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Chapter Six. Contraception and Abortion. Contraception. Contraception procedures are used to decrease chances of fertilization of an ovum Modern contraceptive methods are much more predictable and effective than in past years
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Chapter Six Contraception and Abortion
Contraception • Contraception procedures are used to decrease chances of fertilization of an ovum • Modern contraceptive methods are much more predictable and effective than in past years • Many types of contraceptives play an important role in protecting against sexually transmitted diseases (STDs)
Principles of Contraception • Barrier methods • Block sperm from reaching the ovum • Hormonal methods • Altering body chemistry, preventing ovulation • Natural methods • Based on understanding how sperm and ova function • Surgical methods • Sterilization procedures
Contraceptive Effectiveness vs. User Effectiveness • Contraceptive effectiveness: measure of a contraceptive method’s ability to prevent a pregnancy as directed during intercourse • User Effectiveness: effectiveness of the method in preventing conception when used by the general public • Continuation rate: percentage of people who continue to use a method after a period of time
Emergency Contraception • In 1998, the FDA approved the first combination pill (Preven) • A year later, a progestin pill was developed (Plan B) • ECP’s reduce the risk of pregnancies by delaying or inhibiting ovulation when taken within 120 hours of unprotected intercourse • Effective rates improve when taken earlier vs. later • ECP’s do not induce a medical abortion or affect the developing pre-embryos or embyros Side effects are expected when taking these hormones
Fertility Awareness Methods (FAM) See Table 6-4 for available contraceptive methods
Sterilization • Vasectomy – separation of the vas deferens • Tubal ligation – separation of the fallopian tubes • Hysterectomy – removal of the uterus
Which Contraceptive Methods is Right For You? • Health Risks • Implications of unplanned pregnancy • STD risk • Relationship type Considerations to evaluate when choosing contraception • Affordability • Ease of use • Interference with religious or philosophical expression
What is Abortion? • Expulsion of an embryo or fetus from the uterus before it sufficiently develops • Can also be referred to as those expulsions that are artificially induced by mechanical means or drugs • Miscarriage is generally used as a natural form of expulsion without any causal intervention
Current Legal Status • In 1973, the U.S. Supreme Court made abortion legal in the landmark case, Roe vs. Wade • First Trimester: decision left to pregnant woman and physician • Second Trimester: similar rights but state may dictate regulatory factors • Third Trimester: State regulates and can bar abortions, unless it is to preserve the life of the woman • U.S. Congress has barred the use of federal Medicaid funds to pay for abortions, except in cases of incest, rape, or immediate life-threatening danger
Current Trends • 43% of a decline of abortions was due to the use of emergency contraception • Many states are imposing additional restrictions on abortion i.e. waiting period, counseling, age of consent, and type of procedure • The typical woman having an abortion is: • Age 20 • Has a previous birth history • Has never married • From a lower socio-economic background • Lives in a metropolitan area • Is considered “Christian”
Methods of Abortion • Manual Vacuum Aspiration • MVA is considered a new option not available at all clinics • Cervix is dilated and a plastic tube attached to a syringe is inserted • Gestational sac is removed by suction force
Abortions after the First Trimester • Dilation and Evacuation (D&E) • Method most commonly used after the 12th week of pregnancy • Cervix is opened using dilators and surgical instruments are used to remove the uterine contents, along with an aspirator • Induction of Labor • Prostaglandins are used to induce labor • Delivery of fetus usually occurs in 6-24 hours later • Fewer than 1% use this method
Fever >100 degree F Abdominal pain or swelling, cramping, or backache Prolonged or heavy bleeding Foul-smelling vaginal discharge Vomiting or fainting Abdominal tenderness (to pressure) Delay in resuming menstrual periods (6 weeks or more) Complications of Abortion These are possible physical effects due to an abortion
Psychological After-effects of Abortion • These aftereffects vary with the individual • Many women go through a period of ambivalence • Stronger feelings are felt immediately after the abortion • Support from a partner, friend, and/or family member can be helpful
Chapter Six Contraception and Abortion