Ch 8 Contraception And Abortion Flashcards
Unplanned pregnancy rates
50% of all pregnancies are unplanned and 75% of adolescent pregnancies are unintended
Family planning
Conscious decision on when to conceive or to avoid pregnancy throughout the reproductive years
Contraception informed consent
B: benefits R: risks A: alternatives I: inquiries (chance to ask questions) D: decisions E: explanations (education) D: documentation
Fertility awareness-based methods (FAB)
Also known as periodic abstinence or natural family planning
Avoiding intercourse on fertile days
1) infertile phase: before ovulation
2) fertile phase: approximately 5 to 7 days around the middle of the cycle including several days before and during ovulation and the day afterward
3) infertile phase: after ovulation
FAB methods
Calendar based methods (calendar rhythm method, standard days method)
Symptoms based methods (today method, cervical mucus ovulation detection method, basal body temperature method, symptothermal method)
Spermicides
N-9 reduces sperm motility
Failure rate is 29% in first year alone
Barrier methods
Male and female condoms, diaphragm, cervical caps, contraceptive sponge
Toxic shock syndrome risks are present with
Diaphragms, cervical caps and sponges
Hormonal methods
Prevent the formation of a follicle which inhibits ovulation
Suppressing The surge of the luteinizing hormone
Combined estrogen and progesterone administered as
Oral, injection, transdermal patch, vaginal ring
Transdermal patch
New patch placed on weekly for three weeks, fourth week no patch
Rotate sites
Vaginal ring (nuvaring)
Inserted in to the vagina during the first 5 days of the cycle
Educate to have back up for 7 days after insertion
Removed every three weeks (free of ring for one week)
Combined oral contraceptives warning signs
A: abdominal pain (liver or gallbladder) C: chest pain sob (clot) H: headaches (cva or htn) E: eye problems (vascular accident or htn) S: severe leg pain (thromboembolism)
Clots are common with
Nuvaring
Pseudo menstruation
Mimics menstrual flow during week without hormones
Side effects related to too much estrogen
Nausea vomiting, dizziness, fluid retention, leg cramps, BP unexpectedly high
Progestin only contraception
Safer (fewer cardiovascular side effects)
Side effects include: irregular bleeding and spotting, depression, mood changes, decreased libido and weight gain, recurrent yeast infections, acne
Increases viscosity of cervical mucus and inhibits The surge of LH
Oral progestins (minipill) failure rate 9%: take exact time daily, good for breast feeding
Injectable (depovera) 11-13 wks, slows motility of Fallopian tubes, inhibits LH surge, fertility delayed after
implantable rods that can last up to three years
IUDs
Four devices: paraguard copper (10 yrs), mirena (5 yrs), liletta (3yrs), skyla (3 yrs)
Failure rate 0.2%
Watch for “aches” acronym
Permanent sterilization
Female: tubal occlusion
Male: vasectomy
Best time to start ocp
First day of menstrual flow
Can start other time, but backup contraception must be used for 7 days and you must rule out pregnancy first
Ocp missed dose
Take missed dose plus schedule tablet= two tabs
With three or more doses missed discontinue the pack wait for withdrawal bleeding and start a new pack
If dose is missed with progestin only contraceptives
Take missed dose immediately and use backup contraception for 48 hours
