1. Copyright Atomic Dog Publishing, 2004 Chapter Eleven Contraception and Birth Control

2. Copyright Atomic Dog Publishing, 2004 Factors Influencing Contraceptive Choice and Use - 2 Affordability  Affordability is an important consideration. Choosing a Method  Protection against pregnancy/STDs  Cost  Comfort  Convenience  Psychological reaction

3. Copyright Atomic Dog Publishing, 2004 Factors Influencing Contraceptive Choice and Use - 1 Psychological Factors  Emotional responses to sexual topics (erotophobia/ erotophilia)  Embarrassment about discussing birth control Relationship Factors  Joint decisions  Power dynamics

4. Copyright Atomic Dog Publishing, 2004 Contraception - 1 Hormonal Methods  Oral Contraceptive Agents (Birth Control Pill)  Norplant ®  Jadelle ®  Implanon ®  Depo-Provera ®  Vaginal Rings  Transdermal Applications  Male Hormonal Methods Barrier Methods  Male Condom  Female Condom  Vaginal Spermicides  Contraceptive Sponge  Intrauterine Device (IUD)  Diaphragm  Cervical Cap

5. Copyright Atomic Dog Publishing, 2004 Contraception - 2 Natural Family Planning Methods  Calendar Method  Basal Body Temperature (BBT) Method  Cervical Mucus Method  Hormone-in-Urine Method Nonmethods: Withdrawal and Douching Coitus interruptus/Withdrawal The practice in which the man withdraws his penis from the vagina before he ejaculates. Although some women believe that douching is an effective form of contraception, it is not.

6. Copyright Atomic Dog Publishing, 2004 Contraception - 3 Emergency Contraception  Combined Estrogen-Progesterone  Postcoital IUD Insertion Effectiveness of Various Contraceptive Choices The obvious and most effective form of birth control: abstinence. Its cost is the lowest, it is 100% effective for pregnancy prevention, and it also eliminates the risk of HIV and STDs from intercourse.

7. Copyright Atomic Dog Publishing, 2004 Contraception - 4 How to Put on a Condom

8. Copyright Atomic Dog Publishing, 2004 Contraception - 5 The Female Condom

9. Copyright Atomic Dog Publishing, 2004 Contraception - 6 Vaginal Spermicides

10. Copyright Atomic Dog Publishing, 2004 Contraception - 7 The IUD, as It Is Inserted by a Health-Care Practitioner

11. Copyright Atomic Dog Publishing, 2004 Contraception - 8 The Diaphragm

12. Copyright Atomic Dog Publishing, 2004 Sterilization - 1 Female Sterilization Oophorectomy Surgical removal of the ovaries Hysterectomy Surgical removal of the uterus Salpingectomy Tubal ligation or “tying of the tubes” sterilization procedure In which the woman’s Fallopian tubes are cut out and the ends are tied, clamped, or cauterized so that eggs cannot pass down the fallopian tubes to be fertilized.

13. Copyright Atomic Dog Publishing, 2004 Sterilization - 2 Male Sterilization Vasectomy A minor surgical procedure whereby the vas deferens are cut so as to prevent sperm from entering the penis. The procedure takes about 15 minutes and costs about $800.

14. Copyright Atomic Dog Publishing, 2004 Sterilization - 3 Female Sterilization: Tubal Sterilization

15. Copyright Atomic Dog Publishing, 2004 Sterilization - 4 Male Sterilization: Vasectomy

16. Copyright Atomic Dog Publishing, 2004 Abortion - 1 Induced abortion: deliberate termination of a pregnancy using chemical or surgical methods Spontaneous abortion (miscarriage): unintended termination of a pregnancy

17. Copyright Atomic Dog Publishing, 2004 Abortion in the United States - 1 Incidence of Abortion  Compared to 1990, the numbers of abortions per 1,000 women aged 15–44 and per 1,000 live births have dropped.  In 2006, there were 1.3 million abortions.  Approximately 40% of women who became pregnant unintentionally had abortions.

18. Copyright Atomic Dog Publishing, 2004 Methods of Abortion -1 Suction Curettage/Vacuum Aspiration Abortion procedure performed the first 6 to 8 weeks of pregnancy in which a hollow plastic rod is inserted into the woman’s uterus to evacuate the fetal tissue.

