Birth Control &
Family Planning
Controversial Questions
Who should buy the Condom?
Who should buy birth control?
If you went to a store and you saw
an adult family friend would you
would still buy the condoms their.
Schools should provide birth
control for students.
Controversial Questions
Continued
Who’s job is it to tell the females
parents that she is pregnant?
If a female is on birth control she
wants to have sex.
If you get pregnant who’s job is it
financially support the family?
Dynamic Warm-up
Please take out your folders and a
piece of paper.
Please pick up the health text
books on my desk and copy down
all types of contraceptives on
page 163.
Objective:
Students will begin to learn about
different methods of
contraceptives and their
effectiveness.
OBJECTIVE
Identify contraceptives for
males and females.
II. Identify the advantages,
disadvantages and
effectiveness for each
method.
III. Recognize manufacturer
versus user failure rates for
each method.
I.
Birth Control Methods
Condoms (male and female)
Spermicidal Foam or Jelly
Vaginal Contraceptive Film
Birth Control Pills
Orthro-Evra® Patch
Nuva Ring®
Depo-Provera® Information
IUD (Intrauterine Device)
Emergency Contraception –Plan B
Birth Control Pills
Pills can be taken to prevent pregnancy
Pills are safe and effective when taken
properly
Pills are over 99% effective
Women must have a pap smear to get a
prescription for birth control pills
How does the pill work?
Stops ovulation
Thins uterine lining
Thickens cervical mucus
Positive Benefits of Birth Control Pills
 Prevents
pregnancy
 Eases menstrual
cramps
 Shortens period
 Regulates period
Decreases
incidence of
ovarian cysts
Prevents
ovarian and
uterine cancer
Decreases acne
Side-effects
Breast
tenderness
Nausea
Increase in
headaches
Moodiness
Weight change
Spotting
Taking the Pill
Once a day at the same time everyday
Use condoms for first month
Use condoms when on antibiotics
Use condoms for 1 week if you miss a
pill or take one late
The pill offers no protection from
STD’s
Depo-Provera
Birth control shot given once every
three months to prevent pregnancy
99.7% effective preventing pregnancy
No daily pills to remember
How does the shot work?
Stops ovulation
Stops menstrual cycles!!
Thickens cervical mucus
SIDE EFFECTS
Extremely irregular menstrual bleeding
and spotting for 3-6 months!
NO PERIOD  after 3-6 months
Weight change
Breast tenderness
Mood change
*NOT EVERY WOMAN HAS SIDE-EFFECTS!
NuvaRing
Flexible contraceptive vaginal ring
that contains the hormones
estrogen and progesterone.
The ring releases a continuous
low dose of hormones that stops
the ovaries from releasing an egg
each month.
NuvaRing
Insert the ring in the vagina and
leave it there for three weeks
Remove the ring for one-week
ring-free period, on the same day
of the week at about the same
time. During the one-week break,
you will usually have your
menstrual period.
Side effects
Possible side effects are the same
as birth control pills.
They may include breast
tenderness, headache, nausea,
and spotting. Most side effects
are not serious and often go
away.
Women who use hormonal
contraception should not smoke
Ortho Evra (The Patch)
Transdermal contraceptive patch
that contains estrogen and
progesterone
The patch is thin, beige, flexible ,
two inch square that is worn on
the body.
