chapter 11.doc

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University of Guelph
Family Relations and Human Development
FRHD 2100
Cindy Clarke

Chapter 11 - Contraception and Abortion Contraception, which types to use, when, and the quality of same are often issues for discussion. Also, the issue arises as to why you would need birth control if you are married. Should a married couple or anyone be engaging in sexual relations unless it is for the purpose of procreation? Issues to be address by you as they relate to you own individual beliefs. The following are key issues addressed within this chapter. These notes are meant to be a guide while you read through the chapter. History of Contraception • Origins of contraception are found in ancient Greece and Egypt. • 1800’s groups in the United States were considering controlling fertility to reduce poverty • 1873 Comstock laws (Anthony Comstock) prohibited the distribution of all obscene material including contraceptive information and birth control devices Choosing a Method of Contraception • Individuals and couples should consider: • Personal health and health risks • The number of sexual partners • Frequency of sexual intercourse • Risk of acquiring STI • Personal responsibility • Cost of methods • Advantages and disadvantages of methods Barrier Contraceptives: Condoms and Caps You will find a video detailing how to use a male condom, female condom, and dental dam at • Condom is a penile covering • Female condom (reality vaginal pouch) polyurethane, about 7 inches long, to flexible rings to help with insertion • How it works: • Male condom placed on erect penis prior to vaginal contact • Water based lubricants may be used with the condom, however, oil based lubricants will damage the latex • After ejaculation, the condom must be removed while holding the penis, so that it does not slip off • Use of spermicide (nonoxynol-9) with a condom was recommended, however, this recommendation has been changed as it was found that the spermicide irritated the mucous membranes and my increase the transmission of HIV or other STI’s Effectiveness • Latex condoms are 88-98 % effective • Female condoms have a 79% effectiveness rate • Overall breakage is low if used correctly • Check expiry dates • Do not store condoms in warm locations such as wallets or cars Advantages • Barrier methods offer most protection from STI’s, including HIV • Relatively inexpensive and can be bought over the counter • Some individuals enjoy that they eliminate semen leakage from the vagina Disadvantages • Condom use may reduce spontaneity • Reduce sensation • Latex allergy Diaphragm • Made of latex and available in different sizes • Require a physicians’ visit to ascertain proper size How it works • Create a barrier to cervical entrance with latex and spermicidal jelly • Prior to insertion, diaphragm rim is covered with spermicidal jelly, one tablespoon of jelly is put into the diaphragm • Additional jelly must be added to diaphragm for each act of intercourse • The diaphragm is left in place for at least hours but not more than 24 hours after intercourse Effectiveness and Advantages • Rates range from 82-94% • Advantages: can be inserted prior to sexual activity to increase spontaneity • Spermicidal jelly provides some protection from STI’s and pelvic inflammatory disease • Doesn’t affect hormone levels • Fairly inexpensive Disadvantages • An office visit for fitting and education about insertion and removal • Increase of toxic shock syndrome, urinary tract infections, postcoital drip • May move during different sexual positions • Woman must be comfortable inserting the device Contraceptive Sponge • In Canada a sponge is available under the trademark name: Protectaid • Not available in United States at this time due to manufacturing issues with the trademark: Today’s sponge How it works and effectiveness • Works as a barrier (blocks entrance to the cervix), absorption of sperm, deactivating the sperm • Intercourse may occur as often as wish, it must remain in place for six hours after intercourse • Effectiveness rate: 75-83% • Failure rate higher in women under 30 or those who have frequent intercourse Advantages • Purchased without a prescription or fitting • Inserted prior to sexual intercourse, increasing spontaneity, no extra spermicide needed for additional acts of intercourse • Do not affect hormone levels, are disposable, do not require routine cleaning Disadvantages • Increase risk of toxic shock syndrome and urinary tract infections • Cannot be left in place during a woman’s menstrual period • Possible allergic reaction to spermicide • Woman must feel comfortable inserting it Cervical Cap • Thimble shaped rubber dome, placed over the cervix, must be fitted by physician • Similar to diaphragm but can remain in place up to 48 hours • It works by blocking the cervical opening • Deactivates sperm through the use of spermicial cream or jelly Effectiveness and Advantages • 82-94% • Primary reason for failure is inconsistent or incorrect use • It can be left in place up to 48 hours • Inserted earlier and left in longer than the diaphragm and has a higher effectiveness rate • Does not affect hormone levels Disadvantages • May increase the rate of toxic shock syndrome, cause abnormal pap smears • Increase risk of urinary tract infections, possible allergic reaction to rubber • Must be fitted by doctor • May be dislodged during intercourse Hormonal Methods for Women: The Pill, The Patch, and more • Change hormonal levels • Production of ova can be interrupted and fertilization can be prevented • Do not prevent STI’s • Various types of birth control pills, different levels of hormones in them • Developed to mimic average menstrual cycle • Injections: prevent ovulation and thickening cervical mucus • 99.7% effectiveness • Highly effective,
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