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- 2. Birth Control vs.Contraception
- 3. Percentage of U.S.Women Ages 15–44 Using Contraception and Reasons Figure 5-1 Percentage distribution of women aged 15 to 49 years, by current contraceptive status: United States, 2015–2017. Data from Daniels, K., Abma, J.C. (2018). Current contraceptive status among women aged 15–49: United States, 2015–2017. NCHS Data Brief, no 327. Hyattsville, MD: National Center for Health Statistics. Available at: https://www.cdc.gov/nchs/data/databriefs/db327-H.pdf
- 4. Legal Perspectives ofBirth Control • Griswold v. Connecticut (1965) • Mandated coverage for contraception for federal employees via an act of Congress (1998) • All new health insurance plans must cover all FDA-approved methods of birth control, sterilization, and related education and counseling without cost sharing (2010).
- 5. Race and ReligionAlso Influence Contraception Use Figure 5-3 Percentage of all women aged 15–49 who were currently using female sterilization, oral contraceptive pill, male condom, or LARCs, by Hispanic origin and race: United States, 2015–2017. Data from National Health Statistics Reports. National Survey of Family Growth, 2015–2017. Available at: https://www.cdc.gov/nchs/products/databriefs/db327.htm
- 6. Fertility Awareness Methods “Free,no equipment necessary, but not reliable” Calendar method • Avoidance of intercourse during fertile time of month by calculating time of ovulation Basal body temperature • Fertility cycle related to changes in basal body temperature Cervical mucus or ovulation method • Fertility cycle related to variations in type of cervical mucus
- 7. Pros vs. Consof Fertility Awareness Methods Pros Cons ❑ No side effects ❑ Used by anyone ❑ Cost-effective ❑ Limited effectiveness ❑ Need to abstain from sexual intercourse certain days/month ❑ No protection from STIs
- 8. Birth Control Pills •Most commonly used form of contraceptive • 99% effective • Suppresses a woman’s reproductive hormone cycle One type of birth control pills. © Christy Thompson/Shutterstock
- 9. Oral Contraceptives Used by16% of women aged 15–44 years Pros Cons ❑ Lighter and less painful periods ❑ Reduced PMS symptoms ❑ Improved skin ❑ Protection against ovarian and endometrial cancers, ovarian cysts, benign breast disease, and PID ❑ Mood changes ❑ Spotting ❑ Weight changes ❑ Drug interactions ❑ Decreased libido ❑ Headaches ❑ Fluid retention ❑ Health risks for some women
- 10. Hormone Delivery Methods Depo-Provera •Injectable progestin every 3 months Contraceptive patch (Xulane) • Patch worn on skin for 1-week intervals; fourth week is patch-free NuvaRing • Flexible, plastic ring inserted into the upper vagina and worn for 3 weeks; removed during week of menstruation
- 11. Barrier Methods (1of 5) Spermicides Figure 5-4 Spermicidal agents.
- 12. Barrier Methods (2of 5) Diaphragm, cervical cap • Dome-shaped latex cup sealing cervix Figure 5-5 Diaphragm Figure 5-6 Cervical cap.
- 13. Barrier Methods (3of 5) Condoms Figure 5-7 Condom use
- 14. Barrier Methods (4of 5) Female condoms • Polyurethane sheath lining entire vagina and external genitals Figure 5-8 The internal condom.
- 15. Barrier Methods (5of 5) Pros Cons • Condoms offer protection from STIs. • Can be used as backup for pill users (or with other methods) • Can be used for the short or long term • Small risk of bacterial infection or toxic shock syndrome for diaphragm, sponge, and cervical cap • Must be used properly • May have higher long- term costs
- 16. Intrauterine Device (IUD) •Small object inserted by clinician into a woman’s uterus • Effectiveness is superior to that of pills, patch, or ring An IUD is a small object placed in the uterus through the cervix by a clinician. © Spike Mafford/Photodisc/Thinkstock
- 17. Permanent Methods Female sterilization •Tubal ligation = fallopian tubes cut and tied – Laparoscopic sterilization – Minilaparotomy – Essure Male sterilization • Vasectomy = vas deferens cut and tied
- 18. Other Forms ofContraception Abstinence • No penis-in-vagina intercourse Withdrawal • Coitus interruptus Breastfeeding • Lactational amenorrhea method (LAM)
- 19. Emergency Contraception (EC) •NOT the same as RU-486, otherwise known as “the abortion pill” • Use of high-dose birth control pills taken within 72 hours of unprotected sex • Plan B = progestin-only form of emergency contraception • ella = another form of emergency contraception available by prescription
- 20. Failure Rates A failurerate is the chance that the average couple using a given birth control method will become pregnant in a given year. • Failure rates can be either for “perfect use” (ideal conditions) or “actual use” (failure rate in the real world) • Failure rates range from less than 1% to 30%. • Condoms, sponges, and diaphragms have the largest difference between these rates.
- 21. Contraceptive Failure • Highrates of effectiveness—oral contraceptives, hormone injectables and implants, IUDs, condoms, vaginal hormonal ring, hormone patch, sterilization • Lower rates of effectiveness—diaphragms, cervical caps, sponges, spermicidal agents, fertility awareness methods, rhythm method, withdrawal
- 22. Handling an Unplanned Pregnancy •Adoption—can be “open” or “closed”; private or public • Abortion
- 23. Abortion A controversial issueof debate or a very common medical procedure? …both, actually Abortion continues to be one of the greatest debates in American society. © Rena Schild/Shutterstock
- 24. Perspectives on Abortion(1 of 2) Why do women choose abortions? • Pregnancy would reduce a woman’s ability to work, finish school, or care for others. • Cannot afford a(nother) baby • Relationship issues or not wanting to be a single mother • Completed childbearing • Not ready for a(nother) child • Did not want people to know she was pregnant or had sex
- 25. Perspectives on Abortion(2 of 2) Characteristics of U.S. abortion patients • More than half are in their 20s; women ages 20 to 24 have the highest rates. • 36% are non-Hispanic White, 30% are non-Hispanic Black, 25% are Hispanic, and 9% are other races. • Six in ten already have one child. • Three in ten have two or more children. • Women in poverty have more abortions than wealthy women.
- 26. Abortion Procedures Surgical abortion •Vacuum curettage • Dilation and curettage (D&C) • Dilation and evacuation (D&E) Medical abortion (“abortion with pills”) • Mifepristone, misoprostol (RU-486)
- 27. Global Perspectives Motherhood continuesto be a major risk to life and health in the developing world (most of Asia, Africa, and Latin America)
- 28. Informed Decision Making Ifyou want to prevent pregnancy • Review your and your partner’s needs • Personal medical history • Review failure rates • Risks and benefits of method • Reevaluate periodically
- 29. Discussion • Where canpeople respectfully agree/disagree about when and how women should be able to end their pregnancies? • How should unsafe abortion be addressed as a public health issue? • What are some ways to promote public health and reduce the number of abortions?