The increased hormone level
caused by the patch stops the
ovaries from releasing an egg
each month
How it works
99% effective
Apply patch one week on the same day each
week for three weeks
Can wear it on bottom, abdomen, torso, or on
the outside of your upper arm
During week four do not wear the patch(your
period will begin)
Side effects
Breast tenderness
Headache
Skin irritation
Nausea
Increases blood clot
IUD
(INTRAUTERINE
A T-SHAPED
DEVISE THAT IS
DEVICE)
INSERTED INTO
THE UTERUS
CAN REMAIN IN
FOR 10 YEARS
OF PROTECTION
MUST BE
INSERTED BY A
DOCTOR
IUD
CONTINUED…
KEEPS SPERM
FROM JOINING
EGG
PREVENTS THE
FERTILIZED EGG
FROM
IMPLANTING
INTO THE
UTERUS
IUD CONTINUED…
NO PROTECTION
AGAINST STD’S
99.9 % EFFECTIVE
AGAINST
PREGNANCY
UNLESS A WOMEN
HAS HAD A
CHILD, SHE MAY
HAVE THE
INABILITY FOR
HER UTERUS TO
HOLD THE IUD IN
PLACE
PATCH (ORTHO ERVA)
SKIN PATCH
WORN ON THE
LOWER
ABDOMEN,
BUTTOCKS,
UPPER ARM
RELEASES
HORMONES INTO
THE
BLOODSTREAM
PATCH (ORTHO ERVA)
CONTINUED..
RISK FACTORS:
– NAUSEA
– CHANGES IN
MENTRUATION
– MOOD SWINGS
– WEIGHT GAIN
– HIGH BLOOD
PRESSURE
A NEW PATCH IS
APPLIED ONCE A
WEEK FOR 3 WEEKS.
WEEK 4 NONE
WORN,
MENSTRUATION
OCCURS
A PRESCRIPTION IS
NEEDED
NO PROTECTION
FROM STD’S
99.9 % EFFECTIVE
BARRIER METHOD
Prevents pregnancy blocks the
egg and sperm from meeting
Barrier methods have higher
failure rates than hormonal
methods due to design and
human error
MALE CONDOM
Perfect effectiveness rate = 97%
Typical effectiveness rate = 88%
Latex and polyurethane condoms
are available
Combining condoms with
spermicides raises effectiveness
levels to 99%
MALE CONDOM
Thin membrane made of latex,
polyurethane or sheepskin that fits
over the erect penis to catch semen
when the male ejaculates.
Condoms protect against some STI’s and
unwanted pregnancy.
Have a reservoir tip to collect semen at
ejaculation
How to Use a Male
Condom
Check package for expiration date
Open package carefully (not with teeth!)
Use a water based lubricate if needed
Put condom on before you begin to have sexual
intercourse-before penis touches other person
Place the unrolled condom on the head of the erect
penis.
With one hand squeeze the air out of the tip of the
condom, and with the other hand unroll the condom to
the base of the penis
After ejaculation, before the penis becomes limp,
withdrawal the penis holding the rim of the condom to
the base of the penis
Dispose of used condom in trash, not toilet!
FEMALE CONDOM
Made as an alternative to male
condoms
Polyurethane
Physically inserted in the vagina
Perfect rate = 95%
Typical rate = 79%
Woman can use female condom if
partner refuses
Female Condom
DIAPHRAGM & CERVICAL
CAP
A DOMED SHAPE
RUBBER DISK
WITH A FLEXIBLE
RIM THAT
COVERS THE
CERVIX SO SPERM
CAN NOT REACH
THE UTERUS
USED WITH
SPERMICIDE
DIAPHRAGM & CERVICAL
CAP CONTINUED…
17 OUT OF 100 WILL
GET PREGNANT
83% EFFECTIVE
NO PROTECTION TO
STDS
DIAPHRAGM & CERVICAL
CAP CONTINUED…
RISK FACTORS:
– IRRITATION
– ALLERGIC
– URINARY TRACT
INFECTIONS
– RISK OF TSS
– AFTER BIRTH
HARD TO FIT DUE
TO STRETCHING
OF THE UTERUS &
CERVIX
INSERTED
BEFORE
INTERCOURSE 6
HOURS
CAN BE LEFT IN
UP TO 24 HOURS
USE
ADDITIONAL
SPERMICIDE
PRESCRIPTION &
SIZED BY A
SPONGE
A DISK SHAPED
SPONGE TEXTURE
CONTAINING THE
SPERMICIDE
NONOXYOL-9
SPONGE CONTINUED…
RISK FACTORS:
– IRRITATION
– ALLERGIC
REACTION
– DIFFICULTY
REMOVING
– RISK OF TSS
MAY BE DIFFICULT
TO INSERT
14-28 OUT OF 100
WILL GET PREGNANT
NO PRESCRIPTION
86-72 % EFFECTIVE
NO PROTECTION
FROM STD’S
What You Need to Know
About Nonoxynol-9
N-9 is the active ingredient in all of the
over-the-counter (OTC) spermicidal
products available in the U.S. and has
been used for pregnancy prevention since
the 1950s. An Advisory Review Panel of
the Food and Drug Administration
(FDA) has deemed N-9 a safe and
effective contraceptive.
