© 2011 McGraw-Hill Higher Education. All rights reserved. Chapter Thirteen: Managing Your...
-
Upload
alejandro-messenger -
Category
Documents
-
view
215 -
download
0
Transcript of © 2011 McGraw-Hill Higher Education. All rights reserved. Chapter Thirteen: Managing Your...
© 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter Thirteen: Managing Your Fertility
© 2011 McGraw-Hill Higher Education. All rights reserved.
Birth Control vs. Contraception
Birth control refers to all procedures and methods that can prevent the birth of a child
Contraception refers to procedures used to prevent fertilization
© 2011 McGraw-Hill Higher Education. All rights reserved.
Theoretical Effectiveness vs. Use Effectiveness
Theoretical effectiveness: Measure of a contraceptive method’s ability to prevent a pregnancy when the method is used precisely as directed during every act of intercourse
Use effectiveness: Measure of a contraceptive method’s ability to prevent a pregnancy when used by the general public
© 2011 McGraw-Hill Higher Education. All rights reserved.
Selecting Your Contraceptive Method
SafetyEffectivenessReliabilityReversibility
Affordability Ease of use Interference with
sexual expression
Considerations when choosing contraception
© 2011 McGraw-Hill Higher Education. All rights reserved.
Behavioral Contraceptive Methods
Abstinence No sexual activity 100% effective
Chance No method used 15% use effectiveness
Withdrawal (“coitus interruptus”)
Removal of penis from vagina before ejaculation
73% use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Behavioral Contraceptive Methods (cont.)
Periodic abstinence (rhythm method)
• Calendar (calculating the unsafe days of a women’s menstrual cycle)
• Temperature (rise in body temperature correlates with timing of ovulation)
• Cervical mucus method (evaluate consistency of vaginal discharge to predict ovulation)
• Symptothermal (combines basal temperature and mucus methods)
• Standard days (appropriate for women whose cycle is between 26-32 days)
75% use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Periodic Abstinence
© 2011 McGraw-Hill Higher Education. All rights reserved.
Over-the-Counter Contraceptive MethodsSpermicides
FoamsCreamsJelliesFilmsSuppositories
CondomsMaleFemale
Contraceptive sponge
© 2011 McGraw-Hill Higher Education. All rights reserved.
Over-the-Counter Contraceptive Methods
Vaginal spermicides
OTC agents that are capable of killing sperm
71% use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Over-the-Counter Contraceptive Methods (cont.)
Male condom OTC latex shield designed to cover erect penis and retain semen upon ejaculation
85% use effectiveness
Male condom with spermicide
Latex condom in combination with spermicide
95% use effectiveness
Female condom Polyurethane sheath inserted into the vagina
79% use effectiveness
Contraceptive sponge
Small, pillow-shaped contraceptive that contains spermicide; placed in the vagina to cover the cervical opening
84% use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Use of a Male Condom
Keep a supply on handHandle condoms with carePut condom on before genital contactLubricate the condomTake care the condom is not dislodged from
penisInspect condom for tears before discarding
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prescription Contraceptive Methods
DiaphragmLea’s ShieldFemCapIntrauterine device
(IUD) Oral contraceptives
Combined pillsMinipills
Injectable contraceptive
Contraceptive implantContraceptive ringContraceptive patch
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prescription Birth Control Methods
Diaphragm • Soft rubber cup that covers the cervix• Fitted by health care professional• Used with spermicide
84% use effectiveness
Lea’s Shield or FemCap
• Lea’s shield: Reusable oval silicone device that covers the cervix
• FemCap: Reusable hat-shaped silicone cap that covers the cervix
• Use similar to diaphragm
86% use effectiveness
Intrauterine device (IUD)
• T-shaped device inserted into the uterus• Medicated or unmedicated• Somehow interferes with implantation of
the ovum• World’s most popular reversible
contraceptive method
99%+ use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Use of a Diaphragm
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prescription Birth Control Methods(cont.)
