Contraception and Pregnancy (Ch.7) Flashcards by Deleted Deleted

pro-choice movement

A movement whose followers believe that a
woman has the option to choose whether or not to terminate her pregnancy.

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Ancient Forms of Birth Control

Silphium: a plant used in ancient Greece for preventing pregnancy, was so popular that it eventually became extinct during the third or second century BCE.
Deadly substances, including mercury and arsenic: ingested for contraception in
many ancient cultures (Connell, 1999).
Barrier methods: in ancient Egypt, for example, women inserted tampons soaked in crocodile dung, honey, and various other substances thought to prevent conception into their vaginas before intercourse.

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China’s One-Child Policy

1978, reated in order to alleviate
the social, economic, and environmental problems of over-
population that China was facing, successful, In some rural
areas, there are exceptions if the first child is a girl or if the
child has some sort of disability. Multiple births (e.g., twins) are also allowed. It has been
estimated that the policy prevented 300 million to 400 million
births between 1979 and 2010.

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intra-crural intercourse

Rubbing the penis between the partner’s
thighs; “called soma in some southern African communities”; alternative to penetrative intercourse

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A Brief History of Birth Control in Canada

using, selling, and disseminating contraception was treated as a crime under Canada’s Criminal
Code of 1892 because it was thought that contraception “corrupted morals.” Under this law, a
person could serve up to two years in jail if she or he was found guilty of using contraception

the first birth control clinic opened in Hamilton, Ontario, in 1932

Prime Minister Pierre Trudeau, the use of birth control was removed from the Canadian Criminal Code; this shift reflected Trudeau’s popular position that “the state has no business in the bedrooms of the nation.” At that time it became legal for doctors to prescribe the birth control pill for contraceptive purposes; it had previously been available only as a remedy for “menstrual problems.”

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perfect use vs typical use

Ideal situation in which
the birth control method
is followed 100 per cent
accurately, / Realistic situation in
which some people will
inevitably make mistakes
in use, perhaps because
they are misinformed,
intoxicated, tired, or
forgetful.

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Margaret Sanger (1879-1966)

an American nurse and activist who
strongly believed in educating women about
contraception. She coined the term birth con-
trol, in 1914, to mean the voluntary control of
conception by mechanical and/or chemical
means

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hormonal contraceptives

Mechanism of Action: Inhibits ovulation; thins endometrium to help prevent implantation; thickens cervical mucus to trap sperm

Pros: Menstrual cycle regulation; reduced menstrual flow; decreased acne; reduced symptoms of premenstrual syndrome
(PMS); decreased risk of endometrial and ovarian cancer; increased bone mineral density

Cons: Possible temporary hormonal side effects, such as spotting between menses, breast tenderness, headaches,
decreased levels of desire, nausea, and the perception of weight gain and mood changes; slightly increased risk of breast
and cervical cancer; expensive; do not protect against STIs

Combination Oral Contraceptive Pill (estrogen and progesterone), Transdermal Contraceptive Patch, NuvaRing

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Combination Oral Contraceptive
Pill (estrogen and progesterone)

Failure Rate: Perfect 0.3%, Typical 8%

The pill is taken daily at the same time, either a break for menstruation every 21 days or continuously.

Pros: easy to take

Cons: difficult to remember to take/ take on time

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Transdermal Contraceptive

Failure Rate: Perfect 0.3%, Typical 8%

One patch applied on the skin every week for three weeks, then break for 1 week for menstruation.

Pros: need to remember only once a week

Cons: possible skin irritation from patch

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NuvaRing

Failure Rate: Perfect 0.3%, Typical 8%

Ring inserted into the vagina and placed at the cervix for 3 weeks, then removed for 1 week for menstruation.

Pros: need to remember only once per month

Cons: possible increased risk of vaginitis; interfernce with intercourse reported by 1 to 2.5% of women

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Progestin-Only Hormonal Contraceptives

Mechanism of Action: May inhibit ovulation; thins endometrium to help prevent implantation: thickens cervical mucus to trap sperm

Pros: Chance of developing amenorrhea; appropriate for women who cannot tolerate estrogen methods: appropriate for
women over the age of 35 who smoke; suitable for use while breastfeeding; may reduce menstrual flow, menstrual cramps,
and symptoms of PMS

Cons: Potential irregular bleeding; possible hormonal side effects (see “cons” of combination hormonal contraceptives); do
not protect against STIs

mini-pill, depo-provera, iud

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Mini-pill

Failure Rate: Perfect 0.3%, Typical 8%

Pill taken at approx. same time every day without breaks for menstraution.