19. Copyright Atomic Dog Publishing, 2004 Methods of Abortion - 2 Suction Curettage

20. Copyright Atomic Dog Publishing, 2004 Methods of Abortion - 3 Dilation and suction (D&S) Abortion procedure during the first 12 weeks in which the cervix is dilated before the suction procedure occurs. Dilation and curettage (D&C) Abortion procedure in which a metal surgical instrument is used to scrape any remaining fetal tissue and placenta from the uterine walls after suctioning the contents of the uterus.

21. Copyright Atomic Dog Publishing, 2004 Methods of Abortion - 4 Dilation and Evacuation (D&E) Abortion procedure during the second trimester (13 to 24 weeks’ gestation) in which the cervix is dilated and the fetal parts inside are dismembered so they can be suctioned. Intact Dilation and Extraction (D&X) Also Partial Birth Abortion Abortion procedure involving breech delivery of fetus, except for the head, partial evacuation of the brain, resulting in the vaginal delivery of a dead fetus.

22. Copyright Atomic Dog Publishing, 2004 Methods of Abortion - 5 How Early Medical Abortion Works

23. Copyright Atomic Dog Publishing, 2004 Methods of Abortion - 6 Induced Abortions Abortion method used late in the second trimester that involves inducing premature labor by injecting either saline or prostaglandins through the abdomen into the amniotic sac. Pharmaceutical Abortion/Medical Abortion The intentional termination of pregnancy through the use of pharmaceutical drugs. RU-486: Mifepristone sold as Mifeprex

24. Copyright Atomic Dog Publishing, 2004 Abortion Legislation in the United States - 1 Historical Background of Abortion Legislation In the Colonial United States, abortion was neither prohibited nor uncommon. The legal control of abortion by statute began in 1821. Roe v. Wade: A Landmark Decision (1973) Supreme Court decision that during the first three months of pregnancy, the decision to have an abortion would be between the woman and her physician.

25. Copyright Atomic Dog Publishing, 2004 Abortion Legislation in the United States - 2 Abortion Legislation Since Roe v. Wade  Planned Parenthood of Central Missouri v. Danforth (1976)  The first of the Hyde amendments was passed (1976)  Bellotti v. Baird (1979)  Rust v. Sullivan (1991)  Planned Parenthood v. Casey (1992)  Stenberg v. Carhart (2000)  Ayotte v. Planned Parenthood (verdict expected in 2006)

26. Copyright Atomic Dog Publishing, 2004 Attitudes Toward Abortion Private Attitudes Toward Abortion Although the “nation is deeply divided over the issue of abortion”, the majority of U.S. adults favor legal availability of abortion. Advocacy Groups: Pro-Life, Pro-Choice, and Pro- Dialogue  Pro-life groups advocate a complete ban on abortion.  Pro-choice advocates support the legal availability of abortion for all women.  Pro-dialogue advocates refer to those who seek to explore and focus on concerns that are common to both pro-life and pro-choice advocates.

27. Copyright Atomic Dog Publishing, 2004 Physical and Psychological Effects of Abortion - 1 Physical Effects of Abortion  Rates of Mortality and Complications  Long-Term Effects  Effects of Legal Restrictions on Physical Consequences Psychological Effects of Abortion  Post-abortion syndrome (PAS): Refers to symptoms following abortion such as depression, anxiety, shame, lowered self-esteem, uncontrollable crying, eating disorders, and relationship problems.

28. Copyright Atomic Dog Publishing, 2004 Physical and Psychological Effects of Abortion - 2 Personal Choices: Deciding Whether to Have an Abortion  Consider all the alternatives available to you.  Obtain information about each alternative course of action.  Talk with trusted family members, friends, or unbiased counselors.  Consider your own personal and moral commitments in life.

29. Copyright Atomic Dog Publishing, 2004 The Real Challenge: Reducing the Need for Abortion - 1 Steps to Meeting the Challenge: Create laws and policies that demonstrate concern for both women and the value of developing life. Support research for better male and female contraceptives. Encourage men to share the responsibility for birth control. Promote greater sexual responsibility among men. Involve schools, churches, community organizations, and pro-life and pro-choice groups in helping parents talk with their children about sex and sexual responsibility.

30. Copyright Atomic Dog Publishing, 2004 The Real Challenge: Reducing the Need for Abortion - 2 Provide education to children about the responsibilities of sexuality and parenthood. Implement social policies and services to ease negative family experiences that are related to early sexual activity. Encourage more teenage role models to counsel their peers against early sexual activity and birth control misuse. Encourage popular media role models to convey the message that abstinence is okay. Help women proceed with pregnancies they may want to continue through social policies.