methods “Free, no equipment necessary, but not reliable” Calendar method • Avoidance of intercourse during fertile time of month by calculating time of ovulation Basal body temperature • Fertility cycle related to changes in basal body temperature Cervical mucus or ovulation method • Fertility cycle related to variations in type of cervical mucus
Hormone Delivery Methods Depo-Provera • Injectable progestins every three to four months Ortho Evra • Patch worn on skin for one-week intervals; fourth week is patch-free NuvaRing • Vaginal ring worn for three weeks and removed during week of menstruation
Barrier Methods Spermicides
Barrier Methods Condoms
Barrier Methods Female condoms Polyurethane sheath lining entire vagina and external genitals
Barrier Methods Diaphragm, cervical cap Dome-shaped latex cup sealing cervix
Barrier Methods Pros: • Condoms offer protection from STIs • Can be used as backup for pill users (or with other methods) • Can be used for the short or long term Cons: • Small risk of bacterial infection or toxic shock syndrome for diaphragm, sponge, and cervical cap • Must be used properly • May have higher long-term costs
Permanent Methods Female sterilization • Tubal ligation = fallopian tubes cut and tied • Laparoscopic sterilization • Minilaparotomy Male sterilization • Vasectomy = vas deferens cut and tied
Other Forms of Contraception Abstinence • No penis-in-vagina intercourse Withdrawal • Coitus interruptus Breastfeeding • Lactational amenorrhea method (LAM) Intrauterine device (IUD) • Small plastic object placed in uterus for 1–10 years
Emergency Contraception • NOT the same as RU-486, otherwise known as “the abortion pill” • Use of high-dose birth control pills taken within 72 hours of unprotected sex • Brands = Ovral, Alesse, Preven • Plan B = progestin-only form of emergency contraception
Handling an Unplanned Pregnancy • Adoption—can be “open” or “closed”; private or public • Abortion
Abortion A controversial issue of debate or a very common medical procedure? …Both, actually
Perspectives on Abortion Why do women choose abortions? • Pregnancy would reduce a woman’s ability to work, finish school, or care for others • Can’t afford a(nother) baby • Relationship issues or not wanting to be a single mother • Completed childbearing • Not ready for a(nother) child • Didn’t want people to know she had gotten pregnant or had sex
Global Perspectives Motherhood continues to be a major risk to life and health in the developing world (most of Asia, Africa and Latin America)
Abortion Procedures Surgical abortion • Vacuum curettage • Dilation and curettage (D&C) • Dilation and evacuation (D&E) Medical abortion (“abortion with pills”) • Mifepristone, misoprostol • Misoprostol alone
Informed Decision Making If you want to prevent pregnancy… • Review your and your partner’s needs • Personal medical history • Review failure rates • Risks and benefits of method • Reevaluate periodically
Discussion • Where can people respectfully agree/disagree about when and how women should be able to end their pregnancies? • How should unsafe abortion be addressed as a public health issue? • What are some ways to promote public health and reduce the number of abortions?