Reproductive Choices• Describe the process of human conception.• Identify factors to consider and discuss with their partner when choosing a contraceptive method.• Identify contraceptive methods and discuss the advantages and disadvantages of each.• Evaluate contraceptive methods that would meet their personal criteria, if or when they are needed.• Describe methods used to perform abortions.• Discuss the physiological effects of pregnancy and describe fetal development.• Describe the three stages of labor and the birth process. Chapter Learning Objectives
Topics Of Focus For Reproduction Conception Process Considerations Birth Control Available methods Abortion Types and method Pregnancy Process of pregnancy and and Birth birth
But, Process Of Conception Is Complicated Some things that must happen before conception: Spermatogenesis Creation of sperm in male Egg Release Every month, woman releases an egg into the fallopian tubes and it travels to uterus Fertilization Sperm must travel from vagina, through uterus and up fallopian tube to fertilize egg
More Components To Successful Conception After the egg has taken the sperm into its nucleus: Cell Division Zygote, fertilized egg, divides to form blastocyst Implantation Blastocyst burrows into endometrium of uterus
Birth Control Basics Most sexually active women use some form of birth control. Each individual engaging in sexual activity must assume full responsibility for their own reproductive ability. Risks are associated with a variety of contraceptive methods. Abstinence is the only form of birth control that is 100 % effective and risk-free. Individuals who choose abstinence over vaginal intercourse often engage in activities sometimes called outercourse, such as kissing, hugging, sensual touching, and mutual masturbation. Outercourse has no medical or hormonal side effects; it may prolong sex play and enhance orgasm, and it can be used when no other birth control methods are available.
Contraception Can Prevent Conception When choosing contraceptive method, consider these factors with your partner • Effectiveness • Suitability • Side effects • Safety • Future fertility Reduced risk of sexually transmitted • infections
Abstinence Or Outercourse As Contraception Abstinence Abstain from vaginal intercourse and sexual activity that could result in conception Female health benefits – Less likely to get STI, suffer infertility or develop cervical cancer Outercourse Kissing, hugging, sensual touching, mutual masturbation Nearly 100 percent effective, but if man ejaculates near vagina, sperm can swim up and fertilize egg
Birth Control: Cross-Cultural Perspective Culture, religion, gender roles and folklore can affect birth control options and decisions.
Choosing a Contraceptive How well will it fit into your lifestyle? How convenient will it be? How effective will it be? How safe will it be? How affordable will it be? How reversible will it be? Will it protect against sexually transmitted infections?
Coitus Interruptus Is Not A Reliable Method Failure 30 pregnancies per 100 women Rate Half of men find it unsatisfactory To Fluid can be released prior to Consider ejaculation causing pregnancy or HIV infection
Condom Effectiveness Is 80-85 Percent Primary reason: Not using condom every time Careless removal Reasons for Allowing genital contact before Failure placement Breakage Not 100% effective STI protection To Consider Some men experience erectile dysfunction
Sponge Is Another Barrier Method Failure 15-25 pregnancies per 100 women Rate Not reliable protection against STI Must remain in place for 6 hours To after intercourse Consider May be less effective in women who have had children
Vaginal Spermicides And Film Varies with method Failure • Suppositories 10-25% failure Rate • Film with condom 100% effective Must apply new film or spermicide before every intercourse To Consider Women should shower, not bathe, after sex Must follow directions
Female Barriers Do Not Protect Against STI Failure 95-98 percent effective when used Rate with spermicide Must remain in place 6 hours after intercourse Cervical Must reapply spermicide for each Cap intercourse Not effective without spermicide
Oral Contraceptives Basics Most researched, tested, and carefully followed medications in history. Use does not protect against HIV infection and other STIs. Combination Pills: monophasic and multiphasic Combination oral contraceptives significantly reduce the risk of ovarian and endometrial cancer and produce no increase in serious disease. Progestin-Only Pills Risk of heart disease and stroke is lower than with any combination pill. Can exacerbate depression, and must be taken at exactly the same time everyday.