Pros: easy to take

Cons: must be taken at the exact same time (within 3 hours) each day

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Depo-provera

Failure Rate: Perfect 0.3%, Typical 8%

Intramuscular injection by a health care provider every 3 months

Pros: need to remember only once every 3 months; reduced risk of endometrial cancer, endometriosis, chronic pelvic pain and PMS

Cons: potiental wieght gain and mood changes; decrease in bone mineral density (which may improve after discotinuing)

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hormonal IUD

perfect and typical: 0.2%

small t-shaped device with slow-release hormone instered into the uterus by a physician and a plastic string passes out through the cervix so that the woman can feel it is in place.

pros: not having to think about contraception for 5 years, significantly lower dose of hormones than with OC pills, fewer side effects; significantly reduced menstrual flow

cons: 30% of women report benign ovarian cysts, rare risk of uterine perforation or infection during insertion; expsore to stis while using iud increased risk of PID

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non-hormonal iud

Mechanism of Action: Makes uterine environment inhospitable to sperm;
inhibits implantation

Failure Rate: Perfect: 0.6% (most failures occur in the first 3 months of use)

Small T-shaped device inserted into the uterus by a physician, with
a plastic string passing out through cervix so that the woman can feel it is in place

Pros: Lasts for 5 years; reduced risk of endometrial cancer; no hormonal side effects

Cons: Possible irregular bleeding; increase in blood loss during menstruation;
exposure to STIs while using this method is associated with an increased risk of is 4
PID; possibility of expulsion or uterine perforation

Cervical Barrier Methods

Mechanism of Action: Create barriers at the cervix so sperm ‘cannot get through: ‘spermicide ‘used with these methods.
provides additional protection by killing some sperm

Pros: No hormonal side effects

Cons: Increased risk of toxic shock syndrome (TSS); no STI protection; unsuitable for women with recurrent vaginal or urinary tract infections (UTIs); may be difficult for some women to insert

Female Condom.

Mechanism of Action: 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

Pros: Protects against STIs (it provides more protection than the male condom
does against STis that are transmitted by skin-to-skin contact); made from
polyurethane (and therefore safe to be used by individuals with latex allergies); no
prescription needed; can be used for anal intercourse (by removing the inner ring)

Cons: Bulky apperance, crinkly or suction noises during intercourse; expensive

Male Condom

Mechanism of Action: Creates a , physical barrier to trap sperm
Failure Rate: Latex: perfect: 2% (0.1% when combined with hormonal
contraceptives); typical: 15%; polyurethane and silicone have a higher frequency of
breakage and slippage; nonoxynol-9 spermicidal condoms were once thought to be
more effective but are no longer recommended because they can irritate vaginal/
anal lining, increasing the risk of infection

Rolled onto the penis; must be used with a
water-based lubricant (oil-based lubricants weaken the condom structure and can
result in breakage)

Pros: No prescription needed; help protect against STIs; many universities and
community health centres offer free condoms; putting the condom on can be
incorporated into sex play

Cons: Effectiveness decreases if not stored correctly or if expired; non-latex condoms
are fairly expensive; complaints of reduced sensitivity (a small amount of a water-soluble
lubricant inside the condom, as well as a thin condom, may reduce such complaints)

Contraceptive Sponge

perfect: 9%, typical 16%

moisten with water; lasts 12 to 24 hours; removed 6 to 8 hours after last ejaculation

pros: no prescription, one size fits all, less messy, can be used multiple times

cons: high failure rate

Lea Contraceptive

8.7% with spermicide, 12.9% without

placed against cervix, removed 6 to 8 hours after intercourse, can be reused for approx. 6 months

pros: up to 8 hours of protecttion; one size fits all, no prescription

cons: must be cleaned after each use

Cervical Cap

perfect 9%, typical 20%

held in place against the cervix by suction

pros: safe for latex allergies; can be left for 72 hours

cons: can be dislodged during intercourse; may cause vaginal odour

Diaphragm

perfect 6%; typical 16%

intersted up to 6 hours before intercourse and removed within 24 hours; replaced every 2 years

pros: reduced incidence of cervical dysplasia

cons: difficult to find the spermicidial cream necessary for use with diaphragms; prescription only, significant body weught changes

Spermicides

perfect 18%, typical 29%

needs to be paired with barrier method, only effective for one act of intercourse

A contraceptive substance
that kills sperm to prevent
impregnation.

