Chapter Six
Contraception and Abortion
Contraception
Contraception procedures are used to decrease chances of fertilization of an ovum
Modern contraceptive methods are much more predictable and effective than in past years
Many types of contraceptives play an important role in protecting against sexually transmitted diseases (STDs)
Principles of Contraception
Barrier methods
Block sperm from reaching the ovum
Hormonal methods
Altering body chemistry, preventing ovulation
Natural methods
Based on understanding how sperm and ova function
Surgical methods
Sterilization procedures
Contraceptive Effectiveness vs. User Effectiveness
Contraceptive effectiveness: measure of a contraceptive method’s ability to prevent a pregnancy as directed during intercourse
User Effectiveness: effectiveness of the method in preventing conception when used by the general public
Continuation rate: percentage of people who continue to use a method after a period of time
Oral Contraceptives: The Pill
Hormonal method
Hormonal Methods (cont.)
Emergency Contraception
In 1998, the FDA approved the first combination pill (Preven)
A year later, a progestin pill was developed (Plan B)
ECP’s reduce the risk of pregnancies by delaying or inhibiting ovulation when taken within 120 hours of unprotected intercourse
Effective rates improve when taken earlier vs. later
ECP’s do not induce a medical abortion or affect the developing pre-embryos or embryos
Current Birth Control Methods, cont’d
Prescription Birth Control Methods
Natural Birth Control Methods
Fertility Awareness Methods (FAM)
Sterilization
Vasectomy – separation of the vas deferens
Tubal ligation – separation of the fallopian tubes
Hysterectomy – removal of the uterus
Which Contraceptive Methods is Right For You?
What is Abortion?
Expulsion of an embryo or fetus from the uterus before it sufficiently develops
Can also be referred to as those expulsions that are artificially induced by mechanical means or drugs
Miscarriage is generally used as a natural form of expulsion without any causal intervention
Current Legal Status
In 1973, the U.S. Supreme Court made abortion legal in the landmark case, Roe vs. Wade
First Trimester: decision left to pregnant woman and physician
Second Trimester: similar rights but state may dictate regulatory factors
Third Trimester: State regulates and can bar abortions, unless it is to preserve the life of the woman
U.S. Congress has barred the use of federal Medicaid funds to pay for abortions, except in cases of incest, rape, or immediate life-threatening danger
Current Trends
43% of a decline of abortions was due to the use of emergency contraception
Many states are imposing additional restrictions on abortion i.e. waiting period, counseling, age of consent, and type of procedure
The typical woman having an abortion is:
Age 20
Has a previous birth history
Has never married
From a lower socio-economic background
Lives in a metropolitan area
Is considered “Christian”
Methods of Abortion
Manual Vacuum Aspiration
MVA is considered a new option not available at all clinics
Cervix is dilated and a plastic tube attached to a syringe is inserted
Gestational sac is removed by suction force
Abortions after the First Trimester
Dilation and Evacuation (D&E)
Method most commonly used after the 12th week of pregnancy
Cervix is opened using dilators and surgical instruments are used to remove the uterine contents
Induction of Labor
Prostaglandins are used to induce labor
Delivery of fetus usually occurs in 6-24 hours later
Fewer than 1% use this method
Complications of Abortion
Fever >100 degree F
Abdominal pain or swelling, cramping, or backache
Prolonged or heavy bleeding
Foul-smelling vaginal discharge
Vomiting or fainting
Abdominal tenderness (to pressure)
Delay in resuming menstrual periods (6 weeks or more)
Psychological After-effects of Abortion
These aftereffects vary with the individual
Many women go through a period of ambivalence (back and forth)
Stronger feelings are felt immediately after the abortion
Support from a partner, friend, and/or family member can be helpful