STAGES OF LABOR,
CONTRACEPTION, AND CONCERNS
WARNING: Maturity and an OpenMind are required
STAGES OF LABOR
• Labor – the process by which the baby
gradually moves out of the uterus into the
vagina to be born
1ST Stage of Labor
• Cervix must open to a diameter of about 5” (10
cm)
• Dilation= opening of the cervix
– 1ST & usually longest stage of birth process
• Contractions push baby’s head toward cervix
– Head moves against membranes of amniotic sac 
sac ruptures
– Once “water breaks” contractions will get stronger &
closer together
– Length of 1ST stage varies
2ND Stage of Labor
• Begins when the cervix is fully dilated &
mother feels the urge to push
• Strong uterine contractions & pushing forces
baby’s head through the vagina (“birth canal”)
• Crowning = term used to describe when the
baby’s head can be seen at the opening of the
vagina
• Once head is out, rest of body quickly follows
• Episiotomy = incision made from the vagina toward the
anus to enlarge the opening of the vagina
– usually happens at the crowning point (not always
necessary)
– Stitched back together after birthing process is complete
– Some obstetricians (doctor’s who deliver babies) believe it
prevents tearing tissue; others allow the tissue to tear
because they believe the wounds heal more quickly
– DOCTOR’S PROCEDURE SHOULD BE DISCUSSED BEFORE
BIRTH BEGINS!!!!!
3RD Stage of Labor
• Placenta is fully separated from the wall of the
uterus
– Passes through the vagina = “afterbirth”
CESAREAN (“C-SECTION”)
• Cesarean birth = method of childbirth in which a
surgical incision is made through the abdominal
wall and uterus
– Baby is lifted out through the opening
– REASONS WHY…?
• Baby is not positioned correctly (“breach”)
• Baby fails to descend into birth canal
• Mother’s pelvic structure may not allow vaginal delivery
– Natural or vaginal delivery would be dangerous or impossible
• Mother may have herpes sores
– Seriously effects a baby passing through the vagina
WOMAN MAY HAVE A C-SECTION WITH ONE CHILD, AND A
NATURAL CHILDBIRTH WITH ANOTHER!!!
MEDICATIONS DURING LABOR
• Eases mother’s discomfort
– Some feel the drugs relax them; makes them
better able to deal with contractions
– Others find the drugs make them too drowsy to
concentrate and participate in the birth
MEDICATIONS DURING LABOR
• Meperidine hydochloride
(Demerol)
– Pain reliever; common
• Valium & Vistral
– tranquilizers
• Epidural Block
– Medication is injected
through a tube that has
been inserted between the
vertebrae into the spine
• General Anesthesia
– Female is completely
unconscious
– Used for high-risk cesarean
births
AFTER DELIVERY
• Progesterone levels in mother’s blood drop
– Signals release of prolactin
• Prolactin = hormone that stimulates milk production
• Colostrums
– Secreted 1ST few times after birth
– Yellowish, low-fat, watery fluid
• If female breast-feeds, more nutritious milk is
released a couple of days after birth
Benefits of Breastfeeding
• Colostrums and milk contain antibodies
– Protect infant from infections
– Breast-fed babies are subject to fewer illnesses
– Breast milk is more easily digested than formula
– No child is allergic to breast-milk; they may be
allergic to cow’s milk or formulas
– Studies have shown that breast-fed children have
higher IQs (indirect relationship)
POSTPARTUM PERIOD
• Period of time from birth of a baby until a
female begins her menstrual period
• Body adjusts to changes and begins to return
to pre-pregnancy state
• Because of the extreme hormonal changes,
female may experience “postpartum letdown”
– In more serious cases = postpartum depression
PREPARED CHILDBIRTH TRAINING
• Lamaze Method of Painless Childbirth
– Father/partner assumes role of “coach”
– Teaches mother AND father techniques to deal
with pain or discomfort
– Concentrates on relaxation techniques
– Controlled breathing
WHERE TO GIVE BIRTH
• Birthing centers = facility with home-like settings that
are separate from a hospital and offer medication-free
births
– Only available for low risk births
– May receive more individual care than at a hospital
• Hospitals
– Many have a rooming-in arrangement
• Mother & baby are cared for in the same room
• Allows immediate bonding w/child
• Sometimes fathers are allowed to stay
– Traditional hospitals have a baby taken care of in a nursery
CONTRACEPTION
Contraception = preventing
pregnancy
NONPRESCRIPTED METHODS
• Condom
• Spermicide
• Foam/gel/suppositories
• Fertility Awareness Method
• Abstinence
•
CONDOM
Thin sheath of latex or animal tissue that is
placed on the erect penis to catch semen
(male)
• Acts as a barrier to sperm
• Can only be put on an erect penis (male)
• Space must be left at the end of the
condom (male)
– Allows room for semen when its ejaculated
– Must be taken off while penis is still erect
• Male comdom cannot be reused & must
use a new condom each time a male has
intercourse
• Female condom can be reused!