Oral Contraceptives Advantages Disadvantages Extremely effective when taken Requires a prescription. consistently. Increases risk of cardiovascular Convenient. problems. Moderately priced. Must be taken at the same time Does not interrupt sexual activity every day. Reversible within 3 months of No protection against STIs. stopping the pill. Reduces risk of breast lumps, Side Effects ovarian cysts, iron-deficiency Spotting between periods anemia, pelvic inflammatory Weight gain or loss disease, and endometrial and ovarian cancer. Nausea May relieve painful menstruation. Vomiting Breast tenderness Decreased sex drive
Oral Contraceptives Failure 2-5 pregnancies per 100 women Rate Does not protect from STI Must be taken at the same time daily Antibiotics reduce effectiveness To Consider Should have tests before beginning: • Blood pressure • Blood work and urine sample • Breast and pelvic exam
The Patch Provides Hormones Through Skin Failure 1-5 pregnancies per 100 women Rate Does not protect from STI Risk of blood clot 2 times higher To than oral contraceptive Consider Must apply new patch every week And check that patch is still in place every day
Vaginal Ring Has Fewer Side Effects Failure 2-8 pregnancies per 100 women Rate Does not protect from STI To Must replace within 3 hours if it pops Consider out Not effective if use oil-based vaginal medications
Injection Provides 3 Months of Contraception Failure 2-8 pregnancies per 100 women Rate Does not protect from STI Triples the risk for chlamydia and To gonorrhea Consider Not recommended for more than 2 year use because of bone effects Delayed return of fertility
Implant Provides 3 Years Of Contraception Failure 99% effective Rate No protection from STI To Causes changes in appetite and sex Consider drive May cause depression and ovarian cysts
Five Years Of Contraception With IUD Failure Less than 1 pregnancy per 100 Rate women No protection from STI Provides 5 years of contraception To Consider Should check monthly for string May take up to 1 year for fertility to return after removal
Fertility Awareness Methods Failure 15 - 25 pregnancies per 100 women Rate No protection from STI Must abstain or use contraception To 8-11 days/ month Consider May not work for women with irregular cycles Takes planning and scheduling
Emergency Contraception Reduces pregnancy risk by 89% if Success taken within 5 days of unprotected Rate sex Does not require prescription No protection from STI To Must be taken no later than 120 Consider hours after intercourse No effect once pregnancy is established
Male And Female Sterilization Failure Less than 1 pregnancy per 100 Rate women No protection against STI To Must use another form of birth Consider control for 3 months after procedure Procedure is permanent
Abortion – A controversial method Types of Abortion • Medical abortion – medication induces labor Suction curettage – laminaria inserted and • uterine contents drawn out Dilation and evacuation – 2nd trimester, open • cervix and remove fetus Complications Nausea, vomiting, diarrhea Excessive bleeding Possible shock and death (2nd trimester)
Childfree by Choice• Single, childfree women tend to be better educated, more cosmopolitan, less religious, and more professional than those in the general population.• In general, childfree women are high achievers, often in demanding careers, who describe their work as exciting and satisfying.• Childless couples are predominantly urban, well-educated, and upper middle class, with egalitarian and long-running marriages.
Pregnancy• The average age of mothers in the U.S. has risen, but about 70 % of babies are still born to women in their twenties.• Preconception Care • Preconception care—the enhancement of a woman’s health and well-being prior to conception in order to ensure a healthy pregnancy and baby—includes risk assessment, health promotions, and interventions to reduce risk.
Prepare For Pregnancy Preconception care is important for health of mother and baby. Diet, alcohol, drugs, smoking, illness, infection and exposure to toxins can all affect a pregnancy and birth
Why Is Preconception Care Important? Age Risks to the fetus rise when mothers are older than 35. Nutrition Goal: 22-27 lb weight gain Maximum Weight Gain: 35 lbs Substance Use Risks of smoking and drinking.
Pregnancy Changes A Woman’s Body Pregnancy lasts for 40 weeks, divided into 3- month trimesters Milk glands and ducts in breasts change Changes Growing uterus pushes on bladder Skin stretches Internal organs shift
Pre-pregnancy Care Reduces Complications Complication Frequency Premature Recognize signs of labor 10% Labor and get help Genetic Genetic testing before Varies Disorders pregnancy Vaccinate for rubella Infections Varies STI testing Miscarriage 10-20% Check for genetic cause Ectopic 2% STI testing Pregnancy
Stages Of Labor Process Latent Phase 1. • Contractions last 15-30 seconds and occur 15-20 minutes apart • Usually not uncomfortable 2nd Stage • Strong contractions last 60-90 seconds 2. • Cervix completely dilated • Baby moves into vagina and out of mother’s body 3. 3rd Stage • Uterus expels placenta
Infertility• The World Health Organization defines infertility as the failure to conceive after one year of unprotected intercourse.• Affects one out of seven couples.• In women, the most common causes of sub- fertility or infertility are age, abnormal menstrual patterns, suppression of ovulation, and blocked fallopian tubes.• Male sub-fertility or infertility is usually linked to either the quantity or the quality of sperm, which may be inactive, misshapen, or insufficient.
Options for Infertile CouplesArtificial insemination• the introduction of viable sperm into the vagina by artificial means.Assisted reproductive technology (ART).• The most common ART procedure is in vitro fertilization (IVF), which involves removing the ova from a woman’s ovary and placing the woman’s egg and her mate’s sperm in a laboratory dish for fertilization.Adoption• Adoption matches would-be parents yearning for youngsters to love with infants or children who need loving.• Census records indicate there are currently 1.6 million adopted children in the United States.
Protecting Your Reproductive Health Abstain. Limit sexual intercourse to “outercourse.” Talk about birth control with your partner. Know what doesn’t work–and don’t rely on it. Talk with a health-care professional. Consider long term implications. Resist sex without contraceptive protection. Use back-up methods.Inform yourself about emergency contraception.