chapter 12 PSYC_3150_10
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This 10 page Class Notes was uploaded by Gabriela Saint-Louis on Saturday April 4, 2015. The Class Notes belongs to PSYC_3150_10 at George Washington University taught by Forssell in Spring2015. Since its upload, it has received 226 views. For similar materials see Psychology of Sex Differences in Psychlogy at George Washington University.
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Date Created: 04/04/15
Chapter 12 Contraceptive Choices and Ending Pregnancy INTRO CONTRACEPTIVE METHODS gt methods of contraception used throughout history as well as methods used today 0 HISTORICALLY 0 due to the biblical command to quotbe fruitful and multiplyquot contraception was discouraged by all Christian faiths for many years 0 earliest oral contraceptives came from fruits and plants Pomegranates and yams are high in natural plant estrogens and may prevent conception 0 Before modern methods of contraception were available women inserted any number of substances including crocodile dung mule earwax and weasel testicles into their nether regions in their efforts to avoid pregnancy 0 Douching ushing the vagina with mixtures of water and other substances such as vinegar baking soda or iodine 0 TO DAY 99 of women in US who have ever had sexual intercourse with a male have used at least one contraceptive method 62 of American women aged 1544 use some form of birth control Oral contraceptives tubal sterilization male condoms and vasectomies are the most popular methods used in the US some women do not use contraception because they are trying to get pregnant they are sterile or because they are not currently having heterosexual intercourse I CONTRACEPTIVE METHODS oral contraceptives the patch the ring injectable and implantsreduce fertility by their effect on a woman39s hormonal cycle Condoms cervical caps sponges and spermicides resent a physical barrier that prevents the sperm from meeting the eg 0 change sexual behavior planning sexual activity during less fertile times of a woman39s cycle withdrawal or absitence most effective lUDs surgicalsterilzation gt roles played by Anthony Comstock and Margaret Sanger in the history of Contraception 0 Anthony Comstock oneman purity campaign crusading against tobacco alcohol gambling atheism and pornography The Comstock Act of 1873 allowed for the con scation and destruction of any material that was considered obscene including contraceptive devices physicians were not allowed to provide their patients with any information that might aid in the prevention of pregnancy or sexually transmitted diseases 0 Margaret Sanger obstetric nurse believed women had right to control her own body that every person should be able to decide whether to have a child and that every child should be wanted and loved Led movement for the distribution of information about sexuality and contraception gt De ne effectiveness of a contraception and differentiate between perfect and typical use 0 Effectiveness of method measured by the ear index which estimates the number of unintended pregnancies per 100 women over a year 0 Effectiveness can be measured under quotperfectquot conditions or under quottypicalquot conditions These numbers differ because most people do not use birth control method perfectly and consistently HORMONAL METHODS OF CONTRACEPTION gt mechanism of action of hormonal methods of contraception 0 Oral contraceeptives contain progestin as well as usually estrogen disrupt the woman39s natural cycle and prevent pregnancy by thickening the cervical mucus by disallowing the development of follicles and by preventing ovulation Most oral contraceptives are taken daily for 21 days and then a placebo is taken for 7 days during which a woman will have withdrawal bleeding With perfect use OCs are very effective in preventing pregnancy gt typical side effects of hormonal contraceptives 0 common temporary side effects breast tenderness minor depression nausea or change in skin pigmentation headache and slight weight gain possibly 0 OCs may cause a change in sexual desire oral contraceptives raise levels of sex hormonebinding globulin SHBG a substance that binds testosterone which affects sexualdesue o More serious side effects increased risk of blood clots gt Advantages and disadvantages of hormonal contraceptives 0 Advantages can diminish heavy painful or irregular periods and hel alleviate the anemia that may occur due to a heavy flow improvement of facial acne help decrease ectopic pregnancy reduce ris of pelvic in ammatory disease and ovrian cysts and lower a woman39s risk of getting ovarian and endometrial cancers women who took piill less likely to die prematurely from any cause including cancer and heart disease Hannaford et al 2010 o Disadvantages available only by prescription can be expensive and not always covered by insurance can interfere with a woman39s normal hormonal cycle which is unappealing to some not everyone can take it as estrogen poses a potential health risk to some women do not protect against STls gt different methods of hormonal contraception 0 patch orto Evra placed on the sin of the butt stomach upper outer arm or upper torso protects a woman from pregnancy for a week at a time o ring NuvaRing small exible ring that is inserted into the vagina once a month both release both estrogen and progestin and protect a woman from pregnancy o Implanon a small progestincontaining rod that is inserted on the inside of a woman39s upper arm gives continuous contraceptive protection for up to 3 years BARRIER METHODS gt Compare and contrast the use ef cacy and advantages and disadvantages of different forms of barrier contraceptives 0 FOR WOMEN Diaphragms and cervical caps latex rubber barriers that