Spermicides:
Contraceptive foam, gels,
suppositories, and film contain
chemicals that kill sperm.
They are inserted into the vagina
before intercourse and should be
used with a condom.
75%-80% effective if used alone
98% effective if used with condom
Spermicides-Side Effects
Allergic reaction
Burning or irritation
N-9
N-9 is the active ingredient in all OTC
spermicidal products in the U.S. N-9 is a chemical
detergent that damages sperm cell membranes,
killing the cells.
N-9 is marketed and sold as a spermicidal
contraceptive product in several different
formulations, including:
- Suppositories - Foam - Film - Gel - Cream
N-9 USE
Diaphragms and cervical caps are FDA
approved for use in conjunction with
spermicidal gels and creams. Also, some
condoms include a spermicidal lubricant.
N-9 USE RECOMMENDATIONS FROM
WHO & CDC
N-9 can be used as a contraceptive, alone or in
combination with a cervical barrier method,
and among women at low risk of HIV/STI
infection (Use the product no more than once
daily.)
N-9 should not be used for the purpose of
HIV/STI prevention.
N-9 should not be used for contraception by
women at high risk of HIV infection.
N-9 USE RECOMMENDATIONS FROM
WHO & CDC
Condoms with N-9 should not be
promoted for disease prevention.
(However, it is better to use N-9lubricated condoms than no condoms at
all.)
N-9 should not be used rectally.
Emergency Contraception
Emergency contraception
pills can reduce the
chance of a pregnancy by
89% if taken within 72
hours of unprotected sex!
What is it?
Emergency contraception (EC) is a
safe and effective way to prevent
pregnancy after unprotected
intercourse. It can be started up
to five days (120 hours) after
unprotected intercourse.
How does it work?
The hormones in the morning after pill work
by keeping a woman's ovaries from releasing
eggs — ovulation. Pregnancy cannot happen
if there is no egg to join with sperm. The
hormones in the morning after pill also
prevent pregnancy by thickening a woman's
cervical mucus. The mucus blocks sperm and
keeps it from joining with an egg.
How do I take it?
Taken within a 72 hour period it is 89% effective
If taken after 72 hours it is 75% effective
Can be taken up to 5 days after intercourse but
is more effective if taken
Plan B can be taken in one dose or two doses. If
you take it in two doses, take the second pill 12
hours after the first pill. Or simply take them
both at the same time. It's your choice.
When you take birth control pills as emergency
contraception, you must take the pills in two
doses, 12 hours apart. The number of pills in
each dose depends on the brand of the pill. You
must use the same brand of pill for each dose.
When should I use it?
The condom broke or slipped off, and he
ejaculated in your vagina.
You forgot to take your birth control pills,
insert your ring, or apply your patch.
Your diaphragm or cap slipped out of place,
and he ejaculated inside your vagina.
You miscalculated your "safe" days.
He didn't pull out in time.
You weren't using any birth control.
You were forced to have unprotected vaginal
sex, or were raped.
Emergency Contraception
(ECP)
Plan B is available from drugstores and
health centers without a prescription
for women and men 17 and older.
If you are interested in getting Plan B
and are 17 or older, you can either get
it directly from a Planned Parenthood
health center or from your local
drugstore.
