CONTRACEPTION AND ABORTION APS 214 CONTRACEPTION AND ABORTION

CONTRACEPTION The prevention of pregnancy of one of a number of methods. The common purpose of the contraceptives is to prevent the male sperm from fertilizing the female egg or to keep the egg from implanting in the uterus. Married couples are the most likely to use contraception as compared to unmarried couples.

Reasons for use of contraception Socio-economic factors- larger families pose bigger demands on family finances Prevention of death of mother or child for those women who suffer from pregnancy complications Child spacing through contraception ensures that the baby is breastfed for the recommended period for build up of immune system

Reasons cont’d The couple is able to save and invest in the future Family interaction is increased between mother and father, parents and children which promotes understanding and happiness A small family allows for the parents to know and understand each and every child’s strengths and weaknesses Enhances privacy within the family, and especially for the parents as they can concentrate on their relationship more

Reasons cont’d Prevents pregnancy in old age which predisposes children to birth deformities or death.

TYPES OF CONTRACEPTIVES ORAL CONTRACEPTIVES. The combination pill – contains estrogen and progesterone, which act to prevent ovulation and implantation. The estrogen inhibits the release of the follicle stimulating hormone (FSH) and the luteinizing hormone (LH) from the pituitary gland so that no egg will develop. The progesterone serves as secondary protection by causing a change in the composition of the cervical mucus by making it thick and acidic creating a hostile environment for the sperm

The minipill – contains same progesterone found in the combination pill but at much lower doses. It contains no estrogen, it provides a hostile environment for the sperm and inhibits implantation of a fertilized egg in the uterus.

condom A thin sheath usually made of synthetic material or lamb intestine which is rolled over and down the shaft of an erect penis or inserted inside the vagina before intercourse. When the man ejaculates, the sperm are caught inside the condom. It is the only contraceptive that prevents STI infection.

Intrauterine device (IUD) A small plastic object inserted by a physician into the woman’s uterus through the vagina and cervix. They have two threads hanging down into the vagina so that the woman can feel them and check regularly that the device is in place. The IUD works by preventing implantation of the fertilized egg on the uterine wall, by stimulating the entry of white blood cells into the uterus which attack and destroy “invading cells” (fertilized egg) and also by mechanically dislodging the fertilized egg from the uterine wall

Side effects Cramps, excessive menstrual bleeding and irregular bleeding or spotting between menstrual periods. Though it does not interfere with the normal hormonal balances of the body, it allows conception and then destroys the fertilized egg, which is morally repugnant to some people.

diaphragm A shallow rubber dome attached to a flexible circular steel spring. It covers the cervix and prevents sperm from moving beyond the vagina into the uterus. It is used with spermicidal jelly or cream. The diaphragm does not interfere with the woman’s hormonal system and has few side effects.

Cervical cap Vaginal spermicides A small rubber or plastic cap that fits over the cervix and is held in place by suction. It blocks sperm from entering the cervix . Vaginal spermicides The spermicidal foam contains chemicals that kill the sperm. The foam must be applied near the cervix no more than 20 minutes before intercourse and each time intercourse is repeated, more foam must be applied. The side effects include allergic reactions in some men and women, it is messy and it’s taste repugnant to oral sex.

Rhythm method This method is based on the premise that fertilization cannot occur unless live sperm are present when the egg is in the fallopian tubes. Women who use this method must know their time of ovulation and avoid intercourse just before, during and after that time. There are three ways of predicting the presumed safe period,

Calendar method – to predict when the egg is ready to be fertilized, the woman keeps the length of her menstrual cycles for 8 months. She then calculates her fertile period by subtracting 18 days from the shortest cycle and 11 days from the longest. The resulting figures indicate the range of her fertility period. It is during this time she should avoid intercourse. Disadvantage – the woman may ovulate at a different date from the previous month, and the sperm may live long enough to meet the next egg in the fallopian tube.

Basal body temperature method It is based upon temperature changes that occur in the woman’s body shortly after ovulation. BBT is the temperature of the body at rest upon waking in the morning. To establish her BBT, a woman must check her temperature for 3 months. Intercourse must be avoided from the time the woman’s temperature drops unit her temperature has remained elevated for 3 days.

Other methods of contraception Withdrawal method – coitus interruptus Douching – rinsing or cleansing of the vagina to remove sperms Post - coital contraception – morning after pill – contains high levels of estrogen to prevent implantation of the fertilized egg on the uterine wall. Sterilization- a surgical procedure that permanently prevents the capacity of either gender to reproduce.

Female sterilization Male sterilization Hysterectomy - removal of ovaries or uterus Salpingectomy- tubal ligation – a part of each fallopian tube is cut out, and the ends are tied. Male sterilization vasectomy – each vas deference (sperm carrying ducts) are cut out and tied closed sperm are still produced, in the testicles, but since there is no conduit to the penis, they remain in the testicles and dissolve. It does not affect a man’s desire for sex, ability to have an erection or orgasm, or the amount of ejaculate.

ABORTION This is the removal of the fetus from the woman’s uterus early in pregnancy before it can survive on it’s own. Most of the women who procure abortions are single women, teenage girls, widows and divorced women. There are two types: Spontaneous abortion – occurs naturally could be because of abnormalities in the reproductive system Induced abortion – forceful extraction of fetus

Methods of inducing abortion Vacuum curettage – a hollow plastic rod attached to a vacuum aspirator is inserted into the uterus. The device draws the fetal tissue and surrounding matter out of the uterus. Saline injection – when a fetus is too large, a long needle containing a concentrated salt solution is inserted through the abdominal and uterine walls into the amniotic cavity, this kills the fetus. After 6-48 hours, the uterus contracts until the fetus is pushed out into the vagina. Hysterotomy – a caesarean section in which the uterine wall is cut and the fetus taken out.