Condoms cont…
• Spermicide = chemical that kills sperm that
comes in contact with it
• NEVER USE WITH A CONDOM
– Petroleum-based products = can destroy latex
– EX. Petroleum jelly/vaseline & hand lotion
FOAM/GEL/SUPPOSITORIES
• Least effective of the contraceptive methods
• When used in combination or with a condom,
rate of effectiveness increases
• Have spermicide in them
FOAM & GEL
• Used with an applicator
• is inserted in vagina and
pushed up toward
cervix
• Must be inserted no
more than 30 minutes
before intercourse
SUPPOSITORIES
• Inserted with applicator
• Placed in the upper
vagina/cervix
• Dissolve due to body
heat
• Must be inserted 10-15
minutes before
intercourse
• May cause vaginal
irritation
FERTILITY AWARENESS METHOD
(Natural Family Planning)
• Methods of contraception that involve determining the
fertile days of the female’s menstrual cycle & avoiding
intercourse on those days.
• Female must have a “regular” cycle
• Ineffective for young people
• Requires classes to learn what’s involved
– Careful record-keeping & planning
• Female’s Body temp.
– Decreases slightly before ovulation
– Increases slightly after
• Chart 1ST day of cycle for 8-12 months
– Cervical Mucus Method
•
•
•
•
Checks secretions from cervix each day
Records description on a calendar
Amount increases just before ovulation
Becomes stringy, sticky & clear during ovulation
PRESCRIPTION METHODS
• Oral Contraception
• Diaphragm &
Cervical Cap
• Contraceptive
Implant
• MISC. METHODS
ORAL CONTRACEPTION
“birth control pill”
• Contain hormones that work
similar to the natural female
hormones
• Ovaries stop releasing ova
• Lining of uterus changes
• Cervical mucus thickens
• Must be taken every day at the
same time (regardless of
intercourse!)
• May be less effective if taking
certain medications (i.e.
antibiotics)
SIDE EFFECTS
– Depends on the individual
– May have:
• Nausea
• Breast tenderness
• Breakthrough bleeding/spotting
– SERIOUS SIDE EFFECTS
• High blood pressure
• Blood clots in veins
• strokes
– Not recommended for females
w/certain health conditions
• Migraines, diabetes, high blood
pressure
• Higher risk of serious side-effects if
woman smokes, is seriously
overweight or over 35
DIAPHRAGM & CERVICAL CAP
•
•
•
•
•
•
•
Easy to use & comfortable to wear
Used with spermicide to block & kill sperm
Must have pelvic exam to determine correct size
May be inserted up to 6 hours before intercourse
Reusable  washed with cleaner & water
Regularly checked for holes
Must be refitted if female gains or loses more
than 10 lbs. or has miscarriage/abortion after 14
weeks of pregnancy
DIAPHRAGM
• =soft rubber cup
w/flexible rim that is
worn inside the vagina
– Must be covered in
contraceptive cream/gel
– Must apply gel into vagina
each time intercourse is
repeated but diaphragm is
NOT removed!
– Wait at least 6 hours after
last intercourse to remove
CERVICAL CAP
• =thimble-shaped soft
rubber cup that fits
snuggly onto cervix/neck
of the uterus
– Must be 1/3 full of
spermicide
– Wait at least 8 hours after
intercourse (no more than
48) to remove
DIAPHRAGM
CERVICAL CAP
CONTRACEPTIVE IMPLANT
• Ex. Norplant
• Birth control procedure that involves the
insertion of 6 small rods about the size of a
matchstick under the skin of a female’s upper
arm
• Releases small doses of hormones
• Controls cycle similar to that of oral
contraception
CONCERNS ABOUT SEXUALITY
In this section of information, you are required to
demonstrate a level of maturity to discuss the information. If
you feel you cannot respectfully handle the material we will
go over, please let Mr. Renz know immediately.
