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Reproductive Choices: Conception, Infertility, Contraception, Abortion, Pregnancy & Childbirth

This chapter covers the process of conception, the problem of infertility and alternate methods of having children, the pros and cons of various contraception methods, methods of abortion, health issues in pregnancy and prenatal development, health issues associated with childbirth, and health issues in the postpartum period.

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Reproductive Choices: Conception, Infertility, Contraception, Abortion, Pregnancy & Childbirth

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  1. Reproductive Choices

  2. Chapter 5Reproductive Choices Learning Outcomes: • Describe the process of conception • Discuss the problem of infertility and alternate methods of having children • Discuss the pros and cons of various methods of contraception • Discuss methods of abortion • Discuss health issues in pregnancy and prenatal development • Describe health issues associated with methods of childbirth • Discuss health issues in the postpartum period

  3. Conception • Union of a sperm cell and an egg cell • Zygote: Fertilized egg • Females: XX Males: XY • Miscarriages (spontaneous abortions) of male fetuses more prevalent • Fertilization normally occurs in a fallopian tube. The zygote travels down to the uterus and implants into the wall.

  4. Infertility • Male Fertility Problems • Sperm: low count, low motility, irregularly shaped • Causes: genetic factors, age, injuries, drugs, blood pressure medications, environmental toxins, stress • Female Fertility Problems • Irregular ovulation or failure to ovulate, obstructions or malfunctions of reproductive tract, endometriosis, age-related decline of female sex hormones

  5. Increasing Fertility • Increasing the sperm count Artificial insemination • ICSI (Intracytoplasmic Sperm Injection) • Inducing Ovulation • IVF (Invitro fertilization) • GIFT (game intrafallopian transfer) • Donor IVF • ZIFT (Zygote intrafallopian transfer) • Embryonic Transfer • Surrogate Motherhood • Adoption

  6. Contraception Consider effectiveness, ease of use, health risks • Hormonal Methods • progestin or combination of progestin and estrogen • Oral contraceptives – “The Pill” • Injectable, patches, “morning-after pill” • No protection against STIs • Health risks for women who smoke, are obese, older, hypertension, or a history of vascular disease • Intrauterine Device (IUD)

  7. Contraception Methods • Barrier Methods Condoms • Latex protect against STIs • Less effective than oral contraceptive or IUD Diaphragm • Shallow latex cup or dome • No protection against STIs Spermicides Contraceptive Sponge Cervical cap

  8. Contraceptive Methods • Fertility Awareness (Rhythm Methods) Calendar BBT Ovulation • No protection against STIs • Low reliability • Sterilization • Vasectomy • Tubal sterilization (tubal ligation) • Hysterectomy

  9. Abortion Purposeful termination of pregnancy • Methods • Vacuum aspiration (90% - safest) • Dilation and Curettage (D & C) • Dilation and Evacuation (D & E) – 2nd trimester • Intra-amniotic infusion – 2nd trimester • Intact Dilation and Extraction (intact D & E) • RU-486

  10. Pregnancy • Early Days • Human chorionic gonadotropin (HCG) produced (OTC pregnancy tests – HCG in urine) • “morning sickness” • Prenatal care important

  11. Stages of Prenatal Development Germinal Stage Conception to implantation Embryonic Stage Implantation to 8th week Neural tube (3 weeks) – importance of folate Fetal Stage 9th week until birth Major organ systems, fingers, toes, external genitals are formed by end of 1st trimester Factors that may adversely affect health of embryo/fetus: drugs, X-rays, environmental contaminants, infectious organisms

  12. Childbirth Three Stages 1st Stage: Labor - contractions efface and dilate cervix, ending with transition 2nd Stage: transition, “hard labor” culminating with delivery 3rd Stage: Delivery/Expelling of Placenta

  13. Methods of Childbirth • Anesthetized Childbirth • General • Local: Blocks – pudendal, epidural, spinal • Prepared Childbirth – The Lamaze Method • Can be used in combination with anesthetics • Cesarean Section • 1 in 3 births now done by C-section

  14. Birth Problems • Oxygen Deprivation • Prenatal hypoxia can impair central nervous system development • Prolonged oxygen cutoff at delivery can cause cerebral palsy or death • Preterm and Low-Birth Weight Children • Preterm < 37 weeks Low birth weight < 5 lbs • Neurological and cognitive functioning impaired • Muscles are immature, weakened sucking & breathing reflexes • Respiratory distress syndrome

  15. The Postpartum Period • Postpartum Depression (PPD) • “baby blues”normal – generally last 1-2 weeks • PPD – more serious and persistent mood changes Symptoms: sadness, hopelessness and helplessness, major changes in appetite, sleep patterns, difficulty concentrating, severe fluctuation in mood • Breast-Feeding Versus Bottle Feeding • Benefits of Breast-Feeding Reduces risks of infections, and incidence of allergies

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