CONTRACEPTION

- Also known as family planning or birth

control.
- It is the act of preventing pregnancy.
- This can be a device, a medication, a
procedure or a behavior.
 CONTRACEPTION
There are many types of contraception widely used
now days for family planning purposes.
Each method has its advantages and suits special
cases and not necessarily suits others and the choice
of contraception depends on different needs of the
patients like the period of contraception and also
doctor should decide which method suits needs more.
No method of contraception is completely effective.
 Contraception
Types:-
1. Natural contraception
2. Mechanical contraception
3. Hormonal contraception
4. Surgical contraception
 Types of Contraception
1. Barrier contraceptives
2. Hormonal contraceptives
3. Sterilization
4. Methods based on information
Note: No single method of birth control is
the “best” one. Each has its own
advantages and disadvantages.
Abstinence is the only 100% effective
way to prevent pregnancy and STD’s
 Characteristics of ideal
contraceptive:
Safe
100% effective
Free of side effects
Easily obtainable
Affordable
Acceptable to the user
Free of effects on future pregnancies
Methods that physically or chemically
block sperm from reaching an egg AND
provide a BARRIER between direct skin
to skin contact
Act as a physical block between you
and your sexual partner
Great for STD protection!
 Types of Barrier Methods:
Male Condom
Female Condom
Dental Dam
Diaphragm
Cervical Cap
Sponge

Spermicides – (chemical contraception method)

Types: MALE CONDOMS
Male Condom, Cont.
 Male Condom:
Male condoms are 82 to 98 percent effective at
preventing pregnancy
Condoms can only be used once
Do not use oil-based lubricants such as massage
oils, baby oil, lotions, or petroleum jelly. They
will weaken the condom, causing it to tear or
break.
Water-based are the best – can prevent
breaking of condom.
Good choices: Latex condoms and polyurethane
Bad choices: Never choose “natural” or
“lambskin”
Female Condom
Female Condom, cont…
 Female Condom:
Female condoms are 79 to 95 percent
effective
Worn by the woman, this method keeps
sperm from getting into her body
It can be inserted up to eight hours
before sexual intercourse (though not
necessary)
The female condom is a lubricated polyurethane sheath, similar in appearance to a male condom. It is
inserted into the vagina. The closed end covers the cervix. Like the male condom, it is intended for one-time
use and then discarded.
The sponge is inserted by the woman into the vagina and covers the cervix blocking sperm from entering the
cervix. The sponge also contains a spermicide that kills sperm. It is available without a prescription.
Dental Dam
Small, thin, square pieces of latex
Used to keep partners' body fluids out of
each other's bodies
Can help to prevent skin-to-skin contact
Placed on the vulva or the anus when the
mouth, lips, or tongue are used to sexually
arouse a partner.
Can also cut a condom open on one side
DIAPRAGHM
Typical Effectiveness Rate = 80%
Latex barrier placed inside vagina during intercourse
Fitted by physician
Spermicidal jelly before insertion
Inserted up to 18 hours before intercourse and can be left in for
a total of 24 hours
DIAPHRAGM
CERVICAL CAP
Latex barrier inserted in vagina before intercourse
“Caps” around cervix with suction
Fill with spermicidal jelly prior to use
Can be left in body for up to a total of 48 hours
Must be left in place six hours after sexual intercourse
Perfect effectiveness rate = 91%
Typical effectiveness rate = 80%
Cervical Cap

The cervical cap is a flexible rubber cup-like device that is

filled with spermicide and self-inserted over the cervix
prior to intercourse. The device is left in place several
hours after intercourse. The cap is a prescribed device
fitted by a health care professional and can be more
expensive than other barrier methods, such as condoms.
 Sponge

