Birth control

Birth Control Social Networking Website

OBJECTIVES
Describe the fundamentals of reproduction.
Describe and identify contraceptive choices at different stages of life.
Identify common myths about family planning.
Explain the impact of child spacing on maternal and infant health.

Each month during ovulation an egg is released and moves into one of the fallopian tubes. If a woman has unprotected sex around this time, and egg may meet a sperm in the fallopian tube, and the two may join. This is called fertilization. The fertilized egg then moves through the fallopian tube into the uterus.

Reproduction Health in the United States
Highly effective contraceptive methods have been around for several decades
Half of all the pregnancies in the U.S. are unintended. The majority of them can be attributed to using of less effective methods coupled with inconsistent and incorrect use; gaps in contraceptive use
At least one in two women will experience an unintended pregnancy, one in three will have an abortion by age 45

Choosing a Birth Control Method
Women of any age or stage of life may use any of the contraceptive methods, which are currently available
Contraceptive counseling is patient-centered. Women should be presented and have access to the broadest number of contraceptive options so they can select the one best suited for their lifestyles and reproductive plans
It is imperative that providers understand and are able to present women with all available options

Current Contraceptive Options Most Effective Very Effective Moderately Effective Effective Prevents pregnancy > 99% of the time Prevents pregnancy 91-99% of the time Prevents pregnancy 81-90% of the time Prevents pregnancy up to 80% of the time Copper T IUD Hormonal IUD Implant Sterilization Pills Injectable Patch Ring Condom Diaphragm Sponge Fertility Awareness Cervical Cap Spermicide

Most Effective Options
Copper T IUD
Brand name: Paragard
Approved for up to 10 years of use
Can be used for emergency contraception
Common side effects: heavy periods, menstrual cramps
Candidates are those who:
Want long-acting, reversible method
Want to avoid hormones

Hormonal IUD / Levonorgestrel-releasing
Brand name: Mirena
Common side effects: irregular spotting at first, then can expect lighter periods
Have menstrual symptoms (heavy periods, menstrual cramps) that may disappear with this method
Cannot use estrogen

Myths about IUDs Myth Fact IUDs cause infection Incidence of pelvic infection is not increased while using IUDs. Preexisting STD at time of infection, not IDU, increase risk of pelvic infection IUDs can only be used by women who have been pregnant before IUD is safe and effective also in women who have never been pregnant, even adolescents IUDs cause abortions IUDs work by preventing sperm from reaching the egg IUDs cause ectopic pregnancies IUDs do not increase the risk of ectopic pregnancies. They decrease risk of both ectopic and intrauterine pregnancies IUDs cause infertility IUD is not related to infertility. Women can become pregnant quickly after removal of the IDU

Contraceptive Implant
Brand name: Implanon
Contains etonorgestrel
Common side effects: unpredictable, irregular spotting
Have menstrual symptoms (heavy periods, menstrual cramps) that may disappear with this method
Cannot use estrogen

Oral contraceptive pills
“ Combination pills” estrogen and progestin
Common side effects: nausea, dizziness, headache that go away after few months
Want use a daily method consistently
Have menstrual symptoms (heavy period, menstrual cramping)
“ Mini-pills” progestin-only
Common side effects: irregular spotting
Want use a daily method consistently
Cannot use estrogen
Want rapidly reversible method
Very Effective Options

Myths about the Combination Pills Myth Fact Taking the pill is risky The pill may be risky for some women although for majority of women the benefits outweigh the risk Taking the pill cause weight gain As many women lose weight as gain weight while taking the pill Taking a break from the pill now and then is a good idea There is no healthy benefits to taking a break from the pill. Taking a break may increase a woman’s chances of an unwanted pregnancy The pill cause cancer Most studies show the pill does not increase risk of cervical or breast cancer and it decrease the risk of endometrial (uterine) and ovarian cancer It is difficult for women to become pregnant after stopping taking the pill The pill is out of a woman’s system and she is able to get pregnant within 24 hours of when she stops taking pills.

Contraceptive Patch
Brand name: Ortho-Evra patch
Contains estrogen and progestin
Worn on skin and changed weekly
Ok to shower, swim, exercise with patch
Side effects: nausea, dizziness, headache that go away after few months
Want use an easy non-daily method
May want to regulate period

Vaginal Ring
Brand name: NuvaRing
Flexible, unfitted ring placed in vagina for 3 weeks
Contains estrogen and progestin
Want convenience of 3 weeks regimen
May want to regulate period

Contraceptive Shot
Brand name: Depo-Provera
Intramuscular or subcutaneous injection every 3 months
Common side effects: irregular spotting, stop having periods, weight gain
Want non-daily method
Cannot use estrogen
Do not want to conceive immediately after discontinuing use

Other methods…
Very effective permanent method:
Male and female sterilization
Less effective methods:
Barrier / Coitus Dependent
Male and female condoms can be combined with more effective methods for STI prophylaxis
Cervical cap, diaphragm, sponge, spermicides, coitus interrupts (withdrawal), natural family planning
Abstinence is 100% effective in theory, but the risk of failure is very high
Lactation Amenorrhea
Very effective if breastfeeding on demand

Emergency Contraception (EC)
Prevents pregnancy after having sex
Does not cause an abortion
Nor the same at RU-486/mifepristone
Methods:
Dedicated products: Plan B, Plan B One-Step, Next Choice
High dose of “combination pills”
Copper T IUD

Birth Spacing
World Health Organization (WHO) recommends at least 24 months between pregnancies in order to reduce the risk of adverse maternal, perinatal and infant outcomes (2005 Report of a WHO Technical Consultation on Birth Spacing)

Why Birth Space? Birth-to-pregnancy interval Outcome 6 months or shorter Higher risk of maternal mortality 18 months or shorter Higher risk infant, neonatal, and perinatal mortality; low birth weight, small for gestational age, preterm delivery 18-27 months “ Residual” elevated risks

Birth control

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