CONTRACEPTION: Preventing Pregnancy
ACTIVITY 6.2 – The Contraceptive Methods — 20 minutes
Divide the class into 9 teams. Let the class know that each team will be
assigned one of the 9 contraceptive methods, or birth control, which will be
discussed in this lesson. After they learn some information about each method,
the teams will then “represent” their team’s assigned contraceptive method in
a couple of exercises.
Ask the class to brainstorm and come up with some methods of contraception
that they have heard of. List the suggestions on the newsprint or board. As a
method is suggested, list it either as one of the methods that will be assigned
to a team…:
• ABSTINENCE
• Sex using NO METHOD (“Wishing and Hoping”)
• CONDOMS (Latex4)
• SPONGE
• WITHDRAWAL (“Pulling Out”)
• PILL, PATCH, or RING5
• SHOT
• IMPLANT
• INTRAUTERINE DEVICE (IUD)
…Or, for other methods, list them separately on the board, but in parentheses.
Let the class know that there are other contraceptive methods available, but
that they are not usually considered as choices for young people. These
methods include natural family planning, and sterilization, and these will not
be considered in this session.
As each of the 9 methods is listed, circulate to each team. Hold up the
METHOD SIGN, and ask the team to say if they know what the method is, and
how it works. Supplement the information the team can provide with
information offered by the rest of the class, and with information you provide,
using the FACILTATOR RESOURCE for each method. Be sure to include what
each method is; how it prevents pregnancy; and its advantages and
disadvantages (the “Other Things to Know” section of the FACILITATOR
RESOURCES). It is important to let the students know that IUDs are appropriate
only for females who are a low risk of sexually transmitted diseases (STDs); this
usually means being in a long-term relationship with one person, who has no
other partners.
During this portion of the lesson, encourage questions and answer them as
accurately as possible. As you finish discussing each method, give the METHOD
SIGN and CONTRACEPTIVE EFFECTIVENESS CHART for the method to the team.
ACTIVITY 6.3 -- How effective is it in preventing pregnancy? — 10 minutes
Write out this question on the board or newsprint, and ask the teams to have
one of their members bring their CONTRACEPTIVE EFFECTIVENESS CHART to the
front of the classroom.
Point out that (with the exception of the ABSTINENCE chart) the
EFFECTIVENESS CHARTS are based on what typical couples experience in real
life. This means that some couples might not use the method perfectly, but
they are still counted in measuring the effectiveness of the method.
Show on one of the EFFECTIVENESS CHARTS how to read it and understand it.
Each method has a level of effectiveness in preventing pregnancy that is
measured by counting the percentage of couples who would get pregnant in the
first year of using the method. This means that, if you could observe 100
couples using this method for a whole year, by the end of that year, you would
likely see a certain number of pregnancies. (In the case of the PILL, PATCH, or
RING, that number would be 8).
Show the class that each of the EFFECTIVENESS CHARTS has 100 little pictures
of a female. The lighter ones represent NOT becoming pregnant while using
the method, and the darker ones represent becoming pregnant using the
method. Point out that, the more dark (pregnant) pictures on the CHART, the
higher the pregnancy rate (or failure rate) with that method.
Also point out that the SPONGE has two different failure rates. The pregnancy
rate is MUCH higher for women who have already had a baby (32 per 100) than
for women who have not had a baby (16 per 100). It is not certain why this is
true, but it may be because the sponge can cover the cervix better if the
woman has not yet delivered a child.
Ask the team representatives to hold their CONTRACEPTIVE EFFECTIVENESS
CHART in front of them, so the whole class can see it. Then ask the team
representatives to arrange themselves along a line according to the
effectiveness of their team’s method for preventing pregnancy. The most
effective method should be at one end of the room, and the least effective
method should be at the other end.
Now ask the teams to check their teammate’s position, so that they agree with
their location/placement. If needed, ask the rest of the class to help correct
and adjust the position of the Methods line-up to better reflect exact
BIG DECISIONSTM Lesson 6
effectiveness of each method. Refer to the FACILITATOR RESOURCE:
Protection from Pregnancy for accurate spacing of the different methods.
ABSTINENCE should be at one end of the line, and NO METHOD should be at the
other end. Help assure that the team representatives space themselves
according to the contraceptive effectiveness of their team’s method, with
mathematically linear spacing. Sex with NO METHOD should be far separated
from all the others.
To assure accurate spacing of the methods, it may be helpful to help the
students see the “half-way points” and then arrange themselves
appropriately:
• Show them where 50 pregnancies per 100 couples would be, halfway
across the room. Check that NO METHOD (85 pregnancies per 100
couples) is closer to 100 than to 50 .