The sponge is inserted by the woman into the vagina and

covers the cervix blocking sperm from entering the cervix. The
sponge also contains a spermicide that kills sperm. It is
available without a prescription
 Spermicides
Chemicals kill sperm in the vagina
Different forms:
-Jelly -Foam -- -
Suppository
Some work instantly, others require pre-insertion
Only 76% effective (used alone), should be used in
combination with another method i.e., condoms
Methods that prevent the release
of an egg (ovulation)
Prevents a fertilized egg from
implanting in the uterus (prevents
pregnancy).
NO hormonal methods reduce
chances of STD’s!
Types of hormonal contraception:
Oral Contraceptives (Birth Control Pill)
Birth Control Shot/ Injections (Depo-Provera)
Implants (Norplant I & II)
 The Patch
Vaginal Ring
 Oral Contraceptives
Also called “the pill,”
Some contain estrogen, progestin, or mix of
other hormones depending on pill
The pill is 91 to 99 percent effective at
preventing pregnancy.
Prescribed by doctor
A pill is taken at the same time each day
(once a day for three weeks, no pill fourth
week -will get menstrual period)
Birth Control Pills
Pills can be taken to prevent pregnancy
Pills are safe and effective when taken properly
Pills are over 99% effective
How does the pill work?
Stops ovulation
Thins uterine lining
Thickens cervical mucus
Positive Benefits of Birth Control Pills
 Prevents pregnancy Decreases incidence
 Eases menstrual of ovarian cysts
cramps Prevents ovarian and
 Shortens period uterine cancer
Decreases acne
 Regulates period
Side-effects
Breast tenderness Moodiness
Nausea Weight change
Increase in headaches
 Taking the Pill
Once a day at the same time everyday
Use condoms for first month
Use condoms when on antibiotics
Use condoms for 1 week if you miss a pill or take one late
The pill offers no protection from STD’s
Birth Control Shot
Every 3 months (or 12 weeks),
women get shots of the hormone
progestin in the buttocks or arm
from their doctor.
It is 94 to 99 percent effective at
preventing pregnancy.
It does not protect you from HIV or
other STDs
Depo-Provera
Birth control shot given once every three months to prevent
pregnancy
99.7% effective preventing pregnancy
No daily pills to remember
How does the shot work?
The same way as the Pill!
Stops ovulation
Stops menstrual cycles!!
Thickens cervical mucus
SIDE EFFECTS
Extremely irregular menstrual bleeding and
spotting for 3-6 months!
NO PERIOD  after 3-6 months
Weight change
Breast tenderness
Mood change

*NOT EVERY WOMAN HAS SIDE-EFFECTS!

IMPLANTS
Implants are placed in the body filled with hormone that
prevents pregnancy
Physically inserted in simple 15 minute outpatient procedure
Plastic capsules the size of paper matchsticks inserted under
the skin in the arm
99.95% effectiveness rate
 Norplant I vs. Norplant II
Six capsules Two capsules
Five years Three years

The pill works in several ways to prevent pregnancy.

The pill suppresses ovulation so that an egg is not
released from the ovaries, and changes the cervical
mucus, causing it to become thicker and making it
more difficult for sperm to swim into the womb. The
pill also does not allow the lining of the womb to
develop enough to receive and nurture a fertilized
egg. This method of birth control offers no protection
against sexually-transmitted diseases.
Norplant Considerations
Should be considered long term birth control
Extremely effective in pregnancy prevention > 99%
 Birth Control Patch
This skin patch is worn on the lower
abdomen, buttocks, or upper body
The patch is 91 to 99 percent effective at
preventing pregnancy
It releases hormones progestin and
estrogen into the bloodstream
You put on a new patch once a week for
three weeks. During the fourth week, you
do not wear a patch, so you can have a
menstrual period
The Patch
 Vaginal Ring
The birth control ring releases the
hormones progestin and estrogen
It is 91 to 99 percent effective at
preventing pregnancy
Ring goes inside vagina up around your
cervix
You wear the ring for three weeks, take it
out for the week you have your period,
and then put in a new ring
This method does not protect you from
HIV or other STDs.
 Emergency Contraception
Is a birth control measure, used after
sexual intercourse to prevent pregnancy.

