1. Drawing the Line Learning About Contraception Lesson 5

2. Ground Rules To create a safe environment: Do not use put downs. Be sensitive to others. You have the right to privacy/confidentiality. Use correct terminology. Do not divulge private information. There are no dumb questions. Talk to your parents for more information.

3. Introduction This lesson will focus on contraceptive methods that are used by young people. California law allows anyone to purchase contraception, regardless of age. Contraception, or preventing pregnancy, is not something that happens automatically. We will review the contraceptive process so you can see what is involved.

4. The Contraceptive Process Using contraception is a learning process that includes the following steps: Acknowledge desire or intention to be sexually active (sex doesn’t just happen). Recognize the possibility of pregnancy and STDs. Talk about and plan methods of prevention. Obtain a contraceptive method for personal use. Keep the contraceptive available. Use method correctly and consistently.

5. Methods of Contraception Contraceptive methods fall into three categories: – –Abstinence – –Barrier Methods – –Hormonal Methods Each method has an effectiveness rate that tells how well it can work when used correctly. The best contraceptive method is the one that you will use consistently and correctly.

6. Abstinence Abstinence means not having oral, vaginal or anal sex or any genital touching. Abstinence always prevents pregnancy and protects against STDs and HIV. Plans for remaining abstinent should be discussed with your partner in advance.

7. Following Through with Abstinence Abstinence is the most effective way to prevent pregnancy and protect against HIV and STDs, and it is available to everyone. Here are some ways to plan for abstinence: 1. 1.Talk with your partner. 2. 2.Discuss different ways to show affection. 3. 3.Find activities you can do with other couples. 4. 4.Stay away from alcohol and drugs.

8. Condoms A sheath of latex, synthetic material or lambskin that covers the penis and prevents sperm from fertilizing an egg If lubricated with spermicide, immobilizes sperm Available without a prescription at drugstores or clinics 82–98% effective at preventing pregnancy when used during each act of intercourse Latex and synthetic material condoms may prevent transmission of many STDs and HIV Lambskin condoms may not provide protection against STDs and HIV Barrier Methods

9. 1. 1.Use a new latex condom for each new act of anal, oral or vaginal sex. 2. 2.Put the condom on as soon as the penis is erect and before any contact with the vagina, anus or mouth. 3. 3.Hold the tip of the condom and unroll it to the base of the penis. 4. 4.Leave a half-inch at the tip of the condom for the ejaculate; squeeze the tip to make sure that no air is trapped in the condom. 5. 5.Use only water-based lubricants. Lotions and oils can cause the condom material to disintegrate and tear. 6. 6.Immediately after ejaculation, withdraw the penis, holding the condom firmly at the base to avoid it slipping off or spilling. 7. 7.Remove the condom from the penis away from partner. 8. 8.Never use two condoms at the same time. Correct Condom Use

10. Barrier Methods Female Condoms A plastic sheath with rings at both ends that is inserted into the vagina Prevent sperm from fertilizing an egg Available without a prescription at drugstores or clinics 79–95% effective at preventing pregnancy May prevent transmission of many STDs and HIV

11. 11 Barrier Methods Dental Dams A thin sheet of latex originally used for dental procedures Can be used to protect mucosa during oral sex Available without a prescription at drugstores or clinics Not a birth control method, but used to prevent transmission of STDs and HIV

12. Barrier Methods Spermicides Intended as a supplement to barrier contraceptives. Products such as foam, gel or film that contain chemicals that kill sperm Available without a prescription at drugstores or clinics Increases effectiveness of male and female condoms 72–82% effective at preventing pregnancy when used alone

13. Hormonal Methods Birth Control Pills Taken daily and may contain the hormones estrogen and progestin while others are progestin-only Prevents the release of an egg or prevents sperm from joining egg Available by prescription 91–99% effective at preventing pregnancy

14. Hormonal Methods Patch Thin plastic patch placed on the buttocks, stomach, upper outer arm, or upper torso once a week for three out of four weeks Combined hormones prevent the release of an egg Available by prescription 91–99% effective at preventing pregnancy

