Chapter 8: Contraception and Abortion

Question 1

What are some important factors for contraception methods?

Answer 1

• must meet personal, social, cultural, and interpersonal needs of pt
• should be readily available
• should be economical
• should be acceptable
• should be simple to use

Question 2

What is coitus interruptus?

Answer 2

withdrawal method of contraception

Question 3

What are some fertility awareness based methods of contraception?

Answer 3

• natural family planninng (NFP)
• avoiding intercourse during fertile periods – 3 days before and after ovulation
• charting menstrual cycle with abstinence or other contraceptive methods
• calendar-based: standard days or calendar rhythm methods
• symptoms-based: 2-day, cervical mucus ovulation (cervical mucus changes around ovulation), basal body temp (BBT, dip in temp during ovulation), or symptothermal methods
• biologic marker: home ovulation predictor kits
• breast feeding: lactation amenorrhea where breast feeding delays ovulation; not recommended as birth control

Question 4

What is the failure rate of spermicides?

Answer 4

29% when used alone – not a recommended method of contraception; should be used in conjunction with a condom

Question 5

What are some barrier methods of contraception?

Answer 5

• condoms
• diaphragms
• cervical caps
• contraceptive sponge

Question 6

What are some risks for barrier methods?

Answer 6

with diaphragms, cervical caps, and sponges, there is risk of toxic shock syndrome

Question 7

What are some of the warning signs to teach pts who are starting or taking COCs (combined estrogen-progestin oral contraceptives)?

Answer 7

– ACHES:
* A = abdominal pain – indicates problem with liver or gallbladder
* C = chest pain or SOB – indicates clot problem with lungs or heart
* H = headaches – may be due to CVA or hypertension
* E = eye problems – indicate vascular accident or hypertension
* S = severe leg pain – indicates thromboembolic process

Question 8

What are some types of progestin-only contraceptives?

Answer 8

• oral (minipill) – must be taken at same time every day
• injectable – may have a delayed return to fertility after stopping
• implantable – single rod implanted

Question 9

How soon after unprotected intercourse should a woman take an emergency contraceptive?

Answer 9

oral emergency contraception should be taken within 5 days but ASAP after unprotected intercourse or birth control mishap

Question 10

What are IUDs? What is their typical failure rate?

Answer 10

• intrauterine devices
• T-shaped device inserted into uterine cavity
• offers no protection against STIs or HIV
• educate pt on ACHES symptoms/complications
• typical failure rate = 0.2% in the first year of use

Question 11

What is permanent sterilization?

Answer 11

• surgical procedure intended to render a person infertile
• can have male or female permanent sterilization:
  1. male = vasectomy – interruption of vas deferens
  2. female = tubal occlusion, transcervical sterilization, or tubal reconstruction

Question 12

What is induced abortion?

Answer 12

• purposeful interruption of pregnancy before 20 weeks gestation
• can be elective or therapeutic