2 Types of Emergency Contraception

1. The emergency contraceptive pill

( the “morning after pill)
2. The intrauterine device (IUD or coil)
 Emergency Contraception
Also known as the “morning after pill”
The pills are 75 to 89 percent effective at
preventing pregnancy
Can be taken up to 3-5days AFTER
unprotected sex (depending on brand)
No prescription needed over age of 15
Effectiveness decreases after 24 hours
Emergency contraception should only be
used after no birth control was used
during sex, or if the birth control method
failed, such as if a condom broke
 Intrauterine Device
It is placed inside the uterus by a doctor.
99% effective at preventing pregnancy
Copper IUD: Can stay for up to 10 years
Interferes with sperm, fertilization, and
prevents implantation
Hormonal IUD: Can stay for up to 5 years
It releases a small amount of hormone each
day to keep you from getting pregnant.
 INTRAUTERINE DEVICES (IUD)
T-shaped object placed in the
uterus to prevent pregnancy
Must be on period during insertion
A Natural childbirth required to
use
IUD
Extremely effective without using
hormones > 97 %
The intrauterine device (IUD) shown uses copper as the
active contraceptive, others use progesterone in a plastic
device. IUDs are very effective at preventing pregnancy
(less than 2% chance per year for the progesterone IUD,
less than 1% chance per year for the copper IUD). IUDs
come with increased risk of ectopic pregnancy and
perforation of the uterus and do not protect against
sexually transmitted disease. IUDs are prescribed and
placed by health care providers.
INTRAUTERINE DEVICES
T-shaped object placed in the uterus to prevent
(IUD)
pregnancy
Must be on period during insertion
Extremely effective without using hormones >
97 %
Copper

T vs.. Progestasert
1 year
10 years
99.2 % effective 98% effective
Copper on IUD acts as T shaped plastic that
spermicide, IUD blocks releases hormones over a
one year time frame
egg from implanting
Thickens mucus,
blocking egg
Procedure performed on a man or
a woman permanently sterilizes
Female = Tubal Ligation
Male = Vasectomy
Sterilization
Vasectomy: This operation is done to
keep a man’s sperm from going to his
penis, so his ejaculate never has any
sperm in it that can fertilize an egg.
Operation is more simple than tying a
woman’s tubes
During a vasectomy (“cutting the vas”) a urologist cuts and
ligates (ties off) the ductus deferens. Sperm are still produced
but cannot exit the body. Sperm eventually deteriorate and are
phagocytized. A man is sterile, but because testosterone is
still produced he retains his sex drive and secondary sex
characteristics.
Sterilization
Tubal ligation or “tying
tubes.”
A woman can have her fallopian tubes
tied (or closed) to stop eggs from being
fertilized
Over time, the ends of your fallopian
tubes could fuse back together, and it
may be possible to get pregnant
TUBAL LIGATION
Surgical procedure performed on a woman
Fallopian tubes are cut, tied, cauterized, prevents eggs from
reaching sperm
Failure rates vary by procedure, from 0.8%-3.7%
May experience heavier periods

Surgical sterilization which

permanently prevents the
transport of the egg to the uterus
by means of sealing the fallopian
tubes is called tubal ligation,
commonly called "having one's
tubes tied." This operation can be
performed laparoscopically or in
conjunction with a Cesarean
section, after the baby is delivered.
Tubal ligation is considered
permanent, but surgical reversal

can be performed in some cases

Withdrawal
Natural Family Planning
Fertility Awareness Method
Abstinence
 Natural Family Planning &
Fertility Awareness Method
Women take a class on the menstrual cycle to calculate
more fertile times
NFP abstains from sex during the calculated fertile time
FAM uses barrier methods during fertile time
Perfect effectiveness rate = 91%
Typical effectiveness rate = 75%
No 100% safe day-irregular periods