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Persuasive Argument: Condoms Should Be Made Available to High School Students • Directions: Write a 5 paragraph persuasive argument concerning the above statement. All papers must include an introduction, 3 separate paragraphs that support/prove your point, and a conclusion that leaves the reader with a solid understanding of the writer’s position. Pro Choice or Pro Life 1. Where do you stand? 2. How significant is your agreement/position with the philosophy chosen in number one? - 40 (pro-choice) ---- (pro-life) + 40 Key 1. 2. 3. 4. 5. Strongly Agree Agree Mixed Feelings Disagree Strongly Disagree BMI • What is the correlation between contraception and body mass index (BMI)? Roe v. Wade • In the 1973 Roe v. Wade decision, the U.S. Supreme Court ruled that a woman, in consultation with her physician, has a constitutional right to choose abortion in the early stages of pregnancy-that is, before viability (24 weeks). Abortion Control Act • In 1982, Pennsylvania passed the Abortion Control Act. This Act required women to give: 1. Informed consent before abortions could be performed. 2. Imposed a 24-hour waiting period upon women seeking abortions, during which time the women would be provided with information regarding abortions. Abortion Control Act 3. The act also provided that minors seeking abortions first obtain informed consent from their parents, except in cases of "hardship," in which a court could waive this requirement. 4. Except in "medical emergencies," a wife seeking an abortion must inform her husband of her plans prior to the procedure. Abortion Control Act 5. Finally, the act required that all Pennsylvania abortion clinics report themselves to the state. Planned Parenthood v. Casey In 1992, Planned Parenthood of Southeastern Pennsylvania filed a lawsuit against the state, arguing that the Abortion Control Act violated the Supreme Court's ruling in Roe v. Wade. The Court upheld Roe v. Wade and a woman’s basic right to abortion. New Jersey Law • No parental involvement • No parental notification • No waiting period • Age requirement:13 years and older Medical Abortion • Abortion Pill (Medicines) that end an early pregnancy • 63 days or 9 weeks (Trimester #1) • Cost: $300.00-$800.00 • 97 % effective • In the case that the medical abortion does not work an in-clinic abortion is required Medical Abortion: Step 1 • RU-486 name under development – Mifepristone (1st pill) will be taken at a clinic as well as other antibiotics • Inhibits progesterone, which breaks down the uterine lining Medical Abortion: Step 2 Misoprostol (2nd by mouth or vaginal suppository) • Promotes uterine contractions • Will cause you to have cramps and bleed heavy • May see large blood clots or tissue at the time of the abortion Step 2 - Continued • Most women abort within 4-5 hours, but some take up to a few days. • Bleeding or spotting may continue for up to four weeks after taking the Misoprostol. Step 3 • You must have a follow up visit within two weeks. This is to make sure that the abortion is complete and you are well. An ultrasound will be completed at this time. • If you are still pregnant you may require an in-clinic abortion . In-Clinic Abortions • Medical procedure to end a pregnancy • Cost: $300-$1500 • Most common: Aspiration or Vacuum Aspiration • Up to 16 weeks In-Clinic Abortions Aspiration or Vacuum Aspiration Procedure that empties the uterus with gentle suction from a manual syringe. Sometimes a machine operated suction device is utilized. Aspiration Abortions • • • • • Uterine exam (Ultrasound) Pain medication Speculum inserted into the vagina Numbing medication for the cervix Cervix stretched with dilators – series of increasingly thick rods • Tube inserted into uterus • Suction device empties uterus Aspiration Abortion • At times a curette is used to remove any remaining tissue that lines the uterus • Time required: 10-20 minutes In-Clinic Abortions D&E Dilation and Evacuation • Sometimes referred to as a partial-birth abortion. • Partial-birth (D&E) abortions are late-term abortions of a fetus that has already died, or is killed before being completely removed from the mother In-Clinic Abortions D&E Dilation and Evacuation • Procedure used after 16 weeks of pregnancy, but usually prior to 24 weeks. • This procedure usually combines a vacuum aspiration, dilation & curettage (D&C), and the use of surgical instruments. In-Clinic Abortions D&E Dilation and Evacuation • • • • Receive antibiotics