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Family Planning: Choices Faced By Chiropractic Patients

Family Planning: Choices Faced By Chiropractic Patients. Lisa Z. Killinger, DC Gender-Related Health. Wide range of choices Some advances More options. The “Pill” (Estrogen/Progesterone). Failure Rates: .5-5% Advantages: Spontaneity, effectiveness

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Family Planning: Choices Faced By Chiropractic Patients

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  1. Family Planning:Choices Faced By Chiropractic Patients Lisa Z. Killinger, DC Gender-Related Health

  2. Wide range of choicesSome advancesMore options

  3. The “Pill” (Estrogen/Progesterone) • Failure Rates: .5-5% • Advantages: Spontaneity, effectiveness • Disadvantages/Probs: Increased Risk of blood clots, stroke, uterine and ovarian cancers, etc., no protection against STDs • Not recommended for smokers

  4. Depo-Provera • Failures: 1-7% • Adv: Convenience!! (One shot of progesterone every 3 months) • No period or shortened period ( anemia) • Dis: Systemic side effects/risks of hormones, no protection against STDs

  5. Condoms • Failure overall: 5-20% • Adv: Inexpensive, available w/o prescription or doctor’s visit, protection from STDs (IMPORTANT!) • Recent advances: Durability, sizes, shapes, colors, flavors, ribs, and…. • The ultimate condom designed by a female (undoubtedly); ….???? • Dis: Interferes w/spontaneity, failure rate

  6. Withdrawl • Failure: >20% • Watch out! Risky business! (Not recommended for reliable birth control) • Adv: No monetary cost, can be used by most people • Dis: Failure rate too high, not protective against STDs

  7. Spermicides • Failure: 6-20% • Adv: Comfortable, some protection from STDs, no systemic effects • Disadvantages: May interfere with spontaneity, may have some local effects on cervix, other tissues

  8. IUD • Device inserted by doctor into uterus • Failure: 1-3% • Adv: Effective, reliable, does not interfere with spontaneity, no systemic effects? • Disadvantages: May cause spotting, cramping, may be rejected by body, may have some scarring effect locally in uterus

  9. Diaphragm/Cervical Cap • Failures: 6-20%/10-40% • Adv: No neg. systemic effects on health • Disadvantages: Failure rate high, interferes with spontaneity, • Should be used in conjunction w/ spermides

  10. ECP: Emergency Contraceptive Pill • Best taken w/in 12 hours of contraceptive failure • Up to 72 hours • Failure : 1%

  11. NFP: Natural Family Planning • Failure Rates: 10-20% • Adv: No deleterious effects on health (Least invasive, most natural FP method) • Dis: Requires a high level of cooperation btw partners, requires high level of discipline (no sex on some days) • Failure rate very high if either partner is not committed to following the rules

  12. NFP: How does it go? • Counting the days (requires regular cycles btw. 26 and 32 days long) • Temperature taking (identify ovul. dates) • Monitoring discharge-to identify ovul. dates • May require backup contraceptive plan (have it on hand!!!) • Agreement to not have sex during any potentially risky days/nights (cooperation)

  13. Cycle Beads: NFP • Days 1-7 of cycle: Safe days (unlikely to become pregnant) • Days 8-19 of cycle: NO SEX (Likely to become pregnant) • Days 20-Period: Safe days • If cycle lasts fewer than 26 or more than 32 days, Cycle Beads will not work. NFP still may work.

  14. NFP • You can still use NFP with longer or shorter cycles: Rely more heavily on temperature readings and discharge • Body Temperature should be the same every day first thing in the morning (except during ovulation, temp goes up 2-3 degrees) • Discharge changes from white and thick to clear (like egg white) during ovulation

  15. Issues Surrounding Family Planning Choices: • Faith issues • Health issues • Cost & Access or Availability • Convenience • Commitment • Sexual practices/marital status • Reasons for needing to use birth control

  16. Safe Recommendations: • Stick to education of known risks, benefits • Avoid judging/disrespecting patient’s choice • Consider patient’s reasons for including you in this decision making process • Trust • Respect • Privacy/confidentiality • Others

  17. Team Decision-Making • Both partners need to weigh in • In a marriage, both potential parents need input • The woman, for whom pregnancy will have the greatest impact, should have the final say about family planning choices • Doctor: Be a resource….

  18. Resources • Www.nfprha.org (Family Planning Council of America) • www.obgyn.net (The Obstetrics and Gyn. Network) • www.jhipp.jhsph.edu (Bill and Melinda Gates Inst. For Pop. & Reprod. Health) • www.cdc.gov: Reprod. Health Info Source

  19. For Free STD Testing and Treatment • Scott Co Health Dept: 428 Western Ave. Davenport; 326-8618 Wait for operator; Walk in Tues & Thurs 1-4 PM & Friday 8:30 -11. • Rock Island Co. Health Dept: 2112 25th Ave. Rock Island (309)-794-7080

  20. For Free Family Planning Community Health Care: 500 W. River Drive; Davenport 336-3000 Edgerton Women’s Clinic. 1510 E. Rusholme St. Davenport 359-6633

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