Chapter 9

Contraception and Birth Control

Learning Outcomes

01 Identify contraception and birth control methods

Describe the application and effectiveness of contraception and

02 birth control methods
 Introduction
• The chance of pregnancy is about 30% if intercourse occurs around ovulation.
• Couples who do not use contraception have 90% chance of pregnancy after a year.
• Contraception allows for the prevention of pregnancy and for planning the timing of
pregnancy.
• There are many different types of contraception, but not all types are appropriate for all
situations.
• Traditionally has been the women's responsibility.
• By using a condom, men can help take contraceptive responsibility.
 Birth Control
1. Abstinence - 100% effective
2. Permanent contraception - Sterilization

• Vasectomy - man
• Tubal ligation
(fallopian) - woman
• Hysterectomy
(uterus) - woman
 Birth Control
3. Temporary contraception
a. Hormonal method
• Contraceptive pills
• Implants prevent ovulation
• Injectable contraceptive
• Hormonal intrauterine device (IUD) - make the mucus on your cervix thicker
b. Non hormonal - Prevent sperm and egg union
• Condom (male and female) and spermicides.
• Diaphragm and cervical cap.
• Natural way of determining fertile period of female.
• Copper IUD
Birth
Control
 Contraceptive Pill
• Over 40 different types.
• Although dosages of hormones are different, all work the same way.
• Block Graafian Follicle development
•  ovulation →  egg →  fertilization.
• Reduced endometrium development.
• Combination of estrogen and progestin (some progestin only).
• Inhibits ovulation.
• Thickens the cervical mucous.
• Changes the lining of the uterus to inhibit implantation of the fertilized ovum.
• Alter the rate of ovum transport.
• 99.5 % effective (if used correctly).
 Risks of Oral Contraceptives (OCPs)
• Side effects
• Changes in menstrual flow.
• Breast tenderness.
• Nausea.
• Vomiting.
• Wt. gain or loss.
• Aches
• Abdominal pain.
• Chest pain or shortness of breath.
• Headaches (severe).
• Eye problems (blurred vision, flashing lights and blindness).
• Severe leg pain.
 Implant

• Progestin only (Norplant).

• Prevents ovulation.
• More effective than the pill.
• Advantages:
• Convenience.
• Eliminate user error.
• No menses or very light.
• Decreased cramping.
 Risks of Implant

• Side effects • Contraindications( shouldn’t be taken)

for contraceptive implants
• Changes in menstrual bleeding.
• Liver diseases
• Headaches.
• Breast cancer
• Hair growth.
• Pregnant
• Breast tenderness.
• Cardiovascular disease
• Weight gain.
• Unexplained vaginal bleeding.
• Acne
• Ovarian cycts
 Injectable Contraceptives

• Depo-Provera (DMPA) Progesterone

• Can stop menses.
• Side effects include spotting, weight
gain, headaches, breast tenderness,
dizziness, loss of libido and depression.
• Lunelle Progestin and estrogen.
• Similar to the pill in all aspects.
 Trandermal Contraceptive Patch
• A contraceptive patch is a transdermal patch applied
to the skin that releases synthetic estrogen and
progestin hormones to prevent pregnancy
• The hormones in the patch are the same hormones as
in the birth control pill - estrogen and progestin.
• The hormones in the birth control patch work by
keeping eggs from leaving the ovaries. Pregnancy
cannot happen if there is no egg to join with the
sperm.
• Making cervical mucus thicker. This keeps sperm from
getting to the eggs.
 Barrier Contraceptives
Female condom

• A pouch inserted into the vagina to prevent pregnancy.

• Reduces the risk of sexually transmitted infection
• Safe, effective, and convenient.

Male condom

• A thin covering made of latex, plastic, or animal membrane that

is rolled over an erect penis.
• Prevents sperm from entering a woman's vagina.
 Barrier Contraceptives
Diaphragms
• Comparatively large and can be obtained in different
size.
• High amounts of spermicides is required.
• Prevents sperm passing through the cervix
• Efficiency is 84-94%.
• May cause urinary tract infection Cervical Cap
• Smaller, more rigid and less noticeable.
• Fewer spermicides is required.
• Prevents sperm passing through the cervix
• Efficiency is about 71% for women who have given birth vaginally, and 86% for women
who have never been pregnant or given birth vaginally.
 Contraceptive Sponge

• A foam sponge inserted into the vagina to

prevent pregnancy
• The sponge covers the cervix and
blocks sperm from entering the uterus.
• The sponge also continuously releases a
spermicide that keeps sperm from moving.
 Spermicides
• Nonoxinol-9 – non toxic detergent that
destroys the sperm membrane
• Use in combination with barrier methods
of contraception:
• Foam
• Gel
• Film
• Creams, jellies and suppositorie.
 Intrauterine Device (IUD)

• Copper and plastic (Copper T-380A) -

can prevent pregnancy for up to 10 years
after insertion
• Plastic and Progesterone (progestasert
IUD) 1 year.
• 90-96 % effective in use.
• Prevent implantation.
Intrauterine Device (IUD)
 Fertility Awareness Methods
• Refers to a type of natural family planning.
• To identify end of the fertile time.
• Calendar or rhythm method
• Basal body temperature (BBT) method
• Ovulation may cause a slight increase in basal body temperature.
• Cervical mucous method
• Clear slippery mucous.
• Symptothermal method
• Combination of BBT and Cervical Mucous methods.
Fertility
Awareness
Methods
Fertility
Awareness
Methods
 Emergency Contraception

• 75% - 95% effective.

• Medication administered
within a few days of
unprotected intercourse
• Works up to 5 days (120
hours) after intercourse.
• Does not affect an
already established
pregnancy.
 Sterilization

• Tubal ligations - women

• Cut and seal the fallopian tubes.
• Hysterectomy - women
• Removal of the uterus.
• Vasectomy - men
• Vas deferens are cut and sealed.
Hysterectomy
The
Vasectomy
Procedure
 Abortion
Termination of established pregnancy.
• Miscarriages (Spontaneous abortion).
• Induced Abortions
• Drug induced:
• Mifepristone (RU-486) - Early Abortion Pill
• blocks progesterone action on endometrium.
• Surgical methods
• Vacuum aspiration.
• Dilation and evacuation.
• Hysterectomy.
• Saline, prostaglandins and urea (after the first trimester).
 How RU- 486 Works
Mifeprex Misoprostol
• Blocks progesterone action. • Induces myometrial contractions.
Vacuum Aspiration and Curettage
 Abortion
• 2nd trimester
• Dilation and evacuation.
• Only 1.5% of abortions in second trimester.
• Third trimester
• Controversial.
• Dilation of cervix, fetus removed feet first and collapse of fetal skull for passage through
vagina.
 Preventing Sexually Transmitted
Disease (STD’S)
• Most STD’s are treatable if diagnosed early.
• AIDS is one exception> AIDS is FATAL.
• Some contraceptive methods work to help prevent disease and pregnancy.
• Latex and polyurethane condoms provide barrier protection against virus and bacterial
infection: such as Herpes virus, chlamydia, gonococcus, and HIV.
• Not 100% effective at preventing infection or pregnancy.
• Spermicides are chemicals that kill sperm offer protection against some STD’s, foam or film
can provide extra protection.
• Use of spermicides with barrier methods increase the effectiveness of both the infection and
pregnancy protection of the method.
 A birth control method that is:
• 100% Effective (0% failure rate).
• Completely safe.
• Has no side effects.
• Is reversible.
• Separate from the sex act.
• Inexpensive.
• Easy to obtain.
• Used by either sex.
• Doesn’t require memory.
Effectiveness