Chapter Thirteen:Managing Your Fertility

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Birth Control vs. ContraceptionBirth Control vs. Contraception

Birth controlBirth control refers to refers to allall procedures (umbrella procedures (umbrella term)term)

ContraceptionContraception procedures are used to decrease procedures are used to decrease chances of fertilization of an ovum (more chances of fertilization of an ovum (more specific)specific)

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Selecting YourSelecting YourContraception MethodContraception Method

SafetySafety EffectivenessEffectiveness ReliabilityReliability ReversibleReversible

AffordabilityAffordability Ease of useEase of use Interference with Interference with

sexual expressionsexual expression

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Current Birth Control MethodsCurrent Birth Control Methods

MethodMethodTheoretical Theoretical

EffectivenessEffectiveness

No methodNo method 15%15%

WithdrawalWithdrawal 96%96%

Periodic abstinencePeriodic abstinence 91-99%91-99%

Cervical capCervical cap 91%91%

SpermicideSpermicide 94%94%

Diaphragm with spermicideDiaphragm with spermicide 94%94%

Male condomMale condom 97%97%

Male condom with spermicideMale condom with spermicide 99%99%

Female condomFemale condom 95%95%

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Current Birth Control Methods Current Birth Control Methods (cont’d)(cont’d)

MethodMethodTheoretical Theoretical

EffectivenessEffectiveness

IUD, copper / progestinIUD, copper / progestin 99%+ / 98%99%+ / 98%

Combined pillCombined pill 99%+99%+

MinipillMinipill 99%+99%+

Depo-Provera (3 month)Depo-Provera (3 month) 99%+99%+

Lunelle (1 month)Lunelle (1 month) 99%+99%+

Contraceptive RingContraceptive Ring 99%+99%+

Tubal ligationTubal ligation 99%+99%+

VasectomyVasectomy 99%+99%+

Contraceptive PatchContraceptive Patch 99%+99%+

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Periodic AbstinencePeriodic Abstinence

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Vaginal SpermicideVaginal Spermicide

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Birth Control PillsBirth Control Pills

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Cervical CapCervical Cap

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SterilizationSterilization

VasectomyVasectomy – separating vas deferens – separating vas deferens Tubal ligationTubal ligation – separating fallopian tubes – separating fallopian tubes

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Abortion – Abortion – Termination of a PregnancyTermination of a Pregnancy

First trimester proceduresFirst trimester procedures• Menstrual extractionMenstrual extraction• Vacuum aspirationVacuum aspiration• Dilation and curettage (D&C)Dilation and curettage (D&C)• Medical abortion Medical abortion

Mifepristone (RU-486)Mifepristone (RU-486) MethotrexateMethotrexate

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Abortion – Abortion – Termination of a Pregnancy (cont’d)Termination of a Pregnancy (cont’d)

Second trimester proceduresSecond trimester procedures• Dilation and evacuation (D&E)Dilation and evacuation (D&E)• Hypertonic saline solutionHypertonic saline solution• Prostaglandin procedureProstaglandin procedure

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Abortion – Abortion – Termination of a Pregnancy (cont’d)Termination of a Pregnancy (cont’d)

Third trimester proceduresThird trimester procedures• HysterotomyHysterotomy• HysterectomyHysterectomy

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PregnancyPregnancy

Obstacles to fertilizationObstacles to fertilization• Acid levels in vaginaAcid levels in vagina• Thickening of cervical mucusThickening of cervical mucus• Location of cervical opening for spermLocation of cervical opening for sperm• Location of current fallopian tube for Location of current fallopian tube for

spermsperm

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Pregnancy (cont’d)Pregnancy (cont’d)

Obstacles to fertilization, cont’dObstacles to fertilization, cont’d• Distance for spermDistance for sperm• Movement of sperm “upstream”Movement of sperm “upstream”• Location of egg due to contoured folds Location of egg due to contoured folds

of tubal wallsof tubal walls

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Pregnancy (cont’d)Pregnancy (cont’d)

Aids to fertilizationAids to fertilization• Number of spermNumber of sperm• Deposition of spermDeposition of sperm• Accessory gland productionAccessory gland production• Uterine contractionsUterine contractions• Movement of spermMovement of sperm

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Pregnancy (cont’d)Pregnancy (cont’d)

Aids to fertilization, cont’dAids to fertilization, cont’d• Life of spermLife of sperm• Consistency of mucusConsistency of mucus

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Signs of PregnancySigns of Pregnancy[Probable signs][Probable signs]

Frequency of urinationFrequency of urination Increased size of Increased size of

abdomenabdomen Cervix becomes softerCervix becomes softer Positive pregnancy testPositive pregnancy test

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ChildbirthChildbirth

Stage 1Stage 1 – – effacement and dilation of the effacement and dilation of the cervixcervix

Stage 2Stage 2 – – delivery of fetusdelivery of fetus Stage 3Stage 3 – – delivery of afterbirth (placenta)delivery of afterbirth (placenta)

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