Chapter 7 Flashcards
What kind of problem is Birth control?
• Human righst to access to BC for women, there are places around the wold who can not access this
In Canada when was BC/abortion illegal?
19thC
Where was the first BC clinic in canada?
1932 Birth Control Society of Hamilton became the first Canadian Birth Control Clinic
• Distribution and sale of birth control remained illegal in Canada until 1969
Who states that the state has no business in the bedrooms of the nation?
Pierre trudeau
Why do contraceptive methods fail?
• User error
-miscommunication
• Inconsistent use
-“We use condoms most of the time”
• Non-use
•Contraceptive failure
-broken condom
What is the IMB model?
Information
Motication
Behavioural Skills
All influence sexual behaviours
Who developed the IMB model?
Fisher
What does I stand for in the IMB model?
Information: Must be specific and practical in order to help individual feel well informed
-Eg. Where to obtain contraceptive information and contraceptive devices
What does M stand for in the IMB model?
Motivation: Increases with information, positive attitude, and perceived social acceptability of sex/contraceptive use
-Eg. social expectations to use condoms
What does B stand for in the IMB model?
Behavioural: Skills that function to: refuse sex when contraception is not available; discuss sex with a partner; and acquire contraceptives
- Reduce negative outcomes
- Enhance sexual health and contraceptive use
What is an erotophile?
have positive emotions related to sex and sexual stimuli
What is an erotophobe?
tend to have negative emotions related to sex
What are the 5 steps related to proper contraception use for erotophoobes?
- Obtaining contraceptive information.
- Erotophobes have less sex information than erotophiles do
- Retain less than erotophiles when given the same sex information - Acknowledging that sex may occur.
- Erotophobes may not plan because they don’t acknowledge the possibility - Obtaining contraceptives.
- Erotophobes are more embarrassed thus less likely to use it consistently - Communicating with a partner.
- Erotophobes have difficulty talking about sex, may delegate to a partner - Using contraceptives every time.
- Erotophobes are less comfortable with sex and sexual stimuli thus will find contraceptive use awkward
What was the IMB model study?
2013
-sexually active women between the ages of 17 and 22 were recruited in 1st year undergraduate classes
- results of this study support the IMB model as a paradigm for explaining and predicting sexual health behaviour of young women
- -Predictive model and important for influencing behaviour for dual protective behaviours. Understand that the method can reduce unplanned pregnanies and redcues STI
What are the guidelines for birth control education in canada?
IN a perfect world all of the following should happen:
No limits to access
Education should be comprehensive and inclusive
Education should include methods based on Fisher’s IMB model
Teachers must be well-trained and supported with current information
Education programs should be evaluated periodically
What ar the non barrier, non hormonal forms of BC?
Billings Ovulation Method
-Practice based primarily on cervical mucous observations
Creighton Model
- Practice based on cervical mucous and sympto-thermal observations
- Effectiveness 98% with trained teacher and motivated users
What are the birth control methods approved by the Catholic Church?
Billings method
Creighton Method
What is the fertility awareness method?
Methods of birth control that involve abstaining from inter-course around the time the woman ovulates.
What are the calendar methods?
A type of fertility awareness method of birth control in which the woman determines when she ovulates by keeping a calendar record of the length of her menstrual cycles -abstain from sex days 10-17 -Assumptions: regular cycle, ovulation around day 14, eggs survive 24 hours, sperm live 3 (to 5) days
Why do people choose FAM or NFP?
•Religious reasons
-Beliefs that inhibiting pregnancy is a sin
•Medical reasons
- side effects of birth control
- history of illness that contraindicates hormonal BC use
•Philosophical reasons
-personal health empowerment
What is the FAM?
Fertility awareness method
Promoted outside of a religious context
-Tought from an empowerment perspective outside religious context
No value judgments related to the use of barrier methods, emergency contraception, or abortion
What is the BBT method?
Basal Body temperature
temp stays low until ovulaiton and then increases
Thin and clear cervical ceretions and is a sign that you are ovulating
• Spinnbarkeit kit (fertile fern pattern under a miscroscope shows youa re ovulating)
What is the Justisse method?
For contraception and fertility enhancement
-Feels rhythm method is obsolete and that women can be taught to
observe, chart and interpret the three primary signs of fertility cervical mucus secretions, cervical position & BBT
Who is the Justisse method promoted too?
Methodology promoted for women of all ages Child-bearing ages
Post-partum/Lactating women
Women in peri-menopause
What are saliva kits?
Kits include glass slides/ clear surface, swabs and magnifier
Ferning pattern of buccal
saliva indicative of ovulation
What is the symptothermal method?
• Cross reverencing basal body temp, cervical secretions, spinnbraket formation
What are ovulation kits?
- Use urine to predict the LH surge that signals ovulation
- Relatively expensive
- More expensive
What is the 2 day method?
User asks herself 2 Q’s every day:
- Did I have secretions today?