Oral contraceptive pills
• Daily pills• Estrogen works by reducing ovum development• Progesterone reduces ovulation and thickens cervical
mucus• 92% use effectiveness
Side effects •Tenderness in breasts•Nausea•Headaches•Spotting•Weight gain•Sex drive fluctuation•Frequent vaginal infections•Mild depression
Potential risks Blood clots, stroke, hypertension, heart attack
© 2011 McGraw-Hill Higher Education. All rights reserved.
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prescription Birth Control Methods(cont.)
Minipills • Daily pill• Low-dose progesterone• 92% use effectiveness
Injectable contraceptive
• Each shot effective for a 3-month period • Prevents ovulation and thickens the cervical mucus• 97% use effectiveness
Contraceptive ring (NuvaRing)
• Polymer device containing estrogen and progestin• Placed deep in the vagina for a 3-week period • 92%+ use effectiveness
Contraceptive patch
• Skin patch containing estrogen and progestin• Worn for 3 weeks, then 1 week off, then new patch• 92%+ use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prescription Birth Control Methods(cont.)
Contraceptive implant
• Protection is good for 3 years• Can be used while breastfeeding • Physician must insert and remove• May cause temporary irregular bleeding• Possibility of cardiovascular problems• 99% use effectiveness
© 2011 McGraw-Hill Higher Education. All rights reserved.
Emergency Contraception
Contraceptive measured used to prevent pregnancy within a few days of unprotected intercourse
Hormonal or IUD insertion “Morning after” pill; not RU-486 (“abortion pill”)Plan B available behind the pharmacy counter
Those under age 18 must have a prescriptionWill not cause abortion or affect established pregnancy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Sterilization
Sterilization = Generally permanent birth control techniques that surgically disrupt the normal passage of ova or sperm
Vasectomy: Removal of a section of the vas deferens
Tubal ligation: Fallopian tubes are cut and the ends tied back
© 2011 McGraw-Hill Higher Education. All rights reserved.
Male Sterilization: Vasectomy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Female Sterilization: Tubal Ligation
© 2011 McGraw-Hill Higher Education. All rights reserved.
Abortion: Termination of a Pregnancy
First Trimester ProceduresManual vacuum aspiration
Procedure performed by dilating the cervix and removing uterine contents
Dilation and suction curettage (D&C)Procedure in which the cervical canal is dilated to
allow the uterine wall to be scraped
Medication abortionRU-486 (mifepristone) blocks the action of
progesterone and causes the lining of the uterus to break down
© 2011 McGraw-Hill Higher Education. All rights reserved.
Abortion: Termination of a Pregnancy (cont.)
Second Trimester ProceduresDilation and Evacuation (D&E)
Performed between 13 and 16 weeks of pregnancyCervix is dilated and contents are removed by suction
Partial-Birth AbortionFederal Ban
Third Trimester ProceduresHysterotomyHysterectomy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Dilation and Evacuation
© 2011 McGraw-Hill Higher Education. All rights reserved.
Pregnancy
Obstacles to FertilizationAcid level in the vaginaCervical mucus thicknessLocation of cervical entrance for spermLocation of the correct fallopian tube for
spermDistance sperm travelsMotility of sperm
© 2011 McGraw-Hill Higher Education. All rights reserved.
Aids to Fertilization
200-500 million sperm cells are deposited into the vagina during ejaculation
Sperm are deposited near the cervical openingMale accessory glands help make the semen
nonacidicUterine contractions aid sperm movement in the
proper directionSperm cells move fairly quicklySperm can live for daysCervical mucus is thin and watery at the time of
ovulation
© 2011 McGraw-Hill Higher Education. All rights reserved.
Fertilization and Implantation
© 2011 McGraw-Hill Higher Education. All rights reserved.
Signs of Pregnancy (Presumptive)
Missed menstrual period after sexual intercourse the previous month
Morning sicknessIncrease in size and tenderness of breastsDarkening of the areolar tissue around the
nipples
© 2011 McGraw-Hill Higher Education. All rights reserved.