15. 15 Hormonal Methods Vaginal Ring Small, flexible ring that is inserted into the vagina and remains there for three out of four weeks Releases synthetic hormones to prevent pregnancy Available by prescription 91–99% effective at preventing pregnancy

16. 16 Hormonal Methods Injection Shot of the hormone progestin given in the arm or buttocks every 12 weeks by doctor Prevents sperm from joining the egg, or may prevent release of egg Available by prescription 94–99 % effective at preventing pregnancy

17. 17 Hormonal Methods Implants Soft, thin rod placed under the skin by a doctor Lasts up to three years Releases synthetic hormones to prevent pregnancy Available by prescription 99% effective at preventing pregnancy

18. Intrauterine Contraception A type of Hormonal Method of contraception. Prevents sperm from fertilizing an egg or stops egg from attaching to uterus. Copper T Intrauterine Device (IUD) – –T-shaped device inserted into uterus by doctor – –Remains in place up to 10 years – –99% effective at preventing pregnancy Levonorgestrel Intrauterine System (IUS) – –T-shaped device inserted into uterus by doctor – –Releases progestin each day – –Remains in place up to 5 years – –99% effective at preventing pregnancy – –One brand name is Mirena ©

19. Emergency Contraception (E.C.) Prevents pregnancy after unprotected sex, or when birth control fails. Does not work if someone is already pregnant; does not harm fetus. Prevents fertilized egg from being released, or attaching to uterine lining. Can be taken up to 3 days (72 hours) after unprotected sex. Available at clinics or pharmacies: – –Plan B One-Step is a brand of E.C. available without a prescription for women of all ages (updated 11/12/13). – –If you are under 15 years, you may need a prescription for other brands. – –Call 888-NOT2LATE for where to find over-the-counter E.C.

20. Protection from STDs and HIV Hormonal and intrauterine methods of contraception DO NOT offer protection against STDs, including HIV. Using a condom with these methods can reduce the risk of pregnancy and contracting STDs.

21. CONTRACEPTION COMPARISON CHART MethodDescriptionEffectiveness Length of Protection Protection Against STDs Abstinence Not having intercourse100%ContinuousYES Condom Latex or polyurethane sheath that covers the penis 82–98%One sex actYES Female Condom Polyurethane tube with flexible ring that fits the cervix 79–95%One sex actYES Spermicide Foams, jellies, films inserted into vagina 72–82%Up to 24 hoursNO Pills Hormones taken daily (prescription) 91–99%1 monthNO Patch Hormone patch placed on skin for 3 weeks (prescription) 91–99%1 weekNO Ring Hormone ring inserted in vagina for 3 weeks (prescription) 91–99%1 monthNO Injections Progestin shot given every 12 weeks (prescription) 94–99%3 monthsNO Implants Hormone rods place under skin for 3 years (prescription) 99%3 yearsNO Intrauterine Implanted into uterus by a doctor 99%IUD 10 yrs.; IUS 5 yrs.NO

22. Contraception Summary If you are not practicing abstinence, the best method of birth control is one that you will use consistently and correctly. Students of any age can obtain confidential reproductive health care, including condoms, without parental consent or notification. Students can arrange with the School Nurse to be released during school hours to attend confidential appointments.

23. Safely Surrendered Baby Law Parent or legal guardian can surrender a newborn within the first 72 hours of birth to a person at a designated “safe surrender site” such as a hospital or fire department. Parent may claim physical custody of newborn within 14 days of surrender. More Information: (877) 725-5111 or http://www.babysafe.ca.gov/ http://www.babysafe.ca.gov/

24. Discussion Questions How does a person know when he/she is ready for sex? Why do people choose not to use contraception? Is it difficult for teens to discuss contraception with their partners? Why/why not? Where can you get information? Please refer to your YOUTH RESOURCES CARD for youth friendly resources.