• Next show the students where 25 pregnancies per 100 couples (half of
50) would be. WITHDRAWAL, and the SPONGE for women with children,
are a little higher than this.
• Next, show them where 13 pregnancies per 100 couples (half of 25)
would be. CONDOMS and the SPONGE in females without children would
be a little higher than this.
• Next, show them where 6 pregnancies per 100 couples (half of 13)
would be. The PILL, PATCH, or RING would be a little higher than this.
• Next, show them where 3 pregnancies per 100 couples (half of 6)
would be. This is where the SHOT would be.
• Finally, show them where 1 pregnancy per 100 couples (one-third of 3)
would be. This is where the IMPLANT and the IUDs would be. This is
very close to 0 pregnancies, which is where ABSTINENCE is.
Clearly, things get crowded at the lower failure rates. Do your best to help the
students line up as mathematically correctly as possible.
Once the students, with their CONTRACEPTIVE EFFECTIVENESS CHARTS are
lined up accurately, point out to the students that:
• ABSTINENCE is the only method that, when used consistently and
correctly, is 100% effective, with no pregnancies per 100 couples.
• If couples have sex and use NO METHOD, chances are very high that they
will experience a pregnancy, with 85 (or more) of 100 couples pregnant
in the first year.
• Next to ABSTINENCE (used consistently and correctly), the IMPLANT and
INTRAUTERINE DEVICE (IUD) are the most effective.
• The next most effective method is the SHOT, and then the PILL (or
PATCH or RING).
BIG DECISIONSTM Lesson 6
• Latex CONDOMS are very effective, too, but not quite as effective as
the IMPLANT, SHOT or the PILL (or the PATCH or the RING).
• CONDOMS have a MUCH lower failure rate than having sex using NO
METHOD.
• WITHDRAWAL has a higher pregnancy rate than CONDOMS.
• The contraceptive SPONGE has a higher pregnancy rate for females who
have already given birth to a baby. (The SPONGE team member can
stand at either spot, but the facilitator should point out that it has 2
spots, depending on the female using it.)
• There is a BIG difference between using a method and not using a
method. Reinforce that a person has to keep using a method to avoid
pregnancy.
Thank the team representatives, and have them return to their teams.
ACTIVITY 6.4 -- How effective is it in preventing Sexually Transmitted
Diseases (STDs)?—5 to 10 minutes
Write out this question on the board or newsprint, and ask the teams to have
another one of their members bring their METHOD SIGN to the front of the
classroom.
Ask them to say how effective their method is in preventing STDs, and to
arrange themselves in a line from most effective to least effective.
The spacing should be as shown in the FACILITATOR RESOURCE: Percent
Protection from STDs. All the methods (except CONDOMS and ABSTINENCE)
should be at one end of the room, with zero protection from STDs. At the
other end of the room should be ABSTINENCE (100%). CONDOMS give about 85%
protection, so the student with the CONDOMS METHOD SIGN should stand
appropriately close to the student with the ABSTINENCE sign.
Point out to the students that:
• ABSTINENCE (if used consistently and correctly) is the only method that
has 100% protection (or zero risk).
o However, some activities consistent with abstinence, such as
genital touching, could theoretically transmit some STDs, such as
HPV or Genital Herpes. For this reason, to avoid all risk of these
STDs, a person who chooses ABSTINENCE may also want to avoid
these activities.
BIG DECISIONSTM Lesson 6
• NO METHOD, IMPLANT, PILL/PATCH/RING, SHOT, SPONGE, and
WITHDRAWAL all give zero protection from STDs.
• Latex CONDOMS must be used correctly, every time to be effective, and
they dramatically reduce the chance of HIV and other STDs. However,
CONDOMS are not perfect, so some chance remains.
Other points to make include:
• Many health professionals recommend that sexually active people use
both CONDOMS and a highly effective form of birth control, such as the
PILL.
o These 2 methods can “back each other up” and reduce the chance
of pregnancy.
o When latex CONDOMS are used consistently and correctly, they
reduce the risk of STDs, in addition to reducing the chance of
pregnancy.
• Remind the students that other things can help avoid STDs, too:
o Having few partners in your lifetime
o Avoiding high-risk partners
o Being in a faithful life-long relationship (like marriage) with a
partner who is not infected
o Getting tested for STDs
o Females can get vaccinated to prevent HPV infection
• Using the SPONGE may irritate the vaginal lining, which may make it a
bit easier to get HIV, if a person is exposed. 6 The SPONGE is therefore
not the best method for females at risk for STDs, including most
adolescents.
• Using the INTRAUTERINE DEVICE (IUD) is also not a good method if a
female is at high risk for Chlamydia or gonorrhea, because pelvic
infection can be severe. IUDs are generally reserved for females in long term
relationships with one partner who has no other partners.