Signs of Pregnancy (Probable)
Increased frequency of urinationIncreased in the size of the abdomenCervix becomes softer by the sixth weekPositive pregnancy test
© 2011 McGraw-Hill Higher Education. All rights reserved.
Signs of Pregnancy (Positive)
Determination of a fetal heart beatFeeling of the fetus moving (“quickening”)Observations of the fetus by ultrasound or
optical viewers
© 2011 McGraw-Hill Higher Education. All rights reserved.
Agents that Can Damage a Fetus
Rubella/herpes viruses
Tobacco smokeAlcohol
Certain OTC drugsRadiationAccutane (acne drug)
© 2011 McGraw-Hill Higher Education. All rights reserved.
Intrauterine Development
Three trimesters (13 weeks each)First trimester
ZygoteBlastocystEmbryoFetus (after 8 weeks)
Second trimester: Organs develop, fetal heartbeat and bone structure evident, prominent weight gain in the mother
Third trimester: Fetus increases weight from 2-3 pounds; absorption of major nutrients allowing increased growth and weight
© 2011 McGraw-Hill Higher Education. All rights reserved.
Maintaining a Healthy Pregnancy
Arrange for prenatal careConsume a well-balanced dietTake a supplement with folic acidExercise according to your
physician’s recommendationAvoid and treat infectionsAvoid alcohol, tobacco, and
other drugsLimit your caffeine intakeStay away from x-rays, hot tubs,
saunas, toxic chemicals
© 2011 McGraw-Hill Higher Education. All rights reserved.
Three Stages of Labor
Effacement/dilation of the cervix: Uterine contractions thin the cervix and enlarge
the cervical openingCervix opens to 10 cm during this stage
Delivery of the fetus:Uterine contractions are aided by mother’s
voluntary contractions of abdominal musclesFetus moves through the birth canal
Delivery of the placenta: Placenta detaches from uterine wall
© 2011 McGraw-Hill Higher Education. All rights reserved.
Stages of Labor and Childbirth
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cesarean Deliveries (C-section)Fetus is removed from the uterus through the
abdominal wall Possibly due to one or more of the following
factors:Fetus is improperly positionedMother’s pelvis is too smallFetus is especially largeFetus shows signs of distressUmbilical cord is compressedPlacenta is being delivered before the fetusMother’s health is at risk
© 2011 McGraw-Hill Higher Education. All rights reserved.
Causes of Infertility
Low sperm countPoor sperm motilitySperm abnormalitiesLack of ovulationObstruction of fallopian tubes
© 2011 McGraw-Hill Higher Education. All rights reserved.
Enhancing Fertility
Cold packs on the scrotum (men)Boxer shorts vs. briefs (men)Intercourse no more than every 36 hours
preceding ovulation Frequent intercourse tends to lower sperm counts
© 2011 McGraw-Hill Higher Education. All rights reserved.
Treatments for Infertility
Artificial inseminationSurgical procedures Fertility drugsAssisted reproductive technology
In vitro fertilizationGamete intrafallopian transferZygote intrafallopian transfer Intracytoplasmic sperm injection
Ethical Questions?
© 2011 McGraw-Hill Higher Education. All rights reserved.
Options for Infertile Couples
Surrogate parenting
Adoption
Foster parenting
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cloning Techniques
Procedures involve the following:Surgical removal of an egg from female donorNucleus of the egg is removedCell is taken from a cloning subject
(male/female)Through an electrical jolt, the cell is fused with
the enucleated egg, creating a clonal zygoteEmbryo is implanted in the womb of a surrogate
motherAfter nine months, a genetically matched
reproduction is born
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cloning
Reproductive cloningNot yet accomplishedBanned in selected countries and states
Therapeutic cloningCan be used to create stem cells
© 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter Thirteen: Managing Your Fertility