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Chapter Thirteen: Managing Your Fertility. Birth Control vs. Contraception. Birth control refers to all procedures and methods that can prevent the birth of a child Contraception refers to procedures used to prevent fertilization. Theoretical Effectiveness vs. Use Effectiveness.
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Birth Control vs. Contraception • Birth control refers to all procedures and methods that can prevent the birth of a child • Contraception refers to procedures used to prevent fertilization
Theoretical Effectiveness vs. Use Effectiveness • Theoretical effectiveness:Measure of a contraceptive method’s ability to prevent a pregnancy when the method is used precisely as directed during every act of intercourse • Use effectiveness:Measure of a contraceptive method’s ability to prevent a pregnancy whenused by the general public
Selecting Your Contraceptive Method • Safety • Effectiveness • Reliability • Reversibility Considerations when choosing contraception • Affordability • Ease of use • Interference with sexual expression
Over-the-Counter Contraceptive Methods • Spermicides • Foams • Creams • Jellies • Films • Suppositories • Condoms • Male • Female • Contraceptive sponge
Use of a Male Condom • Keep a supply on hand • Handle condoms with care • Put condom on before genital contact • Lubricate the condom • Take care the condom is not dislodged from penis • Inspect condom for tears before discarding
Diaphragm Lea’s Shield FemCap Intrauterine device (IUD) Oral contraceptives Combined pills Minipills Injectable contraceptive Contraceptive implant Contraceptive ring Contraceptive patch Prescription Contraceptive Methods
Emergency Contraception • Contraceptive measured used to prevent pregnancy within a few days of unprotected intercourse • Hormonal or IUD insertion • “Morning after” pill; not RU-486 (“abortion pill”) • Plan B available behind the pharmacy counter • Those under age 18 must have a prescription • Will not cause abortion or affect established pregnancy
Sterilization • Sterilization = Generally permanent birth control techniques that surgically disrupt the normal passage of ova or sperm • Vasectomy: Removal of a section of the vas deferens • Tubal ligation: Fallopian tubes are cut and the ends tied back
Abortion: Termination of a Pregnancy • First Trimester Procedures • Manual vacuum aspiration • Procedure performed by dilating the cervix and removing uterine contents • Dilation and suction curettage (D&C) • Procedure in which the cervical canal is dilated to allow the uterine wall to be scraped • Medication abortion • RU-486 (mifepristone) blocks the action of progesterone and causes the lining of the uterus to break down
Abortion: Termination of a Pregnancy (cont.) • Second Trimester Procedures • Dilation and Evacuation (D&E) • Performed between 13 and 16 weeks of pregnancy • Cervix is dilated and contents are removed by suction • Partial-Birth Abortion • Federal Ban • Third Trimester Procedures • Hysterotomy • Hysterectomy
Pregnancy Obstacles to Fertilization • Acid level in the vagina • Cervical mucus thickness • Location of cervical entrance for sperm • Location of the correct fallopian tube for sperm • Distance sperm travels • Motility of sperm
Aids to Fertilization • 200-500 million sperm cells are deposited into the vagina during ejaculation • Sperm are deposited near the cervical opening • Male accessory glands help make the semen nonacidic • Uterine contractions aid sperm movement in the proper direction • Sperm cells move fairly quickly • Sperm can live for days • Cervical mucus is thin and watery at the time of ovulation
Signs of Pregnancy (Presumptive) • Missed menstrual period after sexual intercourse the previous month • Morning sickness • Increase in size and tenderness of breasts • Darkening of the areolar tissue around the nipples
Signs of Pregnancy (Probable) • Increased frequency of urination • Increased in the size of the abdomen • Cervix becomes softer by the sixth week • Positive pregnancy test
Signs of Pregnancy (Positive) • Determination of a fetal heart beat • Feeling of the fetus moving (“quickening”) • Observations of the fetus by ultrasound or optical viewers
Rubella/herpes viruses Tobacco smoke Alcohol Certain OTC drugs Radiation Accutane (acne drug) Agents that Can Damage a Fetus
Intrauterine Development • Three trimesters (13 weeks each) • First trimester • Zygote • Blastocyst • Embryo • Fetus (after 8 weeks) • Second trimester: Organs develop, fetal heartbeat and bone structure evident, prominent weight gain in the mother • Third trimester: Fetus increases weight from 2-3 pounds; absorption of major nutrients allowing increased growth and weight
Maintaining a Healthy Pregnancy • Arrange for prenatal care • Consume a well-balanced diet • Take a supplement with folic acid • Exercise according to your physician’s recommendation • Avoid and treat infections • Avoid alcohol, tobacco, and other drugs • Limit your caffeine intake • Stay away from x-rays, hot tubs, saunas, toxic chemicals
Three Stages of Labor • Effacement/dilation of the cervix: • Uterine contractions thin the cervix and enlarge the cervical opening • Cervix opens to 10 cm during this stage • Delivery of the fetus: • Uterine contractions are aided by mother’s voluntary contractions of abdominal muscles • Fetus moves through the birth canal • Delivery of the placenta: • Placenta detaches from uterine wall
Cesarean Deliveries (C-section) • Fetus is removed from the uterus through the abdominal wall • Possibly due to one or more of the following factors: • Fetus is improperly positioned • Mother’s pelvis is too small • Fetus is especially large • Fetus shows signs of distress • Umbilical cord is compressed • Placenta is being delivered before the fetus • Mother’s health is at risk
Causes of Infertility • Low sperm count • Poor sperm motility • Sperm abnormalities • Lack of ovulation • Obstruction of fallopian tubes
Enhancing Fertility • Cold packs on the scrotum (men) • Boxer shorts vs. briefs (men) • Intercourse no more than every 36 hours preceding ovulation • Frequent intercourse tends to lower sperm counts
Treatments for Infertility • Artificial insemination • Surgical procedures • Fertility drugs • Assisted reproductive technology • In vitro fertilization • Gamete intrafallopian transfer • Zygote intrafallopian transfer • Intracytoplasmic sperm injection • Ethical Questions?
Options for Infertile Couples • Surrogate parenting • Adoption • Foster parenting
Cloning Techniques • Procedures involve the following: • Surgical removal of an egg from female donor • Nucleus of the egg is removed • Cell is taken from a cloning subject (male/female) • Through an electrical jolt, the cell is fused with the enucleated egg, creating a clonal zygote • Embryo is implanted in the womb of a surrogate mother • After nine months, a genetically matched reproduction is born
Cloning • Reproductive cloning • Not yet accomplished • Banned in selected countries and states • Therapeutic cloning • Can be used to create stem cells