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Chapter Eleven
Contraception and Birth
Control
Copyright Atomic Dog Publishing, 2004
Factors Influencing Contraceptive Choice
and Use - 2
• Affordability
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Affordability is an important consideration.
• Choosing a Method
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Protection against pregnancy/STDs
Cost
Comfort
Convenience
Psychological reaction
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Factors Influencing Contraceptive
Choice and Use - 1
• Psychological Factors
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Emotional responses to sexual topics (erotophobia/
erotophilia)
Embarrassment about discussing birth control
• Relationship Factors
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Joint decisions
Power dynamics
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Contraception - 1
• Hormonal Methods
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Oral Contraceptive
Agents (Birth Control Pill)
Norplant®
Jadelle®
Implanon®
Depo-Provera®
Vaginal Rings
Transdermal Applications
Male Hormonal Methods
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• Barrier Methods
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Male Condom
Female Condom
Vaginal Spermicides
Contraceptive Sponge
Intrauterine Device (IUD)
Diaphragm
Cervical Cap
Contraception - 2
• Natural Family Planning Methods
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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.
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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.
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Contraception - 4
• How to Put on a Condom
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Contraception - 5
• The Female Condom
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Contraception - 6
• Vaginal Spermicides
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Contraception - 7
• The IUD, as It Is Inserted by a Health-Care
Practitioner
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Contraception - 8
• The Diaphragm
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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.
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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.
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Sterilization - 3
• Female Sterilization: Tubal Sterilization
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Sterilization - 4
• Male Sterilization: Vasectomy
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Abortion - 1
• Induced abortion: deliberate termination of a
pregnancy using chemical or surgical methods
• Spontaneous abortion (miscarriage): unintended
termination of a pregnancy
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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.
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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.
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Methods of Abortion - 2
• Suction Curettage
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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.
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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.
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Methods of Abortion - 5
• How Early Medical Abortion Works
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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
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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.
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Abortion Legislation in the United
States - 2
• Abortion Legislation Since Roe v. Wade
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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)
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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 ProDialogue
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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.
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Physical and Psychological Effects
of Abortion - 1
• Physical Effects of Abortion
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Rates of Mortality and Complications
Long-Term Effects
Effects of Legal Restrictions on Physical Consequences
• Psychological Effects of Abortion
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Post-abortion syndrome (PAS): Refers to symptoms
following abortion such as depression, anxiety, shame,
lowered self-esteem, uncontrollable crying, eating disorders,
and relationship problems.
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Physical and Psychological Effects
of Abortion - 2
• Personal Choices: Deciding Whether to Have an
Abortion
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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.
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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.
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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.
Copyright Atomic Dog Publishing, 2004