Family Planning: Barrier Methods of Preventing Pregnancy

1. Family Planning: Barrier Methods of Preventing Pregnancy

2. 100 people surveyed • What barrier type contraception is the most effective for contraception?

3. #5 • Spermicides (0 responses)

4. #4 • Sponge (0 responses)

5. #3 • cervical cap (0 responses)

6. #2 • IUD (3 responses)

7. #1 • Condom (97 responses)

9. Spermicides What am I? Spermicide contains chemicals that stop sperm from moving. Spermicides are available in different forms, including creams, film, foams, gels, and suppositories. Spermicide can be used alone, or it can be used with other birth control methods to make them more effective. It is always used with the diaphragm and cervical cap. Cost? Spermicide is available at your local family planning clinics, drugstores, and some supermarkets. Applicator kits of foam and gel cost about $8. Refills cost $4-$8. Large cans of foam contain between 20 and 40 applications. Film and suppositories are also about $8.

10. How to use spermicide: In general, inserting spermicide is easy. You will lie down or squat, then gently insert the spermicide deep into your vagina using your fingers or an applicator. For many types of contraceptive creams, film, foams, gels, and suppositories, you need to wait 10 minutes after you insert the spermicide before you can have intercourse. These methods typically remain effective for only one hour after insertion. Or apply directly to Diaphragm or Cervical Cap. Apply on side resting against cervix. A lubricating spermicide eases insertion.

11. Advantages Disadvantages *It can be carried in your pocket or purse. *It can be inserted by a partner as part of sex play. *It does not have an effect on a woman's natural hormones. *It is very easy to get — in drugstores and some supermarkets. *It does not require a prescription. *It can be used during breastfeeding. *If not used exactly as directed, spermicides may not form a good barrier over the cervix. This may make the spermicide less effective. *Some women complain that spermicides are messy or that they leak from their vaginas. *Spermicide may irritate the penis or vagina. Switching brands may solve this problem. Side Effects: Nonoxynol-9 The most commonly used spermicide in the U.S. is called nonoxynol-9. Nonoxynol-9 has certain risks. If it is used many times a day, or if it is used by people at risk for HIV, it may irritate tissue and increase the risk of HIV and other sexually transmitted infections. ***If women always use spermicide as directed, 15 out of 100 will become pregnant each year. If women don't always use spermicide as directed, 29 out of 100 will become pregnant each year.

12. The Sponge What am I? The contraceptive sponge is a small, round, polyurethane sponge that contains N-9 spermicides. It is about 2 inches in diameter. It is designed to fit over the cervix with one side being concave to fit over the cervix. The opposite side has a nylon loop or polyester loop attached to it for removing the sponge. How do I work? The sponge covers the cervix and blocks sperm from entering the uterus and it also continuously releases a spermicide that keeps sperm from moving. Cost? Sponges are available in clinics, drugstores, online, and in some supermarkets. They usually cost anywhere from $9 to $16 for a package of 3.

13. How to insert: The sponge is then slid as far back into the vagina as your finger can reach. The spermicides become active when the sponge is completely wet. Once inside the sponge will unfold and cover the cervix when the woman lets it go. To make sure that the cervix is covered, slide a finger about the edge of the sponge and check the position. The woman should also be able to feel the nylon loop on the bottom of the sponge. To use the sponge the woman moistens the sponge with water with at least two tablespoons of clean water. She then gently squeezes the sponge and fold the sides of the sponge upward away from the loop on the bottom to make it long and narrow.