cover the cervx to prevent sperm from entering the uterus need to be t by a physician and re tted if a woman changes her weight by more than 10 lbs Contraceptive Sponge soft and disposable the sponge provides a physical barrier to sperm entering the uterus as well as the spermicide 0 MENWOMEN soermicides agents that kill sperm Foams jellies creams tablets vaginal suppositories or on a lm 0 available without prescription Male condoms one of the world39s oldest contraceptive devices 0 rubber condoms became available in the 19th century providing protection against pregnancy and disease syphillis at the time 0 only reasily reversible contraeption method available to men other than withdrawal 0 most effective method other than complete abstinence to prevent STI not 100 through consistent condom use decreases risk of HIV transmission by 90 condom use is highest in adolescents and unmarried adults blacks and Hispanics more than other racial groups 0 men and women over 50 are unlikely to use condoms FEMaLE Condoms sheath closed at one end with exible rings at both ends that ts in the woman from the cervix to the labia Not as popular as male condoms 0 Male and female condoms should not be used at the same time as friction can cause breakage BEHAVRIORAL METHODS gt abstinence outercourse withdrawal and fertility awarenessbased methods 0 Abstinence primary abstinence when a person has never had sex some choose abstinence after having had previous sexual expedence can be voluntary or involuntary some people choose to be celibate whereas others are abstinent because they currently have no relationship are in poor health or their life situation precludes a sexual relationship most effective behavioral method of protection against pregnancy and STI 0 Outercourse sexual activity that doesn39t include the insertion of the penis into the vagina mouth or anus may include masturbation body rubbing frottage or dry humping fantasy erotica and sex toys Bene ts important part of foreplay allows for enjoyment of sexual activity without fear of pregnancy or STI help improve sexual enjoyment 0 Withdrawal removing penis from vagina and ejaculating outside of the woman39s body oldest form of birth control third most commonly used method of contraception used by college students after condoms and the pill 2010 one of few methods that obligate male to be responsible for birth control 0 FertilityAwareness Based Methods use of physical signs of a woman39s hormonal uctuations to predict her fertility woman can reduce chances of getting pregnancy by begn ware ofher fritile times and abstaining from sex or using a barrier mthod of contraeption during these times Basal body temperature method cervical mucus method noticing changes in color consistency and pH of cervical uid and cervical mucus during ovulation calendar rhythm method relies on consistency of ovulation during a woman39s cycle symptothermal method combination of calendar method BBT and mucus tests INTRAUTERINE DEVICES IUDS gt Mechanism of action ef cacy and advantages and disadvantages of IUDs 0 Mechanism of action small device made of exible plastic that is placed in the uterus world39s most popular form of reversible birth control used by women used by nearly 128 million worldwide 45 of women in china use it less widely used in the US one of the safest and most effective forms of reversible BC perception in USgt that it is not safe work by preventing fertilization presence of the IUD in uterus causes lowgrade in ammation and prompts the release of white blood cells which are toxic to both sperm and egg 0 Advantages less than 1 failure rates per year Offer long term immediate protection against pregnancy once in IUDs don39t need any further action by woman Fertility returns as soon as the IUD is removed by a clinician 0 Disadvantages nor recommended for women who are anemic or who already have heavy cycles or extreme cramping etc women with active STIs multiple sex partners pelvic in ammatory disease risk if a woman gets pregnant while on IUD 50 greater chance of miscarriage or premature birth unless IUD removed ASAP STERILIZATION has highest user satisfaction rating of all contraceptive methods very effective does not use hormones allows for spontaneous sexual activity and doesn39t affect sexual sensation must be performed by a physician and should be considered irreversible 0 For women 0 tubal sterilization fallopian tubes are cut and cauterized preventing the sperm from meeting the egg in the tubes 0 does not disrupt monthly periods or sexual desire 0 10 million women in US 0 not 100 effective 45 of 1000 women still get pregnant 0 For men 0 Vasectomy man39s vas deferentia are cut 0 will still produce sperm but they will not be added to the semen during ejaculation shooting blanks 0 new form of contraception under development 0 more contraception available for women contraception in men involves completely suppressing production of the millions of sperm that are produced daily whereas in women it involves preventing the development or fertilization of usually one egg per month 0 Gossypol oral contraceptive designed to be taken by men stops the production of sperm without affecting hormone levels or sex drive but may lead to sterility 0 other potential male contraceptiveshormonal injections microbicides ultrasound waves and antibodies to sperm 0 inhibiting calcium channels preventing sperms ability to reach the egg EMERGENCY CONTRACEPTION gt de nition measures that protect against pregnancy after unprotected sex has already occurred 0 hormonallv Emergency Contraception pills ECP Combination pills contain both estrogen and progesterone whereas others such as Plan B contain only progestin Plan B ECP most effective in preventing fertilization if taken within 72 hours