Birth Control Social Networking Website

OBJECTIVES

1. Describe the fundamentals of reproduction.

2. Describe and identify contraceptive choices at different stages of life.

3. Identify common myths about family planning.

1. Explain the impact of child spacing on maternal and infant health.

Each month during ovulation an egg is released and moves into one of the fallopian tubes. If a woman has unprotected sex around this time, and egg may meet a sperm in the fallopian tube, and the two may join. This is called fertilization. The fertilized egg then moves through the fallopian tube into the

uterus.

Reproduction Health in the United States

Highly effective contraceptive methods have been around for several decades

Half of all the pregnancies in the U.S. are unintended. The majority of them can be attributed to using of less effective methods coupled with inconsistent and incorrect use; gaps in contraceptive use

At least one in two women will experience an unintended pregnancy, one in three will have an abortion by age 45

Choosing a Birth Control MethodWomen of any age or stage of life may use any of the

contraceptive methods, which are currently available

Contraceptive counseling is patient-centered. Women should be presented and have access to the broadest number of contraceptive options so they can select the one best suited for their lifestyles and reproductive plans

It is imperative that providers understand and are

able to present women with all available options

Current Contraceptive OptionsMost

EffectiveVery

EffectiveModerately

EffectiveEffective

Prevents pregnancy > 99% of the

time

Prevents pregnancy 91-

99% of the time

Prevents pregnancy 81-

90% of the time

Prevents pregnancy up to 80% of the

time

Copper T IUDHormonal

IUDImplant

Sterilization

Pills Injectable

Patch Ring

CondomDiaphragm

Sponge

Fertility Awareness

Cervical CapSpermicide

Most Effective OptionsCopper T IUD Brand name: Paragard Approved for up to 10 years of useCan be used for emergency contraceptionCommon side effects: heavy periods, menstrual crampsCandidates are those who:

Want long-acting, reversible method

Want to avoid hormones

Hormonal IUD / Levonorgestrel-releasingBrand name: MirenaApproved for up to 5 years of useCommon side effects: irregular spotting at first, then can expect lighter periodsCandidates are those who:

Want long-acting, reversible method

Have menstrual symptoms (heavy periods, menstrual cramps) that may disappear with this method

Cannot use estrogen

Most Effective Options

Myths about IUDsMyth Fact

IUDs cause infection Incidence of pelvic infection is not increased while using IUDs. Preexisting STD at time of infection, not IDU, increase risk of pelvic infection

IUDs can only be used by women who have been pregnant before

IUD is safe and effective also in women who have never been pregnant, even adolescents

IUDs cause abortions IUDs work by preventing sperm from reaching the egg

IUDs cause ectopic pregnancies

IUDs do not increase the risk of ectopic pregnancies. They decrease risk of both ectopic and intrauterine pregnancies

IUDs cause infertility IUD is not related to infertility. Women can become pregnant quickly after removal of the IDU

Most Effective OptionsContraceptive ImplantBrand name: ImplanonContains etonorgestrelApproved for up to 3 years of useCommon side effects: unpredictable, irregular spottingCandidates are those who:

Want long-acting, reversible method

Have menstrual symptoms (heavy periods, menstrual cramps) that may disappear with this method

Cannot use estrogen

Oral contraceptive pills“Combination pills” estrogen and progestinCommon side effects: nausea, dizziness, headache that go away after few monthsCandidates are those who:

Want use a daily method consistently

Have menstrual symptoms (heavy period, menstrual cramping)

“Mini-pills” progestin-onlyCommon side effects: irregular spottingCandidates are those who:

Want use a daily method consistently

Cannot use estrogen Want rapidly reversible method

Very Effective Options

Myths about the Combination PillsMyth Fact

Taking the pill is risky The pill may be risky for some women although for majority of women the benefits outweigh the risk

Taking the pill cause weight gain

As many women lose weight as gain weight while taking the pill

Taking a break from the pill now and then is a good idea

There is no healthy benefits to taking a break from the pill. Taking a break may increase a woman’s chances of an unwanted pregnancy

The pill cause cancer Most studies show the pill does not increase risk of cervical or breast cancer and it decrease the risk of endometrial (uterine) and ovarian cancer

It is difficult for women to become pregnant after stopping taking the pill

The pill is out of a woman’s system and she is able to get pregnant within 24 hours of when she stops taking pills.

Very Effective OptionsContraceptive PatchBrand name: Ortho-Evra patchContains estrogen and progestinWorn on skin and changed weeklyOk to shower, swim, exercise with patchSide effects: nausea, dizziness, headache that go away after few monthsCandidates are those who:

Want use an easy non-daily method

May want to regulate period Have menstrual symptoms

(heavy period, menstrual cramping)

Very Effective OptionsVaginal RingBrand name: NuvaRingFlexible, unfitted ring placed in vagina for 3 weeksContains estrogen and progestinCandidates are those who:

Want convenience of 3 weeks regimen

May want to regulate period

Have menstrual symptoms (heavy period, menstrual cramping)

Very Effective OptionsContraceptive ShotBrand name: Depo-ProveraIntramuscular or subcutaneous injection every 3 monthsCommon side effects: irregular spotting, stop having periods, weight gainCandidates are those who:

Want non-daily method Cannot use estrogen Do not want to conceive

immediately after discontinuing use

Other methods…Very effective permanent method:

Male and female sterilizationLess effective methods:

Barrier / Coitus DependentMale and female condoms can be combined with

more effective methods for STI prophylaxis Cervical cap, diaphragm, sponge, spermicides, coitus interrupts (withdrawal), natural family planningAbstinence is 100% effective in theory, but the risk of failure is very high

Lactation Amenorrhea Very effective if breastfeeding on demand

Emergency Contraception (EC)Prevents pregnancy after having sexDoes not cause an abortionNor the same at RU-486/mifepristone Methods:

Dedicated products: Plan B, Plan B One-Step, Next Choice

High dose of “combination pills”Copper T IUD

Birth SpacingWorld Health Organization (WHO)

recommends at least 24 months between pregnancies in order to reduce the risk of adverse maternal, perinatal and infant outcomes (2005 Report of a WHO Technical Consultation on Birth Spacing)

Why Birth Space?Birth-to-pregnancy interval

Outcome

6 months or shorter Higher risk of maternal mortality

18 months or shorter Higher risk infant, neonatal, and perinatal mortality; low birth weight, small for gestational age, preterm delivery

18-27 months “Residual” elevated risks