If you are younger than 17, you'll need to
go to a health center or private health
care provider for a prescription.
Emergency Contraception
Morning After Pills
1. Preven ($50.00 - $70.00)
2. Plan B ($49.99 or Sliding Scale
Cost) OTC/72 hours
3. Levonorgestrel ($39.99)
Script/72 hours
4. Ulipristal Acetate (UPA or
ELLA)
Script/120 hours
WITHDRAWAL
Removal of penis from the vagina before
ejaculation occurs
NOT a sufficient method of birth control
by itself
Effectiveness rate is 80%
– is not recommended for teens and sexually
inexperienced men because it takes lots of
experience before a man can be sure to know
when he's going to ejaculate
Very difficult for a male to ‘control’
How effective is it?
Of every 100 women whose partners use
withdrawal, 4 will become pregnant each
year if they always do it correctly.
Of every 100 women whose partners use
withdrawal, 27 will become pregnant
each year if they don't always do it
correctly.
Pregnancy is also possible if semen or
pre-ejaculate is spilled on the vulva.
Outercourse
ADVANTAGES
no medical or hormonal side effects
may prolong sex play and enhance
orgasm
can be used when no other methods
are available
Outercourse
POSSIBLE DISADVANTAGES
many people find it difficult to
abstain from vaginal intercourse
many people fail to use protection
from pregnancy or infections if
intercourse takes place
Douche
French term for soak or wash
Douche Bag
Douche Can
STERILIZATION
ADVANTAGES
permanent protection against pregnancy
no lasting side effects
no effect on sexual pleasure
protects women whose health would be seriously
threatened by pregnancy
POSSIBLE DISADVANTAGES
risks of minor surgery if incision is made
some people later regret not being able to have
children
not usually reversible if you change your mind
rarely, tubes reopen, allowing pregnancy to
occur
STERILIZATION
Tubal sterilization — intended to permanently
block woman's tubes where sperm join egg
Vasectomy — intended to permanently block
man's tubes that carry sperm
99.5-99.9% EFFECTIVE
Not effective against sexually transmitted
infections — use latex or female condoms to
reduce the risk.
STERILIZATION
o
o
o
o
o
Tubal sterilization
bruising if incision is made
very rare injury to blood vessels or bowel
pregnancies that rarely occur are more likely to
be ectopic (in a fallopian tube)
Vasectomy
infection or blood clot in or near the testicles
temporary bruises, swelling, or tenderness of
the scrotum
sperm leakage may form temporary small
lumps near testicles
STERILIZATION
COST
$2,000-$6,000/ tubal sterilization
240-$520/ vasectomy
(Vasectomy costs less because it is a
simpler procedure that can be done in the
clinician’s office.)
Natural Family Planning &
Fertility Awareness Method
Women take a class on the menstrual cycle
to calculate more fertile times
Requires special equipment and cannot be
self-taught
NFP abstains from sex during the
calculated fertile time
FAM uses barrier methods during fertile
time
Perfect effectiveness rate = 91%
Typical effectiveness rate = 75%
No 100% safe day-irregular periods
Pro Choice or Pro Life
1.
2.
Where do you stand?
How significant is your
agreement/position with the
philosophy chosen in number
one?
- 40 (pro-choice) ---- (pro-life) +
40
Key
1.
2.
3.
4.
5.
Strongly Agree
Agree
Mixed Feelings
Disagree
Strongly Disagree
Roe v. Wade
In the 1973 Roe v. Wade decision, the U.S.
Supreme Court ruled that a woman, in
consultation with her physician, has a
constitutional right to choose abortion in
the early stages of pregnancy-that is,
before viability. (24 weeks)
Abortion Control Act
In 1982, Pennsylvania passed the
Abortion Control Act. This Act
required women to give:
1. Informed consent before
abortions could be performed.
2. Imposed a 24-hour waiting period
upon women seeking abortions,
during which time the women
would be provided with information
regarding abortions.