of unprotected sex do not provide long term contraception o insertion of an IUD 99 effective in preventing a pregnancy if it is inserted within ve to 7 days after unprotected sex can be left in or removed after next cycle gt mechanism of action effectiveness side effects and advantages and disadvantages of EC a mechanism of action high dose BC pills Main method inhibiting ovulation also may thicken the cervical mucus alter the transport of sperm through the fallopian tubes or directly affect the ability of the sperm to fertilize the egg 0 Effectiveness combination ECPs reduce risk of pregnancy by 75 and progestinonly pills such as PanB reduce the risk by up to 89 ECPs more effective the sooner after sex the pills are taken Emergency IUD insertion is more effective reducing the risk of pregnancy by 99 ABORTION gt De ne 0 medical termination of a pregnancy before the embryo or fetus has developed enough 0 survive outside of the woman gt reasons women may choose to have abortion 0 Reaons usually a woman chooses abortion to reduce the risk of physical psychological social or economic harm for herself or for any present or future children 0 Most likely to get an abortion young poor and unmarried women of color who become pregnant over the age of 40 and women who have had three or more previous live births are also more likely to choose to end a pregnancy gt mechanism of action side effects advantages and disadvantages of medication and surgical abortion procedures 0 Medication abortions taken 2 days apart RU486 ends a pregnancy by blocking the actions of progesterone Misoprostol Aids RU486 by softening and dilating cervix and causes uterine contractions which leads to the expulsion of the embryo Side effects similar to those of miscarriage abdominal pain cramping dizziness fatigue nausea vomiting and diarrhea heavy bleeding also a side effect 0 Surgical abortions Vacuum aspiration safest and most common for of abortion in the US can be performed during the rst trimester an angled tube attached to an aspirator is inserted into the uterus and empties the uterine contents by suction takes 10mins Dilation and curettage performed in a hospital under heavy sedation or general anesthesia cervix is dilated and the uterine contents are scraped from the uterine lining with a metal loop Not as safe as vacuum aspiration and carried a higher risk of hemorrhage infection and perforation of the uterus Dilation and evacuation combines vacuum aspiration with forceps and a curette most commonly used during second trimester when simple vacuum aspiration would be too rislql Some of the uterine contents are removed via vacuum aspiration and the remaining contents are removed with a curette and forceps Riskier because it is performed later in pregnancy gt existence of postabortion syndrome 0 0 most common postabortion emotion is RELIEF rates of psychological distress following abortion are lower than those felt by women before their abortions Many prolife groups claim a large percentage of women wo have undergone abortion are suffering from postabortion syndrome PAS condition similar to posttraumatic stress disorder and characterized by guilt depression lowered selfesteem and ashbacks not recognized as a psychological disorder by American Psychiatric Association or by the American Psychological Association gt legal history of abortion in America 0 0 abortion has been permitted for most of US history began to be criminalized in the mid19th century because of a national desire to increase the population and to protect women from substandard procedures Roe v Wade Decreed that a woman39s right to a safe legal abortion was protected under her constitutionally guaranteed right to privacy During rst trimester abortion decision left to woman and physician39s and states have little right to interfere after rst trimester each state could regulate abortion procedures in ways reasonably related to the woman39 health After viability when the fetus was capable of sustained survival outside of woman39s body the state may choose to regulate or even prohibit abortion but can39t impose restrictions that interfere with life or health of pregnant woman gt effect of the legality of abortion on its incidence worldwide 0 42 million abortions performed worldwide each year 0 legal restrictions on abortions don39t affect its incidence in fact abortion rates are higher in countries where abortion is highly restricted 0 abortion levels are low in western European countries where abortion is legal and covered by national health insurance and there are fewer unintended pregnancies SAMPLE QUIZ QUESTIONS 1 The primary mechanism of action for oral contraceptives is the prevention of ovulation Humans did not always know what caused pregnancy and thought that conception might occur due to eating certain fruits 3 The Bible contains references to contraception True 4 Weekly injections of were found to reduce the production of sperm Testosterone What is thought to be the main quotmechanism of actionquot of emergency contraceptive pills inhibition of ovulation How is abortion most often depicted on TV There are most often negative consequences associated with abortions depicted on TV What is a disadvantage of the quotdilation and curettagequot method of abortion there is a risk of hemorrhage 8 What is a major risk of tubal sterilization ectopic pregnancy 10 Abortion rates are often highest in countries where abortion is highly restricted True Zoe and Darius are newly married and are not yet ready to start a family They decide to avoid pregnancy by having Zoe monitor her temperature monitor changes in her cervical mucus and track the length of her menstrual cycle What is this method called symptothermal method
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