節育 , 懷孕 , 與產娩 : 掌握你的生育計劃

1. 6 節育, 懷孕, 與產娩:掌握你的生育計劃

2. 生育控制的方法 • 避孕 Contraception • Prevents conception • Perfect failure rate • Typical use failure rate (See Table 6.1) • 障礙法 Barrier methods

3. Table 6.1, part 1

4. Table 6.1, part 2

5. How to Use a Condom Figure 6.1

6. Methods of Fertility Management • Hormonal Methods • Oral contraceptives • Pills • Depo-Provera • Ortho-Evra • Nuva Ring • Lunelle and Norplant (currently off the market)

7. Methods of Fertility Management • Surgical Methods of Sterilization • Female • Tubal ligation • Hysterectomy • Male • Vasectomy

8. Methods of Fertility Management • Other Methods of Contraception • IUDs • Progestasert • ParaGuard • Withdrawal • Emergency contraceptive pills • ECPs • Emergency minipills • Abstinence and “Outercourse”

9. The Fertility Cycle Figure 6.4

10. Fertility Awareness Methods • Cervical Mucus Method • Body Temperature Method • The Calendar Method

11. Contraceptive Research • New Barrier Methods • Lea’s Shield • Vaginal Sponge (Protectaid) • FemCap • Contraceptives for Men • “Male Pill” • Injectable Contraceptive • Synthetic Testosterone

12. Table 6.2

13. Contraceptive Research • Implant Refinements • Population Council – Single Rod Implant Delivery System • Biodegradable Implants

14. Contraceptive Research • Injections and Vaccines For Women • Oral or injectable vaccine • Unisex Contraception • New group of drugs as gonadotropins

15. Abortion History and Methods • Landmark case Roe vs. Wade 1973 • What are the main arguments on both sides of this debate? • Methods of Abortion 1) Vacuum aspiration – 1st trimester 2) Dilation and Evacuation (D&E) – 2nd trimester 3) Dilation and Curettage (D&C) – 2nd trimester

16. Vacuum Aspiration Abortion Figure 6.5

17. Abortion History and Methods • Methods of Abortion (continued) 4) Prostaglandin or induction abortions – 2nd trimester 5) Hysterotomy – removal of the fetus surgically 6) Intact dilation and extraction (D&X) – late term abortion 7) Mifepristone (RU-486) – induces abortion by blocking progesterone used with Misoprostil (a Prostaglandin)

18. Planning a Pregnancy • Emotional Health • Maternal Health • Preconception care • Smoking and drinking • Caffeine • X-rays • Healthy weight

19. Planning a Pregnancy • Paternal Health • Klinefelter’s syndrome • Prader-Willi syndrome • Financial Evaluation • Contingency Planning

20. Pregnancy • Prenatal Care • 30% don’t receive adequate care • Choosing a Practitioner • Ob-Gyn • Family practitioner • Midwife • Alcohol and Drugs • Birth defects • Fetal alcohol syndrome

21. Pregnancy • X-Rays • Nutrition and Exercise • Normal weight gain is 25-35 pounds in a normal weight woman • Obese women can gain less, 15-25 pounds recommended • Underweight women recommended 35-45 pounds

22. Pregnancy • Other Factors • Avoid toxic chemicals • Avoid pesticides • Toxoplasmosis – cat feces, raw meat, can have harmful organisms

23. A Woman’s Reproductive Years • Facts • Woman menstruate for about 40 years • After 35, birth defects do rise • Down syndrome is NOT markedly increased with age, 80% are born to moms under 35 • Pregnancy Test and Process • Pregnancy tests measure human chorionic gonadotropin (HCG) • Fertilization

24. Fertilization Figure 6.6

25. A Woman’s Reproductive Years • Pregnancy Testing • HCG (Human Chorionic Gonadotropin found in urine and blood) • Early Signs of Pregnancy • Breast tenderness • Emotional upset • Nausea • Sleeplessness • Vomiting

26. A Woman’s Reproductive Years • First Trimester • Embryo • Fetus – start of third month • Second Trimester • Placenta well established • Notice changes in mother

27. A Woman’s Reproductive Years • Third Trimester • 6-9th month • Greatest growth • 85% of calcium and iron to fetus • Pregnancy is 40 weeks gestation total • Fourth Trimester • Postpartum period – 6 weeks after the birth occurs

28. Amniocentesis Figure 6.7

29. A Woman’s Reproductive Years • Prenatal Testing and Screening • Amniocentesis – draws fluid from amniotic sac • Ultrasound or sonography – uses high-frequency sound waves • Fetoscopy – small incision and optical viewer • Chorionic villus sampling – remove tissue from around fetal attachment to the mother

30. The Birthing Process Figure 6.8, part 1

31. The Birthing Process Figure 6.8, part 2

32. A Woman’s Reproductive Years • Childbirth • Choose a place – home or hospital • The birth process • Episiotomy • A slight incision in perineum • Some use pain-killers

33. A Woman’s Reproductive Years • Perineum • Area between vulva and anus for incision if needed • Afterbirth • Placenta delivery during last stage of birth

34. A Woman’s Reproductive Years • Managing Labor: Nonmedical Approaches • Birth Alternatives • Lamaze • Harris method • Childbirth without fear • Leboyer method • Bradley method • Water birth

35. A Woman’s Reproductive Years • Breast-Feeding and Postpartum Period • Colostrum • Precedes milk • Thick yellow substance • Contains vital antibodies • Breast milk provides perfect nutrition • Postpartum Depression

36. A Woman’s Reproductive Years • Complications • Cesarean Section • 26.1% in 2002 • CDC hoped to reduce to 15% by 2000 but did not meet goal

37. A Woman’s Reproductive Years • Complications (continued) • Miscarriage • 10% of pregnancy • Failure of egg to divide correctly • Ectopic pregnancy • Genetic abnormalities • Maternal illness • Maternal hormonal imbalance

38. A Woman’s Reproductive Years • Complications (continued) • Stillbirth • Sudden Infant Death Syndrome (SIDS)

39. Infertility • Facts • Men and women affected equally • One in 6 people are infertile • Causes in Women • Endometriosis • Pelvic inflammatory disease (PID) • Causes in Men • Low sperm count • Mumps virus • Varicose veins above testes

40. Infertility • Treatment • 90% treatable • 30-70% success • Expensive and time consuming • Fertility drugs and side effects • Alternative insemination • In vitro fertilization • Gamete intrafallopian transfer (GIFT)

41. Infertility • Treatment (continued) • Intracytoplasmic sperm injection (ICSI) • Embryo transfer (surgical and non-surgical types) • Embryo freezing • Embryo adoption

42. Infertility • Options Beyond Treatment • Surrogate motherhood • Adoption • What are some important considerations with surrogate mothers? • Which of these alternatives seem best to you and why?