COMFORT LEVEL
• Many people find discussions about sexuality
uncomfortable
• This is how many people become misinformed
• Having factual information will help form
attitudes to make decisions that promote
health and help prevent diseases and
premature death.
MASTURBATION
• = touching one’s own genitals for sexual
pleasure
• HISTORY’S MISINFORMATION: for many years,
people believed masturbation was wrong and
unhealthy/harmful
– Consequences of masturbation…
• Blindness
• Acne
• Decreased athletic ability
* insanity
* weakness
* hairy palms
SEXUAL ORIENTATION
• Homosexual = someone who has a sexual
attraction for someone of the same gender
• Heterosexual = someone who has a sexual
attraction for someone of the opposite gender
• Many people who have strong emotional
views concerning homosexuality may have
very little information or choose to believe
incorrect info about homosexuals
– Often leads to irrational fear = homophobia
Prejudice
• Beliefs based upon
stereotypes
• Why are there still
some today?
– Media
– Parental Beliefs
– Groups & Clubs
Intolerance
• Lack of acceptance of
other’s opinions,
beliefs, or actions.
MYTHS about Homosexuality
Person is homosexual because…
– … He/she is not yet interested in the opposite sex
– … His/her closest friend is of the same gender
– Homosexuals are child molesters
• About 97% of child molesters are heterosexual males who
attack mostly girls
– … they have not had sex or aren’t interested in having
sex
• Especially if the person is a male
– “You can tell homosexuals by their appearance and
mannerisms”
• Stereotype = an idea or image held about a group of people
that represents an oversimplified opinion, prejudiced
attitude, or uninformed judgment.
Stereotype
• Beliefs about a
certain group of
people
Why are people homosexuals…?
RESEARCH
– Genetic factor passed from
baby to parents
• Chemical balance in the womb
is somehow different
• A baby is born with a different
balance of hormone’s than
heterosexuals
– Behavior is learned
– Combination of behavior &
genetics are responsible for
homosexuality
ADOLESCENTS
– Adolescents who realize they are
homosexual may have a lot of
anxiety
– May worry that their
friends/family will reject them
– People at school may tease or
even violently attack them
– Very aware of prejudice,
discrimination, and possibly
violence they will face
– Highly advised to speak w/a
trained counselor
– Hate Crimes – Mathew Shepard
Diversity
• Differences in race,
language, beliefs, etc.
ABORTION
In this section of information, you are required to demonstrate a level of
maturity to discuss the information. If you feel you cannot respectfully
handle the material we will go over, please let Mr. Renz know
immediately. Additionally, if you have any personal issues that may cause
you to become upset during this discussion and you would like to not be
present during the presentation, please let me know before we begin the
lecture.
ABORTION = termination of a
pregnancy
• Miscarriage = spontaneous abortion
• Happens when the uterus contracts & expels the
lining of the uterus/embryo
• Occurs in about 10% of (known) pregnancies;
estimated 50% (including early/unknown)
• REASONS
– Hormonal deficiency
– Faulty ovum/sperm
– Weak endometrium
• Usually occurs early in the pregnancy
Induced Abortion
• Takes place in a medical setting
• VERY CONTROVERSIAL
• NOT a form of birth control!!
– Regardless of opinion, any abortion is emotionally
traumatic  hormones
1ST Trimester Abortions
PROCEDURE = Mifepristone
PROCEDURE = Methotrexate
• Taken orally; blocks the action of
progesterone
• Given by injection or orally
– Causes uterine lining to thin &
pregnancy to detach
– Causes cervix to soften & dilate
– Increases production of
prostaglandins
• Cause uterine contractions
– MISOPROSTOL
• Induces contractions
• Taken orally or inserted vaginally
w/in a few days of Mifepristone
• Increases effectiveness to 95-98%
– Requires at least 2 visits
– Usually avoids surgery
– Can be used very early in
pregnancy
– Stops ongoing process of
implantation of early
pregnancy
– Misoprostol increases
effectiveness to 95%
• Requires at least 2 visits
• Usually avoids surgery
• Like mifepristone, it
resembles a “natural
miscarriage”
1ST Trimester Abortions Cont…
PROCEDURE = Vacuum Aspiration
– Cervix is gradually opened
– Cannula (straw-like tube) is inserted through the
cervix into the uterus
– Contents of uterus are emptied via suction
– 99% effective
– Requires only 1 visit
– Involves surgical procedure
3RD Trimester Abortion
• The earlier an abortion is performed… the
safer it is
• HIGHLY CONTROVERSIAL!!!
