1. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Fourteen Managing Your Fertility

2. © 2007 McGraw-Hill Higher Education. All rights reserved. Birth Control vs. Contraception Birth control refers to all procedures (umbrella term) Birth control refers to all procedures (umbrella term) Contraception procedures are used to decrease chances of fertilization of an ovum (more specific) Contraception procedures are used to decrease chances of fertilization of an ovum (more specific)

3. © 2007 McGraw-Hill Higher Education. All rights reserved. Selecting Your Contraception Method Safety Safety Effectiveness Effectiveness Reliability Reliability Reversible Reversible Affordability Affordability Ease of use Ease of use Interference with sexual expression Interference with sexual expression

4. © 2007 McGraw-Hill Higher Education. All rights reserved. Current Birth Control Methods Method Theoretical Effectivenes s No method 15% Withdrawal96% Periodic abstinence 91-99% Cervical cap 91% Spermicide94% Diaphragm with spermicide 94% Male condom 97% Male condom with spermicide 99% Female condom 95%

5. © 2007 McGraw-Hill Higher Education. All rights reserved. Current Birth Control Methods (cont’d) Method Theoretical Effectivenes s IUD, copper / progestin 99%+ / 98% Combined pill 99%+ Minipill99%+ Depo-Provera (3 month) 99%+ Lunelle (1 month) 99%+ Contraceptive Ring 99%+ Tubal ligation 99%+ Vasectomy99%+ Contraceptive Patch 99%+

6. © 2007 McGraw-Hill Higher Education. All rights reserved. Periodic Abstinence Figure 14-1

7. © 2007 McGraw-Hill Higher Education. All rights reserved. Vaginal Spermicide Spermicide- chemical capable of killing sperm.

8. © 2007 McGraw-Hill Higher Education. All rights reserved. Condoms Offers substantial protection against STD’s Offers substantial protection against STD’s Nonoxynol-9 may increase disease transmission Nonoxynol-9 may increase disease transmission Male and female types Male and female types Latex vs. Polyurethane Latex vs. Polyurethane

9. © 2007 McGraw-Hill Higher Education. All rights reserved. Birth Control Pills- Contain synthetic hormones; do not provide protection against STD’s

10. © 2007 McGraw-Hill Higher Education. All rights reserved. Cervical Cap Small, thimble-shaped device that fits over the entire cervix; 1/3 full of spermicide

11. © 2007 McGraw-Hill Higher Education. All rights reserved. Emergency Contraception Measure used to prevent pregnancy within 5 days of unprotected intercourse Measure used to prevent pregnancy within 5 days of unprotected intercourse Called post-coital or “morning after” contraception Called post-coital or “morning after” contraception Need prescription from M.D. in most states Need prescription from M.D. in most states Side effects Side effects

12. © 2007 McGraw-Hill Higher Education. All rights reserved. Sterilization generally considered an irreversible procedure Vasectomy – separating vas deferens Vasectomy – separating vas deferens Tubal ligation – separating fallopian tubes Tubal ligation – separating fallopian tubes

13. © 2007 McGraw-Hill Higher Education. All rights reserved. Abortion – Termination of a Pregnancy First trimester procedures First trimester procedures Vacuum aspirationVacuum aspiration Manual vacuum aspirationManual vacuum aspiration Dilation and curettage (D&C)Dilation and curettage (D&C) Medication abortionMedication abortion Mifepristone (RU-486) Mifepristone (RU-486) Methotrexate Methotrexate

14. © 2007 McGraw-Hill Higher Education. All rights reserved. Abortion Abortion Second trimester procedures Second trimester procedures Dilation and evacuation (D&E)Dilation and evacuation (D&E) Hypertonic saline procedureHypertonic saline procedure Prostaglandin procedureProstaglandin procedure Third trimester procedures Third trimester procedures HysterotomyHysterotomy HysterectomyHysterectomy

15. © 2007 McGraw-Hill Higher Education. All rights reserved. Pregnancy Obstacles to fertilization Obstacles to fertilization Acid levels in vaginaAcid levels in vagina Thickening of cervical mucusThickening of cervical mucus Location of cervical opening for spermLocation of cervical opening for sperm Location of current fallopian tube for spermLocation of current fallopian tube for sperm Distance for spermDistance for sperm Movement of sperm “upstream”Movement of sperm “upstream” Location of egg due to contoured folds of tubal wallsLocation of egg due to contoured folds of tubal walls

16. © 2007 McGraw-Hill Higher Education. All rights reserved. Pregnancy (cont’d) Aids to fertilization Aids to fertilization Number of spermNumber of sperm Deposition of spermDeposition of sperm Accessory gland productionAccessory gland production Uterine contractionsUterine contractions Movement of spermMovement of sperm Life of spermLife of sperm Consistency of mucusConsistency of mucus

17. © 2007 McGraw-Hill Higher Education. All rights reserved. Pregnancy (cont’d) Figure 14-7

18. © 2007 McGraw-Hill Higher Education. All rights reserved. Signs of Pregnancy [Probable signs] Frequency of urination Frequency of urination Increased size of abdomen Increased size of abdomen Cervix becomes softer Cervix becomes softer Positive pregnancy test HCG Positive pregnancy test HCG

19. © 2007 McGraw-Hill Higher Education. All rights reserved. Childbirth Stage 1 – E ffacement and dilation of the cervix Stage 1 – E ffacement and dilation of the cervix Stage 2 – Delivery of fetus Stage 2 – Delivery of fetus Stage 3 – Delivery of afterbirth (placenta) Stage 3 – Delivery of afterbirth (placenta)

20. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Fourteen Managing Your Fertility