1. Chapter Thirteen: Managing Your Fertility
Image source: The McGraw-Hill Companies, Inc./Kirstan Price, photographer

2. Birth Control vs. Contraception
Birth control refers to all procedures and methods that can prevent the birth of a child
Contraception refers to procedures used to prevent fertilization
There are differences between the concept of birth control and contraception. Birth control is an umbrella term referring to all procedures you might use to prevent a birth of a child.
Contraception refers to a more specific concept of preventing the fertilization of an ovum.

3. Reasons for Using Birth Control
Provide financial support for children (proper timing)
Prevent having children
Reduce STD risks
Religious doctrine
Alternative lifestyle choices
Financial and legal considerations for couples
Availability of professional services

4. Theoretical Effectiveness vs. Use Effectiveness
Theoretical effectiveness: Measure of a contraceptive method’s ability to prevent a pregnancy when the method is used precisely as directed during every act of intercourse
Use effectiveness: Measure of a contraceptive method’s ability to prevent a pregnancy when used by the general public

5. Selecting Your Contraceptive Method
Considerations when choosing contraception
Safety
Effectiveness
Reliability
Reversibility
Affordability
Ease of use
Interference with sexual expression

6. Behavioral Contraceptive Methods
Abstinence
No sexual activity
100% effective
Chance
No method used
15% use effectiveness
Withdrawal (“coitus interruptus”)
Removal of penis from vagina before ejaculation
73% use effectiveness

7. Behavioral Contraceptive Methods (cont.)
Periodic abstinence (rhythm method)
Calendar (calculating the unsafe days of a women’s menstrual cycle)
Basal body temperature (rise in body temperature correlates with timing of ovulation)
Billings cervical mucus method (evaluate consistency of vaginal discharge to predict ovulation)
Symptothermal (combines basal temperature and mucus methods)
75% use effectiveness

8. Periodic Abstinence
Figure 16-1 Periodic abstinence

9. Over-the-Counter Contraceptive Methods
Spermicides
Foams
Creams
Jellies
Films
Suppositories
Condoms
Male
Female
Contraceptive sponge
Image source: The McGraw-Hill Companies, Inc./Kirstan Price, photographer

10. Over-the-Counter Contraceptive Methods
Vaginal spermicides
OTC agents that are capable of killing sperm
71% use effectiveness
Figure 16-2 Use of Spermicide

11. Over-the-Counter Contraceptive Methods (cont.)
Male condom
OTC latex shield designed to cover erect penis and retain semen upon ejaculation
85% use effectiveness
Male condom with spermicide
Latex condom in combination with spermicide
95% use effectiveness
Female condom
Polyurethane sheath inserted into the vagina
79% use effectiveness
Contraceptive sponge
Small, pillow-shaped contraceptive that contains spermicide; placed in the vagina to cover the cervical opening
84% use effectiveness

12. Use of a Male Condom Keep a supply on hand Handle condoms with care
Put condom on before genital contact
Lubricate the condom
Take care the condom is not dislodged from penis
Inspect condom for tears before discarding
Figure: Maximizing the Effectiveness of Condoms

13. Prescription Contraceptive Methods
Diaphragm
Lea’s Shield
FemCap
Intrauterine device (IUD)
Oral contraceptives
Combined pills
Minipills
Injectable contraceptive
Contraceptive implant
Contraceptive ring
Contraceptive patch
Image source: The McGraw-Hill Companies, Inc./Kirstan Price, photographer

14. Prescription Birth Control Methods
Diaphragm
Soft rubber cup that covers the cervix
Fitted by health care professional
Used with spermicide
84% use effectiveness
Lea’s Shield or FemCap
Lea’s shield: Reusable oval silicone device that covers the cervix
FemCap: Reusable hat-shaped silicone cap that covers the cervix
Use similar to diaphragm
86% use effectiveness
Intrauterine device (IUD)
T-shaped device inserted into the uterus
Medicated or unmedicated
Somehow interferes with implantation of the ovum
World’s most popular reversible contraceptive method
99%+ use effectiveness

15. Use of a Diaphragm
Figure 16-3 Use of a Diaphragm

16. Prescription Birth Control Methods (cont.)
Oral contraceptive pills
Daily pills
Estrogen works by reducing ovum development
Progesterone reduces ovulation and thickens cervical mucus
92% use effectiveness
Side effects
Tenderness in breasts
Nausea
Headaches
Spotting
Weight gain
Sex drive fluctuation
Frequent vaginal infections
Mild depression
Potential risks
Blood clots, stroke, hypertension, heart attack

18. Prescription Birth Control Methods (cont.)
Minipills
Daily pill
Low-dose progesterone
92% use effectiveness
Injectable contraceptive
Each shot effective for a 3-month period
Prevents ovulation and thickens the cervical mucus
97% use effectiveness
Contraceptive ring (NuvaRing)
Polymer device containing estrogen and progestin
Placed deep in the vagina for a 3-week period
92%+ use effectiveness
Contraceptive patch
Skin patch containing estrogen and progestin
Worn for 3 weeks, then 1 week off, then new patch

19. Prescription Birth Control Methods (cont.)
Contraceptive implant
Protection is good for 3 years
Can be used while breastfeeding
Physician must insert and remove
May cause temporary irregular bleeding
Possibility of cardiovascular problems
Use effectiveness not yet known

20. Emergency Contraception
Contraceptive measured used to prevent pregnancy within a few days of unprotected intercourse
Hormonal or IUD insertion
“Morning after” pill; not RU-486 (“abortion pill”)
Plan B available behind the pharmacy counter
Those under age 18 must have a prescription
Will not cause abortion or affect established pregnancy

21. Sterilization
Sterilization = Generally permanent birth control techniques that surgically disrupt the normal passage of ova or sperm
Vasectomy: Removal of a section of the vas deferens
Tubal ligation: Fallopian tubes are cut and the ends tied back

22. Male Sterilization: Vasectomy
Figure 16-4A Vasectomy

23. Female Sterilization: Tubal Ligation
Figure 16-4B Tubal Ligation

24. Abortion: Termination of a Pregnancy
First Trimester Procedures
Manual vacuum aspiration
Procedure performed by dilating the cervix and removing uterine contents
Dilation and suction curettage (D&C)
Procedure in which the cervical canal is dilated to allow the uterine wall to be scraped
Medication abortion
RU-486 (mifepristone) blocks the action of progesterone and causes the lining of the uterus to break down

25. Abortion: Termination of a Pregnancy (cont.)
Second Trimester Procedures
Dilation and Evacuation (D&E)
Performed between 13 and 16 weeks of pregnancy
Cervix is dilated and contents are removed by suction
Rarely used procedures
Hypertonic saline procedure
Prostaglandin procedure

26. Dilation and Evacuation
Figure 16-5 Dilation and Evaluation. The cervix is dilated and the contents of the uterus are aspirated (removed by suction). This procedure is used to perform abortions during the second trimester.

27. Abortion: Termination of a Pregnancy (cont.)
Partial-birth abortion
Federal ban
Third-trimester abortion procedures
Hysterotomy
Hysterectomy

28. Chapter Thirteen: Managing Your Fertility