1. Chapter 10 Elizabeth Lytle, MPH, BSN, RN Los Altos School District Reproductive Choices

2. Topics Of Focus For Reproduction Conception Process Birth Control Considerations Available methods Abortion Types and method Pregnancy and Birth Process of pregnancy and birth

3. Idea Of Conception Is Simple SpermEgg Infant

4. But, Process Of Conception Is Complicated Some things that must happen before conception: Spermatogenesis Creation of sperm in male Egg Release Every month, woman releases an egg into the fallopian tubes and it travels to uterus Fertilization Sperm must travel from vagina, through uterus and up fallopian tube to fertilize egg

5. More Components To Successful Conception After the egg has taken the sperm into its nucleus: Cell Division Zygote, fertilized egg, divides to form blastocyst Implantation Blastocyst burrows into endometrium of uterus

6. Contraception Can Prevent Conception When choosing contraceptive method, consider these factors with your partner  Effectiveness  Suitability  Side effects  Safety  Future fertility  Reduced risk of sexually transmitted infections

7. Abstinence Or Outercourse As Contraception Abstinence Abstain from vaginal intercourse and sexual activity that could result in conception Outercourse Kissing, hugging, sensual touching, mutual masturbation Nearly 100 percent effective, but if man ejaculates near vagina, sperm can swim up and fertilize egg Female health benefits – Less likely to get STI, suffer infertility or develop cervical cancer

8. Overview Of Birth Control Methods

9. Coitus Interruptus Is Not A Reliable Method Failure Rate 30 pregnancies per 100 women To Consider Half of men find it unsatisfactory Fluid can be released prior to ejaculation causing pregnancy or HIV infection

10. Many Nonprescription Barriers Available Condoms Male & Female Spermicide Suppos- itory Gel Sponge Film

11. Condom Effectiveness Is 80-85 Percent Reasons for Failure Primary reason: Not using condom every time Careless removal Allowing genital contact before placement Breakage To Consider Not 100% effective STI protection Some men experience erectile dysfunction

12. Sponge Is Another Barrier Method Failure Rate 15-25 pregnancies per 100 women To Consider Not reliable protection against STI Must remain in place for 6 hours after intercourse May be less effective in women who have had children

13. Vaginal Spermicides And Film Failure Rate Varies with method Suppositories 10-25% failure Film with condom 100% effective To Consider Must apply new film or spermicide before every intercourse Women should shower, not bathe, after sex Must follow directions

14. Prescription Barriers For Women Diaphragm Cervical Cap FemCap

15. Female Barriers Do Not Protect Against STI Failure Rate 95-98 percent effective when used with spermicide Cervical Cap Must remain in place 6 hours after intercourse Must reapply spermicide for each intercourse Not effective without spermicide

16. Hormonal Contraceptives For Women Must Use Consistently Oral Contraceptives ImplantPatch Ring Injection

17. Oral Contraceptives Failure Rate 2-5 pregnancies per 100 women To Consider Does not protect from STI Must be taken at the same time daily Antibiotics reduce effectiveness Should have tests before beginning: Blood pressure Blood work and urine sample Breast and pelvic exam

18. The Patch Provides Hormones Through Skin Failure Rate 1-5 pregnancies per 100 women To Consider Does not protect from STI Risk of blood clot 2 times higher than oral contraceptive Must apply new patch every week And check that patch is still in place every day

19. Vaginal Ring Has Fewer Side Effects Failure Rate 2-8 pregnancies per 100 women To Consider Does not protect from STI Must replace within 3 hours if it pops out Not effective if use oil-based vaginal medications

20. Injection Provides 3 Months of Contraception Failure Rate 2-8 pregnancies per 100 women To Consider Does not protect from STI Triples the risk for chlamydia and gonorrhea Not recommended for more than 2 year use because of bone effects Delayed return of fertility

21. Implant Provides 3 Years Of Contraception Failure Rate 99% effective To Consider No protection from STI Causes changes in appetite and sex drive May cause depression and ovarian cysts

22. Five Years Of Contraception With IUD Failure Rate Less than 1 pregnancy per 100 women To Consider No protection from STI Provides 5 years of contraception Should check monthly for string May take up to 1 year for fertility to return after removal

23. Fertility Awareness Methods Failure Rate 15 - 25 pregnancies per 100 women To Consider No protection from STI Must abstain or use contraception 8-11 days/ month May not work for women with irregular cycles Takes planning and scheduling

24. Emergency Contraception Is Safe Success Rate Reduces pregnancy risk by 89% if taken within 5 days of unprotected sex To Consider Does not require prescription No protection from STI Must be taken no later than 120 hours after intercourse No effect once pregnancy is established

25. Male And Female Sterilization Failure Rate Less than 1 pregnancy per 100 women To Consider No protection against STI Must use another form of birth control for 3 months after procedure Procedure is permanent

26. Abortion – A controversial method Types of Abortion  Medical abortion – medication induces labor  Suction curettage – laminaria inserted and uterine contents drawn out  Dilation and evacuation – 2 nd trimester, open cervix and remove fetus Complications Nausea, vomiting, diarrhea Excessive bleeding Possible shock and death (2 nd trimester)

27. Prepare For Pregnancy Preconception care is important for health of mother and baby. Diet, alcohol, drugs, smoking, illness, infection and exposure to toxins can all affect a pregnancy and birth Preconception care is important for health of mother and baby. Diet, alcohol, drugs, smoking, illness, infection and exposure to toxins can all affect a pregnancy and birth

28. Pregnancy Changes A Woman’s Body Pregnancy lasts for 40 weeks, divided into 3- month trimesters Changes Milk glands and ducts in breasts change Growing uterus pushes on bladder Skin stretches Internal organs shift

29. Pre-pregnancy Care Reduces Complications Complication Frequency Premature Labor 10% Recognize signs of labor and get help Genetic Disorders Varies Genetic testing before pregnancy Infections Varies Vaccinate for rubella STI testing Miscarriage 10-20% Check for genetic cause Ectopic Pregnancy 2% STI testing

30. Stages Of Labor Process 1. Latent Phase Contractions last 15-30 seconds and occur 15-20 minutes apart Usually not uncomfortable 2. 2 nd Stage Strong contractions last 60-90 seconds Cervix completely dilated Baby moves into vagina and out of mother’s body 3.3 rd Stage Uterus expels placenta