Chapter 7 - Contraception Flashcards
1
Q
Examples of ancient contraception
A
- Silphium: Plant used in ancient Greece
- Mercury and arsenic: Deadly drugs used in ancient cultures
- Tampons soaked in crocodile dung, honey, and other substances: Egyptian method
2
Q
Intercrural intercourse
A
- Sexual practice in which a partner moves their penis between the partner’s thighs without any type of penetration
3
Q
What was the most common form of birth control employed during human prehistory
A
- Infanticide
- Which is killing a child within a year of its birth
4
Q
Contraception as a crime in Canada
A
- Was a crime under Canada’s Criminal Code of 1892
- Because of corrupted morals
- Could serve up to two years in jail
- Was not removed from the criminal code until Pierre Trudeau was in office
5
Q
China’s one-child policy
A
- Policy in China restricting the number of children per couple (Typically to one)
- Rich couples we’re able to afford the penalty for multiple children
- Abolished in 2016 because there was an imbalance of men and women in the aging population
6
Q
Gabriello Fallopio’s Invention
A
- Invention of reusable condoms made from linen
- They we’re later made from animal intestines
- These contraceptives we’re seen in a negative light once we wanted to repopulate after the plague (especially by the Catholic Church)
7
Q
Probability of getting pregnant within a year
A
- 85% if you are sexually active and no contraception is being used
8
Q
Hormonal Contraceptives
A
- Reversible but don’t protect against STIs
- Work by inhibiting ovulation, altering the endometrium, and/or altering the consistency of the cervical mucus
9
Q
Combination oral contraceptive pill
A
- Estrogen and progesterone
- Pill taken daily with either a break every 21 days or continuously
- Failure rate:
- Perfect: 0.3%
- Typical: 9%
- Easy to take but difficult to remember
10
Q
Transdermal contraceptive patch
A
- Failure Rate:
- Perfect: 0.3%
- Typical: 9%
- One patch applied on the skin every week for 3 weeks, then a break for 1 week for menstruation
- Need to remember only one per week
- May cause skin irritation from patch
11
Q
NuvaRing
A
- Failure Rate
- Perfect: 0.3%
- Typical: 9%
- ring inserted into the vagina and placed at the cervix for 3 weeks then removed from 1 week for menstruation
- Need to remember only once per month
- Possible increased risk of vaginitis; interference with intercourse reported by a few
12
Q
Mini-pill
A
- Failure rate:
- Perfect: 0.3%
- Typical: 9%
- Pill taken at about the same time without breaks for menstruation
- Easy to take but time specific
13
Q
Injectable (Depo-Provera)
A
- Failure rate:
- Perfect: 0.2%
- Typical: 6%
- Intramuscular injection by a health care provider every 3 months
- Need to remember only once every months, reduced risk of endometrial cancer, endometriosis, CPP, and PMS
- Potential weight gain and mood changes; decrease in bone mineral density
13
Q
Hormonal Contraceptives
A
- Combination pill
- The patch
- NuvaRing
Progestin-Only
- Mini pill
- Injectable
- IUD with hormones
13
Q
Levonorgestrel-releasing intra-uterine system
A
- Hormone releasing IUD
- Failure rate:
- 0.2%
- Placed in uterus by a physician
- Don’t have to think about contraception for 5 years, lower dose of hormones, fewer side effects, reduced menstrual flow
- Rare health issues like ovarian cysts, pelvic inflammatory disease, etc.
14
Q
Copper IUD
A
- Makes uterine environment inhospitable to sperm; inhibits implantation
- Failure rate: 0.8% (usually within the first 3 months of use)
- Placed in uterus by a physician
- Last for 5 years, reduced risk of endometrial cancer, no hormonal side effects
- Possible irregular bleeding, increase blood loss during period, no STI protection, etc.