Abortion Control Act
3. The act also provided that minors
seeking abortions first obtain informed
consent from their parents, except in cases
of "hardship," in which a court could
waive this requirement.
4. Except in "medical emergencies," a wife
seeking an abortion must inform her
husband of her plans prior to the
procedure.
Abortion Control Act
5. Finally, the act required that all
Pennsylvania abortion clinics report
themselves to the state.
Planned Parenthood v. Casey
In 1992, Planned Parenthood of
Southeastern Pennsylvania filed a lawsuit
against the state, arguing that the Abortion
Control Act violated the Supreme Court's
ruling in Roe v. Wade.
The Court upheld Roe v. Wade and a
woman’s basic right to abortion.
New Jersey Law
No parental involvement/notification
required for girls 12 years and older.
No waiting period
Medical Abortion
Abortion Pill
63 days or 9 weeks (Trimester #1)
97 % effective
In the case that the medical abortion does
not work a aspiration abortion / in-clinic
abortion is required
Medical Abortion Cost: $300.00-$800.00
Medical Abortion: Step 1
RU-486 name under development
– Mifepristone (1st pill) will be taken at a
clinic as well as other antibiotics
Inhibits progesterone, which breaks
down the uterine lining
Medical Abortion: Step 2
Misoprostol (2nd by mouth or vaginal
suppository)
Promotes uterine contractions
Will cause you to have cramps and
bleed heavy
May see large blood clots or tissue at
the time of the abortion
Step 2 - Continued
Most women abort within 4-5 hours, but
some take up to a few days.
Bleeding or spotting may continue for up
to four weeks after taking the
Misoprostol.
Step 3
You must have a follow up visit within
two weeks. This is to make sure that the
abortion is complete and you are well. An
ultrasound will be completed at this time.
If you are still pregnant you may require
an aspiration abortion or in-clinic
abortion .
In-Clinic Abortions
Cost: $300-$950.00
Most common: Vacuum aspiration and
D&E (dilation and evacuation)
Up to 16 weeks
Aspiration Abortion
Uterine exam
Pain medication
Speculum inserted into the vagina
Numbing medication for the cervix
Cervix stretched with dilators – series of
increasingly thick rods
Tube inserted into uterus
Suction device empties uterus
Aspiration Abortion
At times a curette is used to remove any
remaining tissue that lines the uterus
Time required: 5-10 minutes
D&E Dilation and Evacuation
Same as an aspiration abortion, however
depending on trimester you may require
a shot through your abdomen to be sure
that there is fetal demise before the
procedure begins.
Time requirement: 10-20 minutes
EXCELLENT REFERENCE SEE:
www.plannedparenthood.org
You tube
Review
Ancient Birth Control Methods
Beaver-Testicle Tea
Dances, Amulets, Rituals &
Myths
Squatting or kneeling to provoke
sneezing
Jumping backwards seven times
Leather pouch containing a cat’s liver on
the left foot
Spitting in a frogs mouth three times
Inserting a finger into the vagina and
“swishing it around” after intercourse
Dances, Amulets, Rituals &
Myths
Soranus - Ancient Greek Doctor of
Gynecology
– Determined that women were fertile during
ovulation and promoted the rhythm method.
Unfortunately, he assumed that ovulation
occurred during menstruation.
Spermicides, IUDs, Pessaries, &
Douches
Dried cow, elephant, & crocodile dung
mixed with honey
Ground dates, acacia tree bark, & honey
blended into a paste
Dried fish or cotton soaked with lemon
Half lemons with the juice squeezed out
Glass or metal diaphragms
Spermicides, IUDs, Pessaries, &
Douches
IUDs originated in the Middle East. Pebbles
would placed in the uteruses of camels
1920 – German gynecologist Ernest Grafenberg
developed the first IUD for humans, which was
made from silkworm gut and coiled wire.
Seaweed, leaves, wooden blocks, and apricot
pits were also used to block the cervix
Vinegar injected into the vagina