Pros: All but the VCF can also function as a lubricant; no prescription needed; can
reduce the risk of PID

Cons: Many spermicides contain nonoxynol-9, which may be irritating to the skin
and can increase the risk of infections, including STI transmission; they can be
messy; taste is not appealing; many take 10 to 15 minutes to take effect and are
effective for only about an hour

Female Sterilization—Tubal Ligation

Mechanism of Action: Prevents the egg and: sperm from ever meeting because fallopian tubes are severed Failure Rate: 0.5% Surgery done either laparoscopically (most common) or transcervically; the surgeon seals the fallopian tubes through burning, clipping, cutting, or tying; a backup form of birth control should be used for 3 months following the procedure Pros: Not having to think about contraception again Cons: Does not protect against STIs; requires general anaesthesia and may entail post-operative side effects; possible increased risk of ectopic preenancy

Male Sterilization—Vasectomy

sperm from entering ej ejaculate because vas deferens is severed Failure Rate: 0.05% after physician clearance has been given;' sperm will still be in the ejaculate for 10 to 30 ejaculations following the surgery Surgery done either through a small puncture in the scrotal skin or through one or two incisions in the scrotal skin; the surgeon removes a 1.5 cm segment from each end of the vas deferens, and the ends are sealed with a suture, cauterization, or clips; a backup form of birth control should be used until two consecutive negative semen samples are produced Pros: Relatively simple procedure with very few complications and no general anaesthesia; most studies do not find evidence of increased risk of testicular cancer; reversal surgery is available Cons: Does not protect against STIs; potential side effects and short-term complications associated with surgery, such as infection and local pain; following surgery, semen analysis needs to be done to ensure effectiveness

amenorrhea

Absence of menstruation.

chronic pelvic pain (cpp)

Chronic or recurrent pelvic pain that apparently has a gynecological origin but for which no definitive cause can be found.

Vaginitis

An inflammation of the vagina, usually due to infection, that can result in discharge, irritation, and pain of the vagina and vulva.

toxic shock syndrome (Tss)

Aserious but uncommon bacterial infection, originally associated with tampon use but now known to have an association with some contraceptive barrier methods.

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.

Information- Motivation- Behavioural Skills (imB) model

social psychology model that identifies three major components (information, motivation, and behavioural skills) that may directly or indirectly affect sexual health behaviours.

therapeutic abortion

abortion performed when the mother’s life is at risk, the pregnancy is likely to cause severe physical or mental health consequences in the mother, or the fetus has a congenital disorder associated with a significant risk of morbidity.

elective abortion

An abortion performed for reasons other than maternal or fetal health.

Abortion around the World

While it is legal in North America, most European countries, China, India, and South Africa, it remains illegal in most African, South American, and Central American nations unless there is a threat to maternal life, health, or mental health (and in some cases exceptions are made for rape or fetal defects). Abortion is illegal with no exception in El Salvador, Malta, and Vatican City

gestation

In mammals, the period of time in which a fetus/ embryo develops in the uterus, beginning with fertilization and ending at birth.

Medical (Non-surgical) Abortions

performed up to seven weeks following the last menstrual period, but they can be done up to the ninth week of gestation;

Surgical Abortions

Manual Vacuum Aspiration: flexible plastic tube is inserted through the woman’s cervix, and a syringe attached to the tube removes the contents of the uterus by creating suction. Vacuum Suction Curettage: sixth to the fourteenth week of gestation - woman’s cervix must be dilated, either with laminaria tents (thin tubes made of sterile, dry seaweed that slowly expand as they absorb fluid) or progressively larger rod-like dilator instruments. Once the cervix has been dilated, a tube is inserted through the opening and into the uterus. The contents of the uterus, including the fetal tissue, are then suctioned out, and a curette is used to gently scrape the uterine lining to ensure that all of the tissue has been removed Dilation and Evacuation: thirteenth through sixteenth weeks of gestation, though it can be performed up to the twenty-fourth week. The procedure is similar to vacuum suction curettage, but it is more complicated because of the increased size of the fetus, and it must be done in a hospital under general anaesthetic. Second- and Third-Trimester Abortions: equire feticide to ensure that the fetus is not born alive. This can be done with an injection of a substance to stop the fetal heart. The fetus is then typically removed through the cervix with the assistance of med- ical devices such as forceps.

feticide

A deliberate act that causes the death of a fetus.