MONSALUD, CAURRINE M.
BSN-2C
METHODS OF CONTRACEPTION
1. Permanent Contraception
Permanent contraception is methods of sterilisation that prevent
pregnancy permanently. The procedure for men is a vasectomy and for
women it is tubal ligation.
VASECTOMY
A vasectomy is a procedure to cut and tie the tubes (vas deferens)
that carry the sperm up from the testicles. This means that sperm can’t
get far along the tubes to mix with the semen. Men who have had
vasectomies still ejaculate and produce semen but since there is no
sperm in it, the woman’s egg can’t be fertilised. After the procedure,
another form of protection should be used until tests show that the
semen is totally sperm-free. This is usually three months after the
operation.The failure rate of vasectomies is 1 in 2,000. They can be
reversed but this is very expensive and doesn’t always result in
pregnancy.
PROS
If the procedure is successful, It's the most effective form of
birth control there is, besides abstinence. Since we all know
abstinence isn't really something anyone wants to voluntarily
practice, vasectomy is the way to go if you're 100% sure you
never want kids (or more kids, in most cases).
CONS
There is a very small chance that the urologist might make a
mistake that results in a lot of pain until it can be fixed with
a second procedure. Most people don't experience this, but
it's possible.
TUBAL LIGATION
Tubal ligation is a procedure to close both fallopian tubes in a woman.
This means that sperm can’t get to the egg to fertilise it. The tubes are
closed using rings or clips or by cutting and tying. It is usually done by
putting a tiny telescope called a laparascope in through a small cut near
the belly button and closing the tubes through another small cut near
the pubic hair. If a laparascope can’t be used then a longer cut is made
near the pubic hair.
Tubal ligations are done in hospital and the woman is put under general
anaesthetic. Depending on the type of operation she may go home the
same day or stay 1-2 days in hospital.There is a new method where 2
little coils are put up into the fallopian tubes and the tubes become
blocked over the next few months. A general anaesthetic isn’t necessary.
The failure rate of tubal ligation is 1 in 200. We don’t do female
sterilisation at Family Planning clinics so talk to your GP if you are
thinking about having the procedure.
PROS
It doesn’t affect your hormones. It won’t change your periods
or bring on menopause. And it doesn't cause the side effects
that birth control pills do, like mood swings, weight gain, or
headaches, or the ones sometimes caused by IUDs, like
cramps, heavier periods, or spotting.
CONS
It’s permanent. While it can sometimes be reversed with
surgery, that's not always possible. Only around half the
women who have a reversal are able to get pregnant. Unless
you're certain you'll never want to get pregnant, tubal ligation
isn’t right for you.
THE LAW AND CONSENT
In New Zealand sterilisation is allowed for the purposes of contraception,
which isn’t the case in all countries. Sterilisation services became more
accessible after the Contraception, Sterilisation and Abortion Act of
December 1977.
If you are in a relationship there is no legal requirement for your partner
to give their consent for you to undergo sterilisation. However, it is a
good idea to discuss it with them as it may affect you both.
There is no age limit on sterilisation procedures in New Zealand. Some
surgeons are reluctant to carry out sterilisation if you are young and
have not had any children. This is because there is a concern that
younger people may change their mind about having children later.
2. Long Acting Reversible Contraception
Long Acting Reversible Contraception is a term used to describe methods
of contraception which are highly effective in protecting a woman from
getting pregnant for an extended period of time. They are the most
effective reversible methods of contraception because they do not depend
on you remembering to take or use them to be effective.
Both hormonal implant and intrauterine methods are available for long
acting protection, and are highly effective in keeping you pregnancy free
for up to 3, 5 or 10 years, depending on the method. They are reversible,
meaning that once you stop using them the contraceptive effect wears off
quickly and women can become pregnant as rapidly as those ones who
have used no contraceptive at all.