Positioned on an exam table Speculum insertion Antiseptic solution used to clean the vagina & cervix • Combination of: Pain medication, sedatives, spinal anesthesia/block or general anesthesia to make the patient unconscious. In-Clinic Abortions D&E Dilation and Evacuation • Uterus held in place with medical instruments • Dilate the cervix with probes of increasing size • Pass a hollow tube (cannula) into the uterus • Through the cannula a tube, bottle and pump are attached to provide a gentle vacuum to remove uterine tissue. This is when cramping begins. In-Clinic Abortions D&E Dilation and Evacuation • Forceps are used to remove larger pieces of tissue from the uterus. Usually for pregnancies beyond 16 weeks. • A curette is used to gently scrape the lining of the uterus. • Suction may be used as a final step to make sure all uterine tissue is removed. • Medications to reduce bleeding and an ultrasound will finalize the procedure. D&E • Time requirement: 30 minutes • Thoughts, comments or questions? • . Emergency Contraception or Morning-After Pills/IUD 1. (ParaGard IUD) Copper-T ($500 $900) 2. ella or Ulipristal Acetate (UPA or ELLA) ($30 - $65 or Sliding Scale Cost) 3. Plan B One Step, Next Choice One Dose & Levonorgestrel ($30 - $65 or Sliding Scale Cost) Emergency Contraception ParaGard IUD Copper-T *Inserted by a doctor or nurse at a health center *Use up to 5 days (120 hours) after unprotected sex *Lasts up to 12 years *99.9% effective Emergency Contraception ella or Ulipristal Acetate (UPA or ELLA) *By prescription only *One pill *Use up to 5 days (120 hours) after unprotected sex *85% effective *Less effective for women with a BMI over 35 Emergency Contraception Plan B One Step, Next Choice One Dose & Levonorgestrel *Available to anyone without prescription *One pill *Use up to 72 -120 hours after accident *Effectiveness: 75%-89% *Less effective for women with a BMI over 25. May not work for women with a BMI over 30 Body Mass Index (BMI) BMI is a number based on your height and weight. It’s a way to figure out if you are at a healthy weight for your height. In general, the higher the number, the more body fat a person has. BMI is often used as a screening tool to decide if your weight might be putting you at risk for health problems. Body Mass Index (BMI) BMI is usually used to broadly define different weight groups in adults 20 years old or older. The same groups apply to both men and women. Body Mass Index (BMI) Underweight: BMI is less than 18.5 Normal Weight: BMI is18.5-24.9 Overweight: BMI is 25-29.9 Obese: BMI is 30 or more What You Need to Know About Nonoxynol-9 • N-9 is the active ingredient in all of the over-the-counter (OTC) spermicidal products available in the U.S. and has been used for pregnancy prevention since the 1950s. An Advisory Review Panel of the Food and Drug Administration (FDA) has deemed N-9 a safe and effective contraceptive. N-9 • N-9 is the active ingredient in all OTC spermicidal products in the U.S. N-9 is a chemical detergent that damages sperm cell membranes, killing the cells. • N-9 is marketed and sold as a spermicidal contraceptive product in several different formulations, including: • - Suppositories - Foam - Film - Gel - Cream N-9 USE • Diaphragms and cervical caps are FDA approved for use in conjunction with spermicidal gels and creams. Also, some condoms include a spermicidal lubricant. N-9 USE RECOMMENDATIONS FROM WHO & CDC • N-9 can be used as a contraceptive, alone or in combination with a cervical barrier method, and among women at low risk of HIV/STI infection (Use the product no more than once daily.) • N-9 should not be used for the purpose of HIV/STI prevention. • N-9 should not be used for contraception by women at high risk of HIV infection. N-9 USE RECOMMENDATIONS FROM WHO & CDC • Condoms with N-9 should not be promoted for disease prevention. (However, it is better to use N-9-lubricated condoms than no condoms at all.) • N-9 should not be used rectally. Contraceptive foam, film, suppositories • • • • Available over the counter Must be inserted close to time of intercourse Limited or no STI protection 74%-94% effective Steps to Success 1. Sexual Arousal 2. Erection 3. Roll on condom 4. Leave room at the tip & squeeze out any air 5. Intercourse 6. Hold onto the base/rim of the condom 7. Withdrawal the penis 8. Orgasm 9. Relaxation 10. Loss of erection Male Condom • Made of latex or polyurethane • Single use barrier method that blocks sperm from entering the female • Approximately 