14. Advantages Disadvantages *It may be difficult for some women to insert or remove the sponge *The sponge may break into pieces and a health care provider will be needed to remove the pieces cause irritation to the vagina *It can make sex messy since it can require too much liquid. There are also complaints that sponges makes sex too dry and a water-based lubricants are necessary to help with dryness *The spermicide in the sponge can also cause certain risks such as irritation to the tissue, can increase HIV infection rate, and will not protect people from STD’s. *It is safe, simple and convenient *IT requires no prescription and is one size fits all *It has no effects on the woman’s natural hormone *Generally it cannot be felt by the woman or the partner *It can be inserted hours ahead of time and can be worn for 24-30 hours side effects: are allergic reaction to the spermicide, increased risk of yeast infection and urinary tract infection, improper use such as leaving the sponge in too long can result in toxic shock syndrome. Nonoxynol-9 can irritate tissues, which leads to an increased risk of HIV and other sexually transmitted infections ***The sponge has a 91% effectiveness level based on the manufacturer if used correctly and consistently. This drops to 84% if not used correctly

15. The Diaphragm What am I? The diaphragm is a shallow, dome-shaped latex or silicone device with a flexible rim that covers the cervix. How do I work? Three types of diaphragms are available: coil spring, arcing spring, and wide seal rim. Used with spermicide on cervical side, acts as a barrier to prevent sperm from entering the cervix. How much do I cost? Diaphragms may be purchased at a drugstore or clinic with a prescription. An examination costs from $50 to $200. Diaphragms average from $15 to $75. Spermicide gel, jelly, or cream costs from about $8 to $17 a kit.

16. How to insert a Diaphragm: Insert inward and down as far as it will go To remove insert finger to relieve suction Then hold between thumb and fingers First apply spermicide Last tuck the rim behind the pubic bone ***The chances of getting pregnant while using a diaphragm are: • Typical use: 20 percent • Perfect use: 9 percent

17. The Diaphragm Symptoms of TSS The symptoms of TSS are sudden and intense. They include: • A sunburn-like rash, and/or peeling skin • A high fever • Severe flu-like symptoms • Headache or muscle aches • Stomach cramps • Sore throat • Nausea or vomiting • Diarrhea • Weakness • Dizziness, lightheadedness, or confusion • Pale, clammy skin Advantages Disadvantages • If the diaphragm is left inside the vagina for more than one day (24 hours), the female runs the risk of toxic shock syndrome (TSS), a serious bacterial infection (as with tampons). • Mild allergic reactions to the rubber or spermicide occasionally occur. • Does not protect against STI’s or HIV • The diaphragm is often not felt by either partner during sex. • The diaphragm is easier for women to learn to insert and remove than a similar contraceptive device, the cervical cap. • Lasts two years so cost effective in the long run

18. The Cervical Cap What am I? Similar to the Diaphragm it is a soft rubber cap with a round rim that fits around your cervix. The only cervical cap available in the United States is the FemCap, a non-hormonal latex-free contraceptive device made of silicone rubber, a non-allergenic easy to clean material. Cost: Cervical caps may be purchased at a drugstore or clinic with a prescription. An examination costs from $50 to $200. Cervical caps average from $60 to $75. Spermicide jelly or cream costs about $8 to $17 a kit. As high as $292

19. Main Difference between the cap and the Diaphragm: *Unlike the diaphragm, the cervical cap protects against pregnancy for two days (48 hours) and for multiple acts of intercourse within that time frame. *The Cervical Cap is a snugger fit, can be carried in a pocket, less interruption to sex, but harder to place. *Both require fitting by a medical professional, last two years, and neither protect against STI’s or HIV ***The chances of getting pregnant while using a cervical cap are: • Typical use: 10 percent • Perfect use: 4 percent

20. The IUD What am I? IUD or intrauterine device, is a small plastic device shaped as a T, about 1 ¼ inch tall, with bendable arms, that is inserted into the woman’s uterus. How Do I work? There are two types of IUD’s available in the U.S.A. 1. Paragard (Copper) – effective for 12 years 2. Skyla or Mirena (Hormonal)- effective 3 or 5 years They prevent pregnancy by one or more of these processes. By either impairing sperm motility, act as a spermicide, irritate the lining of the uterus, and prevent implantation/fertilization. What do I cost? approx. $500 to $1,000 total which includes medical exam, IUD, and appointments.