INTRAUTERINE SYSTEM (IUS)
The IUS is a small, soft, T-shaped device with a reservoir containing the
hormone progestin that is placed in the womb by your healthcare
provider. The IUS works by continuously releasing a low dose of
progestin from the intrauterine system into the womb. It thickens the
mucus of your cervix, which makes it harder for sperm to move freely
and reach the egg and it also thins the lining of your uterus. At 99.8%
effectiveness, you’re about as protected as you possibly can be by a
contraceptive method. It’s a great method for the super organized, the
forgetful, the frequent traveller and pretty much anyone else who is keen
on staying not pregnant. However, there are some individual risk factors
that make an IUS not recommendable to some women.
PROS
It can stay in place for either 3 or 5 years (depending on the
type), but can be removed any time.
At 99.8%, it’s one of the most effective contraceptive methods
Some women may have shorter lighter or less frequent
periods, which reduces the chances of becoming anemic
Suitable for women who want long-acting reversible
contraception for up to 3 or 5 years and wish to avoid daily,
weekly or monthly regimens
CONS
It requires a trained healthcare provider for insertion and
removal
Irregular bleeding and spotting can be common in the first 6
months of use
INTRAUTERINE DEVICE
The IUD might sound a little space age but it just stands for Intrauterine
Device, intrauterine meaning inside the uterus. It might look strange but
it is a highly effective, small, T-shaped device containing a copper thread
or cylinders which is placed in the uterus by your healthcare provider.
The IUD releases copper ions which immobilizes the sperm and makes it
really hard for them to move around in the womb, but does not stop the
ovaries from making an egg each month. On the rare occasion a sperm
does get through, the copper stops a fertilized egg from implanting itself
to the lining too. The IUD, once inserted into the womb, can stay in place
for up 5 or 10 years (depending on the type) or until you decide to
remove it.
PROS
It can stay in place for up to 5 or 10 years (depending on the
type), but can be removed any time
At 99%, it’s one of the most effective contraceptive methods
It doesn’t interrupt sex
CONS
It requires a trained healthcare provider for insertion and
removal
It may causes cramps and/or irregular bleeding
CONTRACEPTIVE IMPLANT
The contraceptive implant might sound a little space age initially but
really it’s a highly effective, easy to hide contraceptive. About same size
than a matchstick, the implant is placed just below the skin of your
upper arm where it constantly releases the hormone progestin in small
doses from a reservoir into your blood stream. The hormone keeps your
ovaries from releasing eggs but also thickens your cervical mucus
making it hard for sperm to move around in the womb and fertilize an
egg.
PROS
At 99.95%, it’s the most effective contraceptive method
available
It can offer an alternative to those affected by the hormone
estrogen
CONS
Does not protect against HIV infection (AIDS) and other
sexually transmitted infections (STIs)
It may cause weight gain, breast and abdominal pain
LAW AND CONSENT
Yet unlike other contraceptives, LARCs are associated with special procedural
risks because they must be inserted and removed by trained healthcare
providers. It is unclear whether the unique invasive nature of LARC changes
the traditional ethical calculus of permitting adolescent decision-making in the
realm of contraception. To answer this question, we review the risk–benefit
profile of adolescent LARC use. Traditional justifications for permitting
adolescent contraception decision-making authority are then considered in the
context of LARCs. Finally, analogous reasoning is used to evaluate potential
differences between permitting adolescents to consent for LARC procedures
versus for emergency and pregnancy termination procedures. Ultimately, we
argue that the invasive nature of LARCs does not override adolescents’ unique
and compelling need for safe and effective forms of contraception. In fact,
LARCs may oftentimes be in the best interest of adolescent patients who wish
to prevent unintended pregnancy. We advocate for the specific enumeration of
adolescents’ ability to consent to both LARC insertion and removal procedures
within state policies. Given the provider-dependent nature of LARCs and the
stigma regarding adolescent sexuality, special political and procedural
safeguards to protect adolescent autonomy are warranted.
