1. ILLINOIS STATE UNIVERSITY DEPARTMENT OF PSYCHOLOGY
CONTRACEPTION
John B. Pryor, Ph.D.
ILLINOIS STATE UNIVERSITY
DEPARTMENT OF PSYCHOLOGY

2. Who needs contraception?
62 million U.S. women in childbearing years (15-44)
Of these 7 out of 10 are sexually active and do not want to become pregnant
Typical U.S. woman wants 2 children and therefore must use contraceptives for 3 decades of her life
Source: Alan Guttmacher Institute 2006

3. Who uses contraception?
98% of U.S. women who have had sex have used at least one form of contraception
89% of women who do not want to become pregnant are using some form of contraception
Method choice varies by age
For women younger than 30, the pill is the leading method
By the time women reach 35, sterilization is more common
Source: Alan Guttmacher Institute 2006

4. Source: Alan Guttmacher Institute 2006
Cross-sectional survey of 38,109 U.S. women
Source: Alan Guttmacher Institute 2006

5. Some facts about common forms of contraception.....

6. Methods of Birth Control - typical failure rates
0.00% - Abstinence
0.15% - Sterilization - Males
0.40% - Sterilization - Females
18.0% - Withdrawal
85.0% - No Method
Failure rates calculated from
samples of married couples:
What percent have a pregnancy
in a year using this method?

7. Depo-Provera
Depo-Provera is a synthetic hormone (progestin) that is injected into the buttock or arm every 12 weeks. The hormone keeps the ovaries from releasing eggs. It also thickens the cervical mucus. This keeps sperm from joining with an egg. For some women, their menstrual periods are suppressed.
Typical
failure
rate =
.03%

8. Nexplanon/Implanon/ Implanon NXT
Small plastic rod inserted just under the skin of a woman's upper arm that contains etonorgestrel (progestin-like hormone). Lasts up to 3 years. Inhibition of ovulation in almost all cycles as the primary mechanism of action.
Typical
failure
rate =
.05%

9. The Pill
Combined pills keep the ovaries from releasing eggs (ovulation). Mini-pills can also prevent ovulation. But they work mainly by thickening the cervical mucus. This prevents the sperm from joining with the egg. Mini-pills may also prevent fertilized eggs from implanting in the uterus.
Typical
failure
rate = 1.0-
2.0%

10. Birth Control Patch (brand name: ORTHO EVRA)
The contraceptive patch contains
hormones similar
to those in birth control pills.
You must change your patch once a week
for three consecutive weeks. You do not need
to apply a patch during the fourth week.
Typical
failure
rate = 1.0%
Possible
side effects?
More estrogen
exposure than
the pill
Blood clots

11. The Ring Typical failure rate = 1.0% .
The vaginal contraceptive ring consists of a flexible, transparent, colorless vaginal ring about 2.1 inches in diameter containing the hormones etonogestrel and ethinyl estradiol, which are similar to the active ingredients in some oral contraceptives. After the ring is inserted, it releases a continuous low dose of the hormones. A new ring is used each month for continuous contraception A woman inserts the ring herself, and it should remain in the vagina for three weeks. She then removes the ring for one week during which she will have her menstrual period. .
Typical
failure
rate = 1.0%

12. The Intrauterine Device (IUD)
IUDs are small devices made of plastic that contain copper or a natural hormone. IUDs usually work by preventing fertilization of the egg. They also may work by affecting the way sperm or eggs move or by affecting the lining of the uterus in ways that prevent implantation.
Typical
failure
rate =
.08%

13. The Condom barrier method added protection if used with spermicide
reccomended model - latex with reservoir tip
polyurethane condoms available if
you are allergic to latex
use water-based lubricants only
Typical
failure
rate = 12.0%

14. Putting on a condom Put a drop or two of lubricant inside the condom
Putting on a condom Put a drop or two of lubricant inside the condom. Place the rolled condom over the tip of the hard penis. Leave a half-inch space at the tip to collect semen. If not circumcised, pull back the foreskin before rolling on the condom.

15. Putting on a condom (continued) Pinch the air out of the tip with one hand. (Friction against air bubbles causes most condom breaks.) Unroll the condom over the penis with the other hand. Roll it all the way down to the base of the penis. Smooth out any air bubbles. Lubricate the outside of the condom.

16. Cervical Cap Diaphram The Diaphragm & Cervical Cap
Diaphragms and cervical caps are soft rubber barriers that are intended to fit securely over the cervix. Both are used with a spermicide cream or jelly. Each blocks the entrance to the uterus, and the jelly or cream immobilizes sperm, preventing it from joining the egg.
Typical failure
rate =17.0%

17. Sponge Soft polyurethane sponge containing nonoxynol 9 spermicide
Blocks path of sperm
Sponge abosorbs sperm
Spermicide kills sperm on contact
Typical failure
rate =32.0%

18. Female Condom
Typical
failure
rate = 24.8%

19. Foam, Jelly, Film, Suppository
contain spermicide
barrier method
must be reapplied for each subsequent intercourse
very frequent use could make women more susceptible to some STIs (studies of prostitutes)
Typical
failure
rate = 20.0%-50%

20. Fertility Awareness Methods
trying to predict peak fertility times & avoiding intercourse during those times
three methods of prediction
basal body temperature method
cervical mucus method
calendar or "rhythm" method
Typical
failure
rate = 20.0%

21. Breastfeeding
Breastfeeding can be used as birth control when, after giving birth, a woman breastfeeds her baby exclusively. That means the baby does not drink anything besides breast milk. The act of breastfeeding naturally changes a woman's hormones so that she does not ovulate. Effective upr to 6 mons. after a birth.
Typical
failure
rate = 1-2%

22. Emergency Contraception
Post-Coital Contraceptives
morning after pill (e.g., Preven & Plan B)
- Emergency contraception (EC) consists of the same hormones found in ordinary birth control pills.
within 72 hours of unprotected intercourse
Side-effects: nausea, vomiting, and cramping
20-25% become pregnant
Like regular contraceptive pills, Plan B generally acts by preventing ovulation or fertilization, according to the F.D.A. Plan B may in rare circumstances prevent a fertilized egg from becoming implanted, something abortion opponents decry. But regular oral contraceptives do that, too.

23. Emergency Contraception
The U.S. Food and Drug Administration (FDA) announced on August 24, 2006 the approval of Plan B as an over-the-counter (OTC) option for women aged 18 and older. Plan B will remain available as a prescription-only product for women age 17 and under.
As much as 43% of the decline in abortion between 1994 and 2000 can be attributed to the use of emergency contraception.

24. Reasons for Emergency Contraception
His condom broke or slipped off, and he ejaculated inside your vagina.
He forced you to have unprotected vaginal intercourse.
Your diaphragm or cervical cap slipped out of place, and he ejaculated inside your vagina.
You miscalculated your "safe" days for periodic abstinence or fertility awareness methods.

25. Reasons for Emergency Contraception (continued)
You forgot to take your birth control pill more than two days in a row.
You weren't using any birth control.
He didn't pull out in time.

26. RU 486
antiprogesterone that blocks uterine receptors of progesterone, a hormone critical for the maintenance of pregnancy
induces abortion when administered in early pregnancy
success rate is 96 percent for women who are less than 63 days from their last menstrual period

27. life-time failure rate
30 years of reproduction ( age 17-47)
LTF = 1 - (1 - AFR)years
LTF (pill) = 1 - ( )30
pill (2%) %
HALF OF ALL COUPLES WILL HAVE A PREGNANCY ANYWAY
ATF=annual failure rate