21. Advantages Disadvantages *safe, cost-effective, reliable in long- term protection from pregnancy *immediate return to fertility when removed. *Can be recommended to women regardless of parity, age, or history of ectopic pregnancy. *Can be used as an emergency contraception if inserted within 5 days after unprotected intercourse, prevents implantation. *increased risk of Pelvic Inflammatory Disease *unintentional expulsion of the device, *infection *uterine perforation *Also IUD’s do not protect against HIV or STI’s.

22. Side Effects: ***Must be inserted by a Health Care Provider. Must have a negative pregnancy test before insertion, cervical cultures to rule out STI’s, and sign a consent form. Warning Signs Report any of these signs to your clinician as soon as possible: P ■ Period late (pregnancy), abnormal spotting or bleeding A ■ Abdominal pain, pain with intercourse I ■ Infection exposure (any STD), abnormal discharge N ■ Not feeling well, fever, chills S ■ String missing, shorter or longer ***The copper IUD is more than 99% effective***

23. Male condom— Worn bythe man, a male condom keeps sperm from getting into a woman’s body. Latex condoms, the most common type, help prevent pregnancy, and HIV and other STDs, as do the newer synthetic condoms. “Natural” or “lambskin” condoms also help prevent pregnancy, butmay not provide protection against STDs, including HIV. Typical use failure rate: 18%. Condoms can only be used once. You can buy condoms, KY jelly, or water-based lubricants at a drug store. Do not use oil-based lubricants such as massage oils, baby oil, lotions, or petroleum jelly with latex condoms. They will weaken the condom,causing it to tear or break.

24. Instructions for use 1. Open package 2. Remove condom 3. Apply condom to head of penis 4. Roll the condom to the base of penis (Penis must be erect) 5. Remove when coitus is over (Better to remove while penis is erect)

25. Female condom—Worn by the woman, the female condom helps keeps sperm from getting into her body. It is packaged with a lubricant and is available at drug stores. It can be inserted up to eight hours before sexual intercourse. Typical use failure rate: 21%, and also may help prevent STDs.

26. Advantages/disadvantages • No prescription needed • Single use • Easily accessible-drug stores to supermarkets • Fairly inexpensive • Helps decrease contraction of STIs • *Reluctance for male to use*

27. Side effects • Anaphylactic shock-latex allergy • Wal-mart: $2.83-3 pack • COSTCO: $12.48-40 pack Costs

28. References • http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/PDF/Contraceptive_methods_508.pdf • http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/Contraception.htm • http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/Contraception.htm#5 • http://graphics8.nytimes.com/images/2007/08/01/health/adam/10347.jpg • http://www.riversideonline.com/source/images/image_popup/mcdc7_femalecondom.jpg • http://intimatehealthhelp.net/wp-content/uploads/2012/09/condom2.jpg • http://blog.georgetownvoice.com/wp-content/uploads/2010/03/condoms_31.jpg • http://www.bing.com/images/search?q=Question+Mark+Face&FORM=IRTRRL&crslsl=0#view=detail&id=FA8699CA48AF5C4B44B4A871D8B0424036CD1AD7&selectedIndex=0 • http://www.the-other-view.com/images/trojanlogo.jpg • http://www.freelogovectors.net/wp-content/uploads/2012/02/durex-logo.jpg • http://www.pinkapple.com/productphotos/vcf_contraceptive_122.jpg • http://origin.kaboodle.com/hi/img/c/0/0/171/5/AAAADOw7x98AAAAAAXFYZA.jpg?v=1312565249000 • http://0.tqn.com/d/contraception/1/S/S/7/-/-/Caps.JPG • http://www.familyplanning.org/pdf/Facts_About_IUDs.pdf • http://www.plannedparenthood.org/health-info/birth-control/iud • Lowdermilk, D. and Perry, S. (2014). Maternity Nursing (8th ed). St. Louis: Elsevier. • http://www.plannedparenthood.org/health-info/birth-control/spermicide • http://www.plannedparenthood.org/health-info/birth-control/cervical-cap