- Did I have any secretions yesterday?
Cervical secretions today OR yesterday, (potentially fertile/avoid unprotected sex)
No cervical secretions/ two consecutive dry days today and yesterday (pregnancy less likely)
Thin and watery secretions means ovulation and should be avoided
What is the standard day method?
For women with a relatively standard monthly cycle
- Assumes a” fixed window” of fertility
- No calculation or observation
- Easy to teach, learn and use
Pregnancy avoidance involves not having unprotected between days 8 and 19 of the cycle
Uses fertility bracelets
Which non hormonal non barrier form of BC is more effective?
Calendar Method: 5% failure rate
BBT Monitoring: 2% failure rate
Sympto-Thermal Methods: 2% failure rate Cervical
Mucous Monitoring: 3% failure rate
When are IMB failure rates low?
Failure rates are lower when the woman’s cycle is very regular and when the couple are highly motivated and have been well instructed in the methods.
What is a vasectomy?
Vas deferens cut
Sperm do not integrate with ejaculate
Generally no changes to erection, orgasm, ejaculation
Should be considered permanent (although reversible)
How do we know a vasectomy worked?
• Considered a succes when provide sperm sample a couple weeks later to see if there is anything still in there
What is the female version of a vasectomy?
Fallopian tubes “cut and tied” or clipped, cauterized
Does not affect menstrual cycling/ ovarian function
-Hysterectomy with oophorectomy cause sterilization and menopause
Performed laproscopically or trans- cervically
May be performed upon request after a planned c-section
What is coitus interruptus?
Heterosexual sexual practice where the male withdraws his penis from the vagina prior to ejaculation. Ejaculation and orgasm occurs outside and away from the woman’ s genital area.
Withdrawal one of the oldest strategies of birth control
22% failure rate
What is the pill?
- A combined hormonal method that contains both estrogen and progestin
- Prevents ovulation
- Thickens cervical mucous to prevent passage of sperm through cervix
- Typical effectiveness rate is 97%
What is Evra?
Hormones are absorbed transdermally - through the skin
- Works in the same way as oral contraceptives
- New patch applied weekly
- Prevents ovulation, thickens cervical mucus
- 99%effective
May not be effective if you are over 198lbs
What is NuvaRing?
Hormones are introduced into the body through a soft, flexible ring that is inserted into the vagina
- Ring sits inside vagina for three weeks, is removed for one week, and a new ring is then inserted
- Slowly releases a low dose of estrogen and progestin
- Prevents ovulation, changes uterine lining and thickens cervical mucous
- ~97% effective with perfect use
What is Depo-Provera?
- Anintramuscular injection of progestin administered every 10 to 13 weeks
- Preventsovulation, changes uterine lining and thickens cervical mucous
Can be used by people over 35 and those who smoke
• ~98%effective
What is an IUD?
Aplastic T-shaped device with a copper wire that contains no hormones
• Thins uterine lining and thickens cervical mucous
• Inserted into the uterus by physician
• Can remain in for up to 10 years
• ~98%effective
What is an IUS?
AplasticT-shapeddevice containing the hormone progestin
• Thins uterine lining and thickens cervical mucous
• Inserted into uterus by physician
• Can remain in fo rup to 5 years
• ~98%effective
What is plan B?
Also known as the morning after pill or emergency contraception (ECP)
- Main mechanism of action is to stop the release of an egg from a woman’s ovary
- Ideally used within 24 hours of unprotected sex or broken condom.
- Still very effective up to 72 hours after
- May work up to 5 days after but effectiveness drops dramatically
No perscription needed
What is ELLA?
Can be taken within 5 days of unprotected sex
- Does NOT become less effective over time
- It may be less effective for women 194 pounds or more
- Avoid using if on hormonal birth control (plan B is a better option)
How do you obtain contraceptives?
Allcontraceptivemethods(exceptplanB) discussed so far require a physician prescription
What are external condoms?
- Thin latex or polyurethane (non- latex) that fits over an erect penis
- Catches sperm during ejaculation to prevent it from entering the vaginal/ cervical canal
- Typical effectiveness is 88%
What are internal condoms?
- Polyurethane sheath that covers the entire length of the vagina
- Provides a physical barrier to prevent sperm from entering cervical canal
- Typical effectiveness rate is 80%
What re the different pregnancy termination methods?
Vacuum aspiration/curettage (MVA)
Dilation and evacuation
Induced labor
What is vacuum aspiration?
• Conceptus is removed from the uterus using a vacuum aspirator • Performed during the first trimester • Up to 14 weeks • Women may be given medication to relax her, but will generally be awake during the procedure
What is dilation and evacuation?
Similar to vacuum extraction, but usually for later second trimester abortions (14-24 weeks)
• In hospital, general anesthetic
What is induced labor?
Late second trimester
• Medications are used to induce labour
(into amniotic sac, or intravenously)
• Ex. Digoxin, Methotrexate and misoprostol
