Contraception

Historical and Social Perspectives

• Evidence of contraception since the beginning of recorded history

• U.S. contraceptive efforts– 1800s Comstock laws– 1915: Margaret Sanger– U.S. Supreme Court rulings

• Griswold vs. Connecticut• Eisenstadt vs. Baird

Contemporary Issues on Contraception

• Planning for wanted children• Physical health of mother• Insurance coverage of contraceptives• Population growth• Cultural gender-role expectations• Wide diversity of views among cultures and

religious groups

Average Number of Children

Sharing Responsibility for Contraception

• Ask about birth control before intercourse

• Read and discuss options together

• Attend a class or clinic together

• Share expenses

Choosing a Birth Control Method

• Consider effectiveness and cost

• Consider ease of use and side effects

• Characteristics of ineffective use

Choosing a Birth Control Method

Choosing a Birth Control Method

Choosing a Birth Control Method

Choosing a Birth Control Method

Hormone-Based Contraceptives: 4 Basic Types of The Pills

• Combination pill

• Triphasic pill

• Constant dose

• Progestin-only pill

Other Hormone-Based Contraceptives

• Vaginal ring• Transdermal patch• Injected contraceptives

Barrier Methods

• Condom

– Sheath fits over erect penis

Barrier Methods: The Female Condom

Vaginal Spermicides

• Can be purchased in pharmacies without a prescription

• Types– foam, sponge, suppositories, creams, film

Cervical Barrier Devices

• Diaphragm• Cervical cap• Fem Cap• Lea’s Shield

Cervical Barrier Devices

• Diaphragm• Cervical cap• Fem Cap• Lea’s Shield

Intrauterine Devices

• Affect sperm motility & viability

• Thicken cervical mucous

• Alter endometrial lining

• Impair tubal motility

Intrauterine Devices

Emergency Contraception

• Hormonal: – Birth control pills taken within 72 hours of

unprotected intercourse• Copper-T:

– Inserted up to 5 days after unprotected sex • Access Issues

Emergency Contraception

Fertility Awareness Methods

• Standard days method

• Mucus method

• Calendar method

• Basal body-temperature

Basal Body Temperature

Female Sterilization

Male Sterilization: Vasectomy

Nursing: A Less than Effective Method of Birth Control

• Amenorrhea is common for a brief period after birth while breastfeeding

• 80% ovulate before first period

Withdrawal Before Ejaculation: A Less than Effective Method

• Difficult to judge when to withdraw• Anxiety may lower pleasure• Cowper’s gland fluid may carry sperm• Any sperm on vulva may travel into

vagina/uterus• Unreliable