15
Q
Non hormonal contraceptives
A
- Copper IUD
16
Q
Cervical barrier methods
A
- Contraceptive sponge
- Cervical cap
- Diaphragm
- Spermicides
- Internal condom
- External condom
17
Q
Contraceptive sponge
A
- Failure Rate Nulliparous (never given birth):
- Perfect: 9%
- Typical 12%
- Failure Rate Parous (Given birth before):
- Perfect: 20%
- Typical: 24%
- Moisten with water; lasts 12 to 24 hours; removed 6 to 8 hours after last ejaculation
- No prescription needed, one size fits all, already contains spermicide, multiple intercourse acts within the effective period
- High failure rates
18
Q
Cervical Cap
A
- Failure rate:
- Nulliparous failure: 14%
- Parous failure: 29%
- Held in place against cervix by suction
- Made of silicone, can be left in for 72 hours
- Can be dislodged during intercourse, may cause vaginal odour
19
Q
Diaphragm
A
- Failure Rate:
- Perfect: 6%
- Typical: 12%
- Inserted up to 6 hours before intercourse and removed within 24 hours; replace every 2 years
- Reduced incidence of cervical dysplasia
- Difficult to find the spermicidal cream necessary for use with diaphragms, available by prescription only, significant body weight changes require resizing of the diaphragm by a physician
20
Q
Spermicides
A
- Failure Rate:
- Perfect: 18%
- Typical 28%
- Spermicide should be paired with barrier methods in order to be more effective; regardless of how long the spermicide is effective, it is only effective for one act of intercourse
- Vaginal contraceptive film: inserted into the vagina at least 15 minutes, but no more than an hour prior
- Bioadhesive jelly: inserted with an applicator, effective immediately and for up to 24 hours
- Foam: Inserted with an applicator; effective immediately and for up to 1 hour
- Suppositories: Inserted 10 to 15 minutes prior to intercourse; effective for 1 hour
- Jellies or creams: Primarily for use with a diaphragm or cervical cap; effective for 6 to 8 hours if used with these devices or 1 hour if used alone
- Can function as a lubricant, no prescription needed, can reduce risk of PID
- Can contain irritants to the skin, yucky taste, takes a little bit to work
21
Q
Internal condoms
A
- Creates a physical barrier to trap sperm
- Failure Rate:
- Perfect: 5%
- Typical: 21%
- Inserted into vagina up to 8 hours before intercourse, with flexible ring end at cervix, outer portion covers the vulva
- Protects against STIs, no prescription needed, can be used for anal if you remove the rink
- Bulky, crinkly, suction noises, expensive
22
Q
External condom
A
- Creates a physical barrier to trap sperm
- Failure Rate:
- Perfect: 2%
- Typical: 18%
- Rolled onto penis, must be used with a water-based lubricant to not break the condom
- No prescription needed, help protect against STIs, can be found for free
- Effectiveness decreases if not stored correctly or expired, good ones can be expensive
23
Q
Surgical Methods
A
- Female sterilization (tubal ligation)
- Male sterilization (vasectomy)
24
Q
Female Sterilization
Tubal Ligation
A
- Prevents the egg and sperm from ever meeting because fallopian tubes are severed
- 99% effective
- Surgeons seals the fallopian tubes through burning, clopping, cutting or tying
- Does not protect against STIs, requires surgery
25
Q
Male Sterilization
Vasectomy
A
- Prevents sperm from entering ejaculate because vas deferens is severed
- Failure Rate: 0.05%
- Sperm will still be in the ejaculate for 10 to 30 ejaculations
- Removes 1.5cm segment from each end of the vas deferens, and the ends are sealed with a suture, cauterization, or clips
- Simple procedure, reversible
- Does not protect against STIs, may have some pain for a little bit after the procedure, semen analysis is needed after to ensure effectiveness
26
Q
Amenorrhea
A
- Absence of period
27
Q
Chronic Pelvic Pain (CPP)
A
- Chronic or recurrent pelvic pain that apparently has a gynaecological origin but for which no definitive cause can be found
28
Q
Vaginitis
A
- Inflammation of the vagina
- Usually due to infection
- Can result in discharge, irritation, and pain in vagina and vulva
29
Q
Toxic Shock Syndrome
A
- Serious but uncommon bacterial infection, originally associated with tampon use but now known to have an association with some contraceptive barrier methods
30
Q
A
31
Q
Natural Methods
A
- Do not protect against STIs
- Intercourse must be avoided during the ovulation phrase
32
Q
Fertility Awareness Methods
A
- Rely on a detailed understanding of female physiology and menstrual cycle
- Failure Rate of 24%
- Can be really complicated to understand/remember and may also be messed up by a lot of factors
33
Q
The sympto-thermal approach
A
- Used to chart basal body temp, cervical position, and cervical mucus to gain insight into when one is fertile and therefore likely to get pregnant
- Rise of 0.2 degree following ovulation, and the fertile time last three days following this temp rise
- Perfect use is 91 to 99% effective and typical use if 80% effective
34
Q
Rhythm Method
A
- Calendar based method of family planning that estimates the start and end of the fertile time based on past cycle lengths and involves abstaining from intercourse during the fertile time
- Low failure rate, but shouldn’t be the primary method because there are too many things that are unpredictable
35
Q
Lactational Amenorrhea
A
- 98% effective
- Hormonal suppression of ovulation caused my breastfeeding
- Must be exclusively breastfeeding pretty much for it to work
36
Q
The Withdrawal Method
A
- One must be able to recognize when ejaculation is imminent and have the self control to withdrawal
