Family Planning 101: Key Concepts in Adolescent Health Care April 2010 Meera Beharry, MD Division of Adolescent Medicine University of Rochester Medical Center ACT for Youth Center of Excellence Cornell University Family Life Development Center Cornell University Cooperative Extension of New York City New York State Center for School Safety University of Rochester Medical Center Div. of Adolescent Medicine

Objectives Define family planning Describe methods of contraception Identify resources for adolescents

Family Planning The use of education and birth control to limit the number of offspring and the population of a country. American Heritage® New Dictionary of Cultural Literacy, 3rdEd, 2005 by Houghton Mifflin Company

Legal Issues Distributing information and counseling patients about contraception was illegal under federal and state laws. AP Margaret Sanger, 1914

US fertility rates: and Key Family Planning Events MMWR, Dec 03, (47); Birth Control Pills, IUD approved by FDA Timing of ovulation established Title X established

Myriad of Methods Ring Implant Diaphragm Injection (“shot”) Patch IUD Pills Condoms Abstinence Cap Spermicides

How do you choose?

Decision 1 Hormonal, Non-hormonal or both?

Non-Hormonal/Barrier Condoms

Non-Hormonal/Barrier Condoms Diaphragm Cervical Cap Diaphragm Cervical Cap Spermicide Spermicides

Non-Hormonal/Barrier Condoms Diaphragm Cervical Cap Copper IUD

Non-Hormonal/Barrier Condoms Diaphragm Cervical Cap Spermicide Copper IUD Abstinence 1 Period abstinence/fertility awareness 1 “Withdrawal”, coitus interruptus 1 Society for Adolescent Med., J Adolesc Health 2006;38:83–87

Hormonal Pill –Daily –Emergency (not recommended as a regular form of birth control)

Hormonal Pill Patch

Hormonal Pill Patch Injection

Hormonal Pill Patch Injection Ring

Hormonal Pill Patch Injection Ring Progesterone IUD IUD

Hormonal Pill Patch Injection Ring Progesterone IUD Implantable device

Advantages/Disadvantages

Non-Hormonal/Barrier Advantages No hormones Fewer or no medical contraindications* Can prevent STD Disadvantages Event based use Some need a doctor’s visit

Hormonal Advantages Not event dependent Additional health benefits –Menstrual symptoms –Acne –Lower cancer risk –Less blood loss Disadvantages Require use as prescribed Some medical contraindications

Quick Quiz Does a young woman need to have a pelvic exam before starting birth control?

NO!

Decision 2: if hormonal method Any contraindications?

W.H.O. Absolute Contraindications to Estrogen Containing Products Blood clotting problems Stroke Very high blood pressure Some cancers Some liver diseases Major surgery with prolonger immobilization Migraine headaches with aura

Decision 3: if hormonal method, How often do you take it?

How Often Do You Take It? MethodFrequency PillsEvery day

How Often Do You Take It? MethodFrequency PillsEvery day PatchOnce a week

How Often Do You Take It? MethodFrequency PillsEvery day PatchOnce a week RingOnce a month

How Often Do You Take It? MethodFrequency PillsEvery day PatchOnce a week RingOnce a month InjectionEvery 3 months*

How Often Do You Take It? MethodFrequency PillsEvery day PatchOnce a week RingOnce a month InjectionEvery 3 months* Implant (Implanon®)Every 3 years*

How Often Do You Take It? MethodFrequency PillsEvery day PatchOnce a week RingOnce a month InjectionEvery 3 months* ImplantEvery 3 years* IUDEvery 5 years*

Quick Quiz: Match the method

Match the Frequency & the Method FrequencyMatch ColumnsMethod a) Once a month 1-Implant b) Once a week 2-Injection c) Daily 3-IUD d) Every 3 months 4-Patch e) Every 5 years 5-Pills f) Every 3 years 6-Ring

Match the Frequency & the Method FrequencyCorrect AnswerMethod a) Once a month a-61-Implant b) Once a week b-42-Injection c) Daily c-53-IUD d) Every 3 months d-24-Patch e) Every 5 years e-35-Pills f) Every 3 years f-16-Ring

Emergency Contraception

What if…. …the condom broke or slipped off... …you forgot your regular birth control... …you were forced to have sex... Association of Reproductive Health Professionals

Emergency Contraception What is it? –A method for preventing implantation –A method for preventing fertilization There are three types available in the U.S.

Association of Reproductive Health Professionals

Emergency Contraception Pills What they are not: –They are not the “abortion pill” –They are not a form of family planning

Resources Internet: – – – Current health care provider – Family Planning Benefit Program – _planning/program_sites.htm

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