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Chapter Eleven

Chapter Eleven. Contraception and Birth Control. Risk and Responsibility. In the United States, half of all pregnancies are unintended Half of unintended pregnancies occur in couples who do not use contraception Those who discuss preventing pregnancy are most likely to use contraceptives .

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Chapter Eleven

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  1. Chapter Eleven Contraception and Birth Control

  2. Risk and Responsibility • In the United States, half of all pregnancies are unintended • Half of unintended pregnancies occur in couples who do not use contraception • Those who discuss preventing pregnancy are most likely to use contraceptives

  3. Men, Women, and Birth Control: Who Is Responsible? • Women may have a greater interest than male partners in controlling fertility • Traditionally been seen as the woman’s job • Male-controlled methods now account for 35% of reversible contraceptive use

  4. Adolescents and Contraception • Adolescents are less likely than older individuals to use contraction • Condoms are preferred method • Condom use may be stigmatized

  5. Birth Control and Contraception: What’s the Difference? • Birth control: any means of preventing a birth from taking place; includes contraception and abortion • Contraception: birth control that works specifically to prevent conception

  6. Choosing a Method • Best method is the one you will use correctly and consistently • Theoretical effectiveness assumes consistent and correct usage • User effectiveness: Actual statistical effectiveness incorporating those who use method but do not do so consistently and correctly

  7. Sexual Abstinence • Most reliable form of birth control • Involves refraining from sexual activity that could cause pregnancy • Abstinence doesn’t necessarily rule out affection or non-coital sexual activities • Practitioners’ definitions of abstinence vary • From a contraceptive perspective, abstinence from vaginal intercourse is required

  8. Hormonal Methods Oral contraceptives • “the pill”; the most widely used form of reversible contraceptive in the U.S. • Highly effective in preventing pregnancy • Contains progestin and (usually) estrogen • How they work: • Suppress ovulation • Thicken cervical mucous • Thin the lining of the uterus • Slow the rate of ovum transport

  9. Hormonal MethodsOral contraceptives • Effectiveness rates • Suppresses ovulation • Multiple types • Advantages • Disadvantages • Possible problems

  10. Other Hormonal Methods • Injectable contraceptives: Depo - Provera • The Patch: Ortho Evra • Effectiveness rates • Advantages • Disadvantages • The vaginal ring: Nuva Ring

  11. Other Hormonal Methods • The vaginal ring: Nuva Ring • Effectiveness rates • Advantages • Disadvantages • Implants: Jadelle

  12. Barrier Methods of Contraception • Condom • Spermicide: nonoxynol – 9 • Latex vs. polyurethane • Women and condom use • Effectiveness and advantages • Possible problems • The female condom

  13. Barrier Methods of Contraception • Diaphragm and Cervical Cap • Both cover the cervical opening to prevent entry of semen • Both are filled with spermicidal jelly and cream • Different shapes and style of fit • Effectiveness • Advantages • Possible problems

  14. Barrier Methods of Contraception • Contraceptive sponge • The FemCap • Spermicide • Foam • Film • Creams, jellies, and vaginal suppositories

  15. Intrauterine Device (IUD) • Tiny plastic or copper device inserted into uterus • Multiple types currently available • 10-12 years • Not an abortifacient • Projections for increased popularity

  16. Fertility Awareness Based Methods • Calendar (rhythm) method • Basal body temperature (BBT) method • Ovulation method • Symptothermal method

  17. Men: Vasectomy Women: Tubal ligation Laparoscopy Essure Sterilization

  18. Emergency Contraception • Taken within 120 hours of unprotected sex • Plan B • Concentrated doses of progestin and/or estrogen • Stops ovulation, fertilization, and implantation • Will not abort an established pregnancy • Different from “abortion pill” • Copper IUD • Less common method; interferes with implantation

  19. Abortion • Medical definition: expulsion of the conceptus • Can happen naturally (miscarriages) • Can be medically or surgically induced • Abortions are not all the same • Circumstances of pregnancy vary • Differences by stage of pregnancy

  20. Abortion • Under safe, clean, legal conditions abortion is a safe medical procedure • Self-administered or illegal abortions can be very dangerous, sometimes fatal

  21. Methods of Abortion • Medical Abortion • A two-drug regimen (mifepristone with misoprostol) that can terminate early pregnancy. • Most effective up to 49 days after the beginning of the pregnant woman’s last period

  22. Mifepristone/Misoprostol

  23. Methods of Abortion Surgical Abortion • Vacuum Aspiration • Used in first trimester • Dilation and Evacuation (D&E) • Used in second trimester • Only 1.5% of US abortions • Hysterotomy • Used in later stages of pregnancy • Like a cesarean section; extremely rare

  24. Prevalence of Abortion • About half of unintended pregnancies end in abortion • Highest rates: Ages 18-29, unmarried, Black or Hispanic, and/or economically disadvantaged women • Number of abortions decreased between 1994 and 2000 • Emergency contraception accounts for as much as 43% of decrease

  25. Three Factors Leading to Abortion • Failure to practice contraception • Incorrect or inconsistent use of contraception • Failure of contraceptive method • Emotional issues for women • Reevaluation of relationships • Examination of childbearing plans • A search to understand role of sexuality • An attempt to clarify life goals

  26. Women, Men, and Abortion • Emotional issues for men • Experience of guilt and anxiety • Ambivalence about parenthood • Powerlessness • May experience erectile or ejaculatory difficulties • Effect on relationships • Stress, conflict, and guilt sometimes lead to break-up • Clinics now provide counseling for both men and women

  27. The Abortion Debate • Pro-life Argument • Human life begins at fertilization • Same rights in utero as after birth • Abortion is moral equivalent of murder • Pro-choice Argument • Women should be able to choose whether or not they will have children • Abortion should be available as a back-up birth control method • Women will get illegal and unsafe abortions if the procedure is made illegal

  28. The Abortion Debate • Abortion and Religion • The Bible is silent on abortion • Scriptural basis for or against is a matter of interpretation • The debate about when human life begins is theological • American religious organizations take both pro-choice and pro-life stances

  29. The Abortion Debate • Constitutional Issues • U.S. Supreme Court • Roe v. Wade (1973) • Webster v. Reproductive Rights (1989) • Planned Parenthood v. Casey (1992)

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