- Effectiveness:
- Perfect: 96%
- Typical: 81%
- Pregnancy can still occur from pre-ejaculate
37
Q
Abstinence
A
- Refraining from some or all aspects of sexual activity
- Can be 100% effective if they actually follow it
- We should teach this as an option to kids, not the only option because then they’ll engage in risky sex practices
38
Q
Birth Control around the World
A
- Mostly used by women
- Most common contraceptive methods in the world are female sterilization, IUD, OC pills, and condoms
39
Q
Birth control in Canada
A
- Most used: condoms, OC pills, withdrawal method
- Don’t have much access in the country as others
- IUD is on the rise
40
Q
Why use birth control
A
- People don’t have money
- We don’t want teen pregnancy
- We don’t want an overpopulation issue
41
Q
Not getting birth control
A
- 28% of women have not asked their doctors about birth control
- Some may not feel comfortable or have opportunities to ask
42
Q
Why do people take sexual risks
A
- Personality, situational, and relationship factors may influence an individual’s decision to engage in sexual risk taking
43
Q
Information-Motivation-Behavioural Skills (IMB) model
A
- Social psychology model that identifies three major components
- Information,
- Motivation, and
- Behavioural skills
- These may directly or indirectly affect sexual health behaviours
- Ex: Contraceptive needs to be available and understood (information), they need the motivation to use the contraception (motivation), need to be confident in getting and using the contraception (behaviour skills)
- This can be achieved through sex ed
44
Q
Talking to your partner about contraception
A
- Doesn’t need to be a long conversation
- Just tell them if you’re on anything or if they should get a condom type vibe
- Longer term relationships may want longer term solutions
- Both partners should have equal part in contraception
45
Q
Emergency contraception (EC)
A
- Any contraceptive method used after intercourse and before the time that the egg can implant in the uterine lining
- Not the same as an abortion, and it does not have an effect on established pregnancies
- Not recommended as a regular method of birth control, ut rather just a backup
- Two main methods: Hormonal and the IUD
46
Q
The Emergency Contraceptive Pill
A
- Plan B: Levonorgestrel and progestogen
- Yuzpe: Levonorgestreal, ethinyl estradiol, and estrogen
- Plan B is more effective and has fewer side effects
- Available without prescription since 2005
- Should be taken within 72 hours
- Reduce risk of pregnancy by 75 to 89%
47
Q
Post-coital IUD Insertion
A
- Post coital insertion of an IUD
- Effectiveness approaches 100%
- Needs to be inserted within seven days
- Requires a doctors appointment and prescription
- Similar side effects to the ones of getting a normal IUD
48
Q
Therapeutic abortion
A
- Abortion when the birthing person’s life is at risk
- Preg is likely to cause severe physical or mental health consequences in the parents, or the fetus has severe problems
49
Q
Elective Abortion
A
- Performed for other reasons than maternal or fetal health
50
Q
History of abortion in Canada
A
- 1869: Abortion was made illegal in Canada leading to potential life in prison
- Dr Henry Morgentaler was like nah, later went to the supreme court and won in 1988
- The Canadian Abortion Rights Action League was the first national abortion rights group
51
Q
Medical Nonsurgical Abortions
A
- Performed up to seven weeks following the last menstrual period, but can be done up to the tenth week of gestation
- Doctor injects methotrexate into the hip muscle to stop the growth of the fetus
- Five to seven days later the woman takes misoprostol as a pill or as a suppository to cause the uterus to contract and the contents of the uterus are usually expelled with 24 hours
Or
- Mifepristone which blocks progesterone, which prepares the lining of the uterus for an egg. Without progesterone the preg cannot proceed
- Then they take misoprostol
- About 94 to 98% effective
52
Q
Surgical abortions
A
- Manual vacuum aspiration
- Vacuum suction curettage
- Dilation and Evacuation
53
Q
Manual Vacuum aspiration
A
- During the first seven weeks of preg
- Flexible plastic tube is inserted into the cervix and a syringe attached to the tube removes the contents of the uterus by creating suction
54
Q
Vacuum suction curettage
A
- 6th to 14th week of gestation in hospital
- Under general or local anaesthetic
- Cervix gets dilated
- Tube is inserted and the contents of the uterus are suctioned out, then a curette is used to scrape the lining to ensure everything is removed
- Less than a 1% failure rate
55
Q
Dilation and Evacuation
A
- 13th to 16th weeks
- Similar to vacuum suction curettage but more complicated because of the size of the fetus
- Must be done under general anaesthetic
- Beyond the 16th week the fetus must be removed with forceps
56
Q
A
57
Q
Second and third trimester abortions
A
- Occur after the 20th week of gestation
- Inject a substance to stop the fetal heart and remove the fetus with forceps
- May induce labour to deliver or get a C-section as a last resort
58
Q
Psychological effects of abortion
A
- Severe negative psych rections are rare, then tend to be mild with slight regret, sadness, or guilt
- A lot of people have relief and happiness
- Majority don’t have long term issues
59
Q
Adoption
A
- Putting kids up for adoption is pretty rare (estimate of around hundreds)
- Majority of unplanned preg end either in abortion or in parenting
- There are still lots of kids to adopt, just not babies