85%-98% effective • Some protection against STIs • Over the counter • Inexpensive • May leak, break, or interfere with spontaneity Female condom • Rubber sheath with a flexible ring that is inserted in to the female • Single use barrier method that blocks sperm from entering the female • 79%-95% effective • Some protection against STIs • Over the counter • May leak, break, or interfere with spontaneity • More difficult to use Diaphragm • Dome-shaped rubber disk that covers the cervix so sperm cant reach the uterus • Best if used with a spermicide • 80%-94% effective • Inserted before intercourse, left in for at least 6 hours • Can be used multiple times • Uncomfortable to use • Has to be fitted • Limited protection against STDs Cervical Cap • Soft rubber cup with a round rim which fits around the cervix • 80%-94% effective • Hard to insert • Can remain in place for up to 48 hours without being removed IUD (Intrauterine device) • A T-shaped device inserted into the uterus by a doctor • Can last from 1 to 10 years • About 2 in 100 pregnancies a year • May result in ectopic pregnancies in the fallopian tubes Hormonal Contraception Combination Pill • Effectiveness • Adult Users 99.7% • Actual effectiveness: 92 % – Forget to take a pill daily – Eating disorders Combination Pill • Benefits – regular cycle every 28 days, reduces cramps and flow, reduces risks of uterine and ovarian cancer and other diseases • Side Effects – nausea, headaches, weight gain, fluid retention, bleeding between periods, depression, mood changes, changes in vision, dizziness, yeast infections, and smokers increase chances of stroke and heart attack • Who should not use it – heavy smokers, suffer from severe depression, get migraines, have had blood clots, cancer or blood diseases • Cost – Depends on insurance coverage Extended Cycle Pill • Prevents ovulation, changes lining, difficult for fertilized ovum to implant, thickens the cervical mucous • Only four period per year • 99% effective • Advantage for women who suffer from severe cramping or PMS • Side Effects – irregular bleeding, fluid retention (hands and feet), raise blood pressure, nausea, vomiting, headache, vision, appetite, depression infections and allergic reactions • Who should not use it – same as mini and combo pill users • Cost - $100 to $120 for three months Nuva Ring • It is a small, flexible ring that is inserted into the vagina once a month • It is left in place for three weeks and taken out for the remaining week • The Ring releases synthetic estrogen and progestin to protect against pregnancy for one month. Vaginal Ring • Small, flexible, plastic ring that is about 2 inches wide • Placed in the vagina each month and releases hormones similar to those in birth control pills • Prevents ovulation, removed after three weeks, after having a menstrual period insert a new one • Effectiveness – 98-99% • Benefits – regular menstrual period, shorter and lighter flow • Side effects – bleeding between period, nausea, headaches, weight gain or loss, mood changes Vaginal Ring • Who should not use it – Smokers, High Blood Pressure, CVD, liver disease, cancer – Cost - $30-35 a month Ortho Evra (patch) • Patch worn on the lower abdomen or on the upper body • Releases progestin and estrogen into the bloodstream • Less effective for women weighing more than 198 pounds • New patch applied once a week for 3 weeks, 4th week no patch is worn so female can have her menstrual period Skin Patch • Hormones are released to prevent ovulation from occurring, mucus thickens, ovulation returns three months after the patch is last used • Effectiveness – 99% in women who weigh 198 pounds or less • Other benefits – menstrual cycle regular, shorter and lighter flow • Side effects – bleeding between periods, nausea, headaches, weight gain or loss, mood changes • Who should not use them – Same as others, include history of blood clots • Cost - $30-$35 a months Norplant (Implant) • 6 matchstick sized rubber rods implanted under skin of the upper arm • Steadily releases a contraceptive steroid levonorgestrel • Very effective. About 1 in 100 pregnancies • Lasts for 5 years • Reversible • Expensive • No STD protection Depo-Provera (injection) • Injectable progestin that prevents ovulation • Prevents sperm from reaching egg and keeps egg from implanting in the uterus • Less than 1 out of 100 pregnancies • 1 injection every 3 months • Not safe against STDs • Fertility may take a few months to get back to normal MISCELLANEOUS WITHDRAWAL • pregnancy is possible if sperm are ejaculated on or into the vagina • not effective against sexually transmitted infections WITHDRAWAL • • • • • • • ADVANTAGES can be used when no other method is available POSSIBLE DISADVANTAGES requires great self-control, experience, and trust not for men who ejaculate prematurely not for men who don’t know when to pull out not recommended for teens No Method No Protection • Free • No protection against pregnancy • No protection against STDs ABSTINENCE • • • • • • • • 100% EFFECTIVE ADVANTAGES No medical or hormonal side effects Easy to use Prevents sexually transmitted infections 100%FREE POSSIBLE DISADVANTAGES many people find it difficult to abstain from sex • many people fail to use protection when abstinence ends • A commitment required by both people • Peer pressure STERILIZATION • • • • • • • • • • ADVANTAGES permanent protection against pregnancy no lasting side effects no effect on sexual pleasure protects women whose health would be seriously threatened by pregnancy POSSIBLE DISADVANTAGES risks of minor surgery if incision is made some people later regret not being able to have children not usually reversible if you change your mind rarely, tubes reopen, allowing pregnancy to occur STERILIZATION • Tubal sterilization — intended to permanently block woman's tubes where sperm join egg • Vasectomy — intended to permanently block man's tubes that carry sperm • 99.5-99.9% EFFECTIVE Not effective against sexually transmitted infections — use latex or female condoms to reduce the risk. STERILIZATION • o o o • o o • Tubal sterilization bruising if incision is made very rare injury to blood vessels or bowel pregnancies that rarely occur are more likely to be ectopic (in a fallopian tube) Vasectomy infection or blood clot in or near the testicles temporary bruises, swelling, or tenderness of the scrotum sperm leakage may form temporary small lumps near testicles STERILIZATION • COST $2,000-$6,000/ tubal sterilization 240-$520/ vasectomy (Vasectomy costs less because it is a simpler procedure that can be done in the clinician’s office.) OUTERCOURSE • NEARLY 100% EFFECTIVE • pregnancy is possible if sperm are ejaculated on or inside the vagina • reduces the risk of many sexually transmitted infections — unless body fluids are exchanged through unprotected oral or anal intercourse. Outercourse • ADVANTAGES • no medical or hormonal side effects • may prolong sex play and enhance orgasm • can be used when no other methods are available Outercourse • POSSIBLE DISADVANTAGES • many people find it difficult to abstain from vaginal intercourse • many people fail to use protection from pregnancy or infections if intercourse takes place Fertility Awareness Methods • Nothing to purchase • Permitted by some religious groups that don’t allow other methods • Requires commitment to other person • No intercourse during menstrual cycle • 80%-99% effective if done correctly Facts to Know About Birth Control Methods • How it works: the way the birth control methods works to prevent pregnancy • Instructions for correct use: directions for using the birth control method the right way • Effectiveness: – Theoretical Effectiveness: % that tells how well birth control works if adult users use it the correct way every time and have no preexisting conditions that reduce how well it works – Actual user Effectiveness: % that tells how well birth control works if adult users do not use it in the correct way and have no conditions that reduce how well it works Facts To Know • Other Benefits from correct use: benefits from the birth control method that are in addition to its use to prevent pregnancy • Side Effects: unwanted changes, including health risks, that might occur when the birth control method is used • Who should not use: a list of cautions that identify users who should not use the birth control method because it might cause health risks or might be inappropriate • Cost: an estimate of how much money the birth control method will cost Kinds of Birth Control methods • Abstinence from Sex • Oral Contraceptives - Combination Pill, Progestin Only Pill, Extended-Cycle Pill • Vaginal Ring • Injectable Contraceptives – injectable Progestin • Skin Patch • Barrier Methods – Spermicides, Diaphragm, Cervical cap, Male and Female Condom • Fertility Awareness Methods – basal Body Temperature Method, The Calendar Method, The Mucous Method • Sterilization – Tubal Ligation (Female), Vasectomy (Male) • Unreliable Methods – The Douche and Withdrawal