Procreation Conception, Pregnancy and Childbirth Contraception Abortion Sexual Positions
Contraception • Contraception: Deliberate prevention of conception or impregnation through the use of various devices, agents, drugs, sexual practices, or surgical procedures. • Post Partum Taboo: Cultural belief that forbids sexual intercourse for a specified period of time after the birth of a child
Contraception Historical Look: • Two thousand years ago the Chinese inserted oil-soaked paper into the vagina to cover the cervix • In Oceania, moss plugs were used for this purpose • Ancient Egyptians used a very appealing concoction of crocodile dung and honey • Ancient Athens, women rubbed their cervix with an oil of cedar and an ointment of lead to prevent conception • Sixth Century Greek physician recommended a cervical cap made by cutting a pomegranate in half, scooping out the flesh of the fruit and then inserting it into the vagina prior to intercourse
Contraception Historical Look: • Contraceptive sponge in use in the 1800’s was soaked in a solution of quinine prior to insertion an had a string attached for easy removal • Diaphragm was invented in 1842 by a German anatomy professor • Roman soldiers reputedly made condoms from the muscles of dead enemies • Small intestines of animals, fish bladders, and lambskins were condoms also • 1564 a linen sheath was used as a condom and for protection of venereal disease Two other ancient and widespread forms of contraception that are still practiced today are coitus interruptus and interfemoral coitus.
Contraception Coitus Interruptus: Sexual intercourse deliberately interrupted by withdrawal of the penis from the vagina prior to ejaculation • Secretions from the Cowper’s gland sometimes carry live sperm Interfemoral Coitus: Sexual activity in which the male rubs his erect penis between the thighs of a woman without insertion into the vagina • No likely to result in conception, but It is possible that sperm deposited just outside the vagina could cause a pregnancy and this method offers not protection against sexually transmitted diseases
Contraception Barrier methods of Birth Control • Conceptpion occurs when a sperm fertilizes an ovum. The fertilized egg, or embryo, then attaches to the wall of the uterus and develops into a viable fetus. There are two way s of preventing this event: • The sperm are blocked from reaching the egg • Any eggs that have been fertilized by sperm are prevented from developing further
Contraception • Failure Rate • If 5 women out of 100 become pregnant during a year of using contraceptive A, then A’s failure rate is 5 percent. • Perfect user vs. typical user failure rates • Effectiveness = 100 - failure rate • Contraceptive A is 95 percent effective
Contraception • Combination birth control pills (oral contraceptives) such as Loestrin and Ovcon contain estrogen and progestin. • Higher levels of estrogen inhibit FSH production, so the message to ovulate is never sent. • Higher levels of progestin keep cervical mucus very thick, making it difficult for sperm to get through. • The use of combination pills is one of the most effective methods of birth control.
Contraception • Varying levels of estrogen and progestin • Most women do best with no more than 30 to 35 micrograms estrogen. • Triphasic pill (Ortho Tri-Cyclen) - three phases in progestin levels. • Progestin-only pills (Micronor, Nor-Q-D, and Ovrette) - also called mini-pills.
Contraception • Serious side effects associated with use of the pill include: • Slight but significant increases in certain diseases of the circulatory system. • The pill may aggravate already existing cancers. • The amount of vaginal discharge and susceptibility to vaginitis increases. • About 20 percent of women report increased irritability and depression.
Contraception Pill, Patch and the Ring: • The patch (Ortho Evra) contains the same hormones as combination birth control pills but is administered through the skin. • The vaginal ring (NuvaRing) is a flexible, transparent ring made of plastic and filled with the same hormones as the combination pill but with slightly lower doses. • Emergency contraception is available in pill form for such emergencies as rape or a condom breaking.
Contraception Injections: • Depo-Provera (DMPA) is a progestin administered by injections. It works by: • Inhibiting ovulation • Thickening cervical mucus • Inhibiting growth of the endometrium • More effective than the pill. • Must be repeated every three months for maximum effectiveness.
Contraception IUD: • The intrauterine device (IUD) is a small piece of plastic that is inserted into the uterus by a doctor or nurse practitioner, and remains in place until the woman wants to have it removed. • Immobilizes sperm that reaches the uterus and prevents them from moving into the fallopian tube. • Most common side effects are increased menstrual cramps, irregular bleeding, and increased menstrual flow.
Contraception • The diaphragm is inserted into the vagina and fits snugly over the cervix. • A contraceptive cream or jelly must be applied. • Diaphragm blocks entrance to the uterus, while cream kills any sperm that gets past the barrier. • Failure rate of 20 percent due to improper use. • The cervical cap fits more snugly over the cervix than the diaphragm and should also be used with a spermicidal cream.
Contraception Condoms: (Male) • A thin sheath that fits over the penis. • Widespread use for contraception and protection against diseases dates from about 1843. • Catches semen and prevents it from entering the vagina. • Perfect-user failure rate is about 3 percent. • Typical-user failure rate is about 18 percent. • Many failures result from improper or inconsistent use. Condoms: (Female) • One ring of the female condom is inserted into the vagina while the other is spread over the vaginal entrance. • Prevents sperm from entering the vagina and blocks the entrance to the uterus. • Perfect-user failure rate is 5 percent. • Typical-user failure rate is 21 percent.
Contraception • Spermicides come in a tube or can, along with a plastic applicator which is filled and inserted into the vagina. • Applicator’s plunger pushes spermicide into the vagina near the cervix. • Consists of chemicals that kill sperm and an inert base that blocks entrance to the cervix. • Failure rates can be as high as 25 percent.
Contraception Withdrawal: • Coitus interruptus (pulling out) is probably the most ancient form of birth control. • With a failure rate of around 19 percent it is not a very effective method. • Over long periods of time may contribute to sexual dysfunction in the man and woman.
Contraception • Rhythm methods are the only form of “natural” birth control. They require abstaining from intercourse during the women’s fertile period. • The calendar method is based on the assumption that ovulation occurs about 14 days before the onset of menstruation. • In the standard days method (SDM), a woman who knows that she is regular, with a cycle length of between 26 and 32 days, abstains from days 8 to 19.
Contraception • With the basal body temperature method (BBT) the woman waits for her daily temperature to rise sharply on the day after ovulation. • Intercourse would be safe beginning about three days after ovulation. • Additional rhythm methods are the cervical mucus method and thesympto-thermal method. • The typical failure rate of all rhythm methods is around 25 percent.
Contraception Sterilization: • Voluntary surgical contraception (VSC) is a surgical procedure whereby an individual is made permanently sterile. • Vasectomy is the male sterilization operation. • Vasovasostomy is the surgical procedure to reverse a vasectomy. • Minilaparotomy and laparoscopy are two of several techniques used to sterilize a woman. • In some cases it is possible to reverse female sterilization by using highly refined microsurgery techniques.
Contraception • Tubal Ligation
Contraception Attitudes toward Contraception: • Attitudes and emotions play an important role in making a person more or less likely to use contraceptives effectively. • Erotophobes don’t discuss sex, have sex lives that are influenced by guilt and fear of social disapproval, have intercourse infrequently with few partners, and are shocked by sexually explicit films. • Erotophiles are just the opposite and are more likely to be consistent, reliable contraceptive users.