– Supposed to be available only in extreme
circumstances
– Fewer than 2% of abortions are performed 21 wks
or after
– Generally limited to cases of severe fetal
abnormalities or situations when the life or health
of the woman is seriously threatened
3RD Trimester Abortion Procedure
• Guided by ultrasound, physician grasps fetus’s
legs w/forceps & pulls them out into the birth
canal
• Physician (“abortionist”) delivers baby’s entire
body except for the head  legal
• Physician creates a hole in the base of the
fetal skull
• Suction catheter removes brain material
• Skull collapses & fetus is removed
Roe vs. Wade
• Supreme Court Case granting women the
“Right to Choose” to continue or terminate a
pregnancy
• 1973
•Any form of sexual contact when forced against any person’s will (male
or female) is an act of violence
•May occur with the attacker being a stranger… more often the attacker
is someone the victim knows.
SEXUAL ABUSE AND VIOLENCE
SEXUAL ABUSE & INCEST
• Children & adolescents who are victims of
sexual abuse often know their abuser
– Usually not a physically forced attack
– Adult uses mental force/persuasion as influence
– May start when child is young & continue for years
– Why would abuse continue for so long…?
• Fear, loyalty, or obedience
• May not understand that forced sexual contact is wrong
• CONFUSION  if contact feels good (STILL ILLEGAL)
IMPORTANT TO REMEMBER THE VICTIM IS N E V E R AT FAULT
Sexual Abuse
• Incest = any sexual contact b/w family members
who cannot marry by law
– Particular type of sexual abuse
– Most important thing a victim can do is tell someone
to help stop the abuse!
– Most important thing if told  believe & help the
victim
– Groups are available to help victims as well as
abusers/attackers
Hypothesis the following about RAPE…
• 1. More victims are male or female?
• 2. Most victims of sexual assault report what
happened to the police.
• 3. TRUE OR FALSE….Rape is sometimes ok, like
if 2 people are married.
• 4. Define “rape” in your own words
• 5. What do you think might be the difference
between “acquaintance rape” and “date rape”?
• 6. Why might males be less likely to report sexual
assault?
• 7. What are 2 things you can do to protect yourself
from becoming a victim of sexual assault?
• 8. What are 2 things you must do or avoid doing
immediately after being a victim of sexual assault?
RAPE
• Definition
• ALWAYS ILLEGAL
• “Law enforcement in some states is geared
toward an outdated perception of rape
involving strangers, the report found. That
perception doesn’t reflect that most sexual
assaults take place between people who know
each other, that most do not involve physical
force or weapons, and that most do not result
in serious injuries other than the rape itself.”
RAPE cont…
• Acquaintance rape = rape by someone the victim
knows
• Date rape = rape that is done by someone the victim is
romantically involved with/dating
– 57% of college rapes happen on dates
– Even though the victim know their attacker (or has had
consensual intercourse previously) it is still rape if it’s not
wanted
– Many rape cases go unreported
• Male victims often do not report it
– Society stresses males are stronger & can protect themselves
– Statistics
PROTECTING YOURSELF AGAINST…
RAPE
• USE COMMON SENSE
• Avoid putting yourself
at risk
– Well-lit places
– w/other people
– If go alone  tell
someone of plans
– Give an air of confidence
DATE RAPE
• Know who you’re going
out with
• Always have your own
money with you
• Date rape drugs
WHAT TO DO IF SOMEONE YOU KNOW
IS RAPED….
• Notify police IMMEDIATELY (sex crimes officer)
• DO NOT shower, change clothes, or douche ( )
– Eliminates evidence for prosecuting offender
• Get a physical exam ASAP
– Checks for damage to body
– Antibiotics to fight potential infections
• Counseling
– Severely stressful and emotionally traumatic
experience
– Many communities have a rape counseling center
Hypothesis the following about RAPE…
• 1. More victims are male or female?
• 2. Most victims of sexual assault report what
happened to the police.
• 3. TRUE OR FALSE….Rape is sometimes ok, like
if 2 people are married.
• 4. Define “rape” in your own words
• 5. What do you think might be the difference
between “acquaintance rape” and “date rape”?
• 6. Why might males be less likely to report sexual
assault?
• 7. What are 2 things you can do to protect yourself
from becoming a victim of sexual assault?
• 8. What are 2 things you must do or avoid doing
immediately after being a victim of sexual assault?