Chapter
10
Reproductive Choices
Elizabeth Lytle, MPH, BSN, RN
Los Altos School District
Topics Of Focus For Reproduction
Conception
Process
Birth Control
Considerations
Available methods
Abortion
Types and method
Pregnancy
and Birth
Process of pregnancy and
birth
Idea Of Conception Is Simple
Sperm
Infant
Egg
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
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
Overview Of Birth Control Methods
Coitus Interruptus Is Not A Reliable Method
Failure
Rate
30 pregnancies per 100 women
Half of men find it unsatisfactory
To
Fluid can be released prior to
Consider ejaculation causing pregnancy or
HIV infection
Many Nonprescription Barriers Available
Condoms Male & Female
Spermicide
Suppository
Gel
Sponge
Film
Condom Effectiveness Is 80-85 Percent
Primary reason: Not using condom
every time
Reasons Careless removal
for
Failure Allowing genital contact before
placement
Breakage
Not 100% effective STI protection
To
Consider Some men experience erectile
dysfunction
Sponge Is Another Barrier Method
Failure
Rate
15-25 pregnancies per 100 women
Not reliable protection against STI
To
Consider
Must remain in place for 6 hours
after intercourse
May be less effective in women
who have had children
Vaginal Spermicides And Film
Failure
Rate
Varies with method
• Suppositories 10-25% failure
• Film with condom 100%
effective
Must apply new film or spermicide
before every intercourse
To
Women should shower, not bathe,
Consider
after sex
Must follow directions
Prescription Barriers For Women
Diaphragm
Cervical
Cap
FemCap
Female Barriers Do Not Protect Against STI
Failure
Rate
95-98 percent effective when used
with spermicide
Must remain in place 6 hours after
intercourse
Cervical
Cap
Must reapply spermicide for each
intercourse
Not effective without spermicide
Hormonal Contraceptives For Women
Must Use
Consistently
Oral
Contraceptives
Implant
Patch
Ring
Injection
Oral Contraceptives
Failure
Rate
2-5 pregnancies per 100 women
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
Rate
1-5 pregnancies per 100 women
Does not protect from STI
Risk of blood clot 2 times higher
than oral contraceptive
To
Consider Must apply new patch every week
And check that patch is still in place
every day
Vaginal Ring Has Fewer Side Effects
Failure
Rate
2-8 pregnancies per 100 women
Does not protect from STI
Must replace within 3 hours if it
To
pops
out
Consider
Not effective if use oil-based vaginal
medications
Injection Provides 3 Months of Contraception
Failure
Rate
2-8 pregnancies per 100 women
Does not protect from STI
Triples the risk for chlamydia and
gonorrhea
To
Consider Not recommended for more than 2
year use because of bone effects
Delayed return of fertility
Implant Provides 3 Years Of Contraception
Failure
Rate
99% effective
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
Rate
Less than 1 pregnancy per 100
women
No protection from STI
To
Consider
Provides 5 years of contraception
Should check monthly for string
May take up to 1 year for fertility to
return after removal
Fertility Awareness Methods
Failure
Rate
15 - 25 pregnancies per 100 women
No protection from STI
Must abstain or use contraception
8-11 days/ month
To
Consider May not work for women with
irregular cycles
Takes planning and scheduling
Emergency Contraception Is Safe
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
Rate
Less than 1 pregnancy per 100
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)
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
Pregnancy Changes A Woman’s Body
Pregnancy lasts for 40 weeks, divided into 3month 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%
and get help
Labor
Genetic
Genetic testing before
Varies pregnancy
Disorders
Infections
Miscarriage
Ectopic
Pregnancy
Varies
Vaccinate for rubella
STI testing
10-20% Check for genetic cause
2%
STI testing
Stages Of Labor Process
Latent Phase
• Contractions last 15-30 seconds and
1.
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