1

Unintended,
occur earlier Unintended,
than desired - occur after
29% desired family
size reached -
20%

Intended - 51%

Approximately 6.4 million pregnancies per year

 Nonuse all year -
8%

Inconsistent Consistent,
use - 27% long-acting
method use -
50%

At-risk gap use -

15%
28 million U.S. women at risk for
unintended pregnancy
Unintended
pregnancies
per 1,000
women
 Perfect-Use
Effectiveness Family Planning Typical-Use Rate
Rate of
Group Method of Pregnancy
Pregnancy
No Method No method 85% 85%
Male latex
14% 3%
condoms
Diaphragm 20% 6

Cervical cap 20%-40% 9%-26%

Less effective Female condoms 21% 5%

Spermicide 26% 6%

Withdrawal 19% 4%
Fertility 20% 1%-9%
Awareness
CONTRACEPTIVE CHOICES

ABSTINENCE Diaphragm
FERTILITYAwarenes Cervical Cap
CALENDAR HORMONAL
BASAL Body Temp. Oral Contraceptives
SYMPTOTHERMAL Norplant
WITHDRAWAL Depo- Provera
BARRIER METHOD IUD
Spermicides Emergency Contraception
Condoms STERILIZATION

CONTRACEPTION AND PREGNANCY 9

ABSTINENCE
 This is the only sure method of birth control to prevent an
unintended pregnancy or unwanted STD’s
Abstinence from intercourse does not necessarily equate with
being nonsexual
It is possible to attain a level of intimacy without risking
pregnancy
Many young adults decide to delay sexual intercourse for a
variety of reasons

CONTRACEPTION AND PREGNANCY 10

FERTILITY AWARENESS

This method helps women understand their menstrual cycle better

It requires a high level of motivation and cooperation by both
partners
These methods have a high user failure rates
Not recommended for couples who could not tolerate a
pregnancy
Offer no protection against STD’s

CONTRACEPTION AND PREGNANCY 11

CALENDAR METHOD
Also referred to as the rhythm method
This requires abstinence during ovulation
Should be supplemented with another option if pregnancy
cannot be tolerated
This could be effective if a women knew the exact day of
her ovulation
To be safest abstinence is necessary from day11to 21 of
woman’s cycle
The egg can by fertilized anytime between the release by
the ovary and its exit from the fallopian tube
There is a 30% failure rate

CONTRACEPTION AND PREGNANCY 12

BASAL BODY TEMPERATURE METHOD

Designed to determine when a woman is ovulating

BBT drops slightly 1 to 2 days before ovulation
Then rises sharply by approximately ½-1 degrees during
ovulation
Sexual activity should be stopped for 3 to 4 days after
temperature elevates
Intercourse before ovulation carries a greater risk than post
ovulation
Sperm can remain viable for up to 72 hours

CONTRACEPTION AND PREGNANCY 13

SYMPTOTHERMAL METHOD

Combination of BBT and cervical mucus monitoring

During ovulation mucus becomes watery
Sexual intercourse should be avoided until mucous thickens or
dries
This is works better than the calendar method
It has a 20% failure rate

CONTRACEPTION AND PREGNANCY 14

WITHDRAWAL

Also referred to as coitus interruptus

Leads to many unintended pregnancies
Pre ejaculate carries sperm that may be released into the vagina
before withdrawal
This method requires an inordinate amount of self control by
both partners
Has an extremely high failure rate

CONTRACEPTION AND PREGNANCY 15

Barrier methods
(non-hormonal)
Condom
Thin latex or polyurethane that fits over an erect penis
Catches sperm during ejaculation to prevent it from
entering the vaginal/cervical canal
Typical effectiveness is 82%
Reduces but does not eliminate the spread of STIs and
HIV
Condom (female)
Polyurethane sheath inserted into the vagina
Provides a physical barrier to prevent sperm from entering
cervical canal
Sperm is trapped in the condom, which is thrown away after
use
 Typical effectiveness rate is 79%
Sponge and Spermicides
• The sponge is a soft, disposable, device with a spermicide
• Typical effectiveness is 76%-88%
• Fits over the cervix
• Traps and absorbs sperm to increase effect of spermicide
• Spermicide in the sponge disables the sperm
• Effective for up to 12 hours

• Spermicides disable sperm

• Typical effectiveness is 88%onge
DIAPHRAGM
An oval dome shaped device with a flexible spring at the outer
edge
Needs to be fitted by a clinician
A spermicide is applied into the dome and a small amount is
spread around the rim
Should be left in place for 6-8 hrs after intercourse and then
removed
Failure rate ranges from 3-16%

CONTRACEPTION AND PREGNANCY 23

 CERVICAL CAP
It is designed to fit tightly over the cervix
Should be filled with spermicide before intercourse
A clinician must fit the cap to fit each woman
Can remain in place up to 48 hrs. with no additional spermicide
The smaller size makes it more difficult to ensure coverage of cervix

CONTRACEPTION AND PREGNANCY 24

Hormonal methods of
birth control
The pill
A hormonal method that contains:
a. estrogen and progesterone or
b. progesterone only
Prevents the release of a mature egg
Thickens cervical mucous
Changes the lining of the uterus
Typical effectiveness rate is 91%
Transdermal patch
A patch that releases hormones through the skin
Thin, smooth and beige patch
Prevents the release of a mature egg
Thickens cervical mucous
Changes the lining of the uterus
Typical effectiveness rate is 91%
Nuva Ring (vaginal ring)

Soft and flexible ring, inserted into the vagina

The ring slowly releases hormones while in the vagina for 3
weeks
Prevents the release of a mature egg
Thickens cervical mucous
Changes the lining of the uterus
Typical effectiveness rate is 91%
Depo Provera – Injectable contraceptive

An injection of progestin administered every 12 to 13

weeks
Prevents the release of a mature egg
Thickens cervical mucous
Changes the lining of the uterus
Typical effectiveness rate is 94%
NORPLANT
A progestin only implant (levonorgestrel)
Consists of flexible, matchstick-like capsules filled with LVG
Inserted under the skin of the upper arm
Dissipate after 5 years and need to be removed and replaced
Suppresses ovulation
Major side effects include irregular menstrual periods
Headaches, nausea, dizziness, acne, hair loss, increase in facial
or body hair and breast tenderness

CONTRACEPTION AND PREGNANCY 34

35
Hormonal methods of birth control
Side effects that may occur during the first few months on
hormonal contraception include :
 irregular bleeding, spotting

 nausea

 mood swings

 bloating

 breast tenderness

 headaches
Emergency contraception
Can be taken up to 5 days after intercourse
The sooner it is taken, the better it works
Delays or prevents the release of an egg
May prevent implementation of a fertilized egg
95 % effective if taken within 24 hours after intercourse
85% effective if taken 25-48 hours after intercourse
58% effective if taken 49-72 hours after intercourse
Intrauterine Contraception -IUC
T-Shaped device that is inserted in the uterus by a Doctor or
Nurse Practitioner
Two types of IUC:
the Copper intrauterine device (no hormone)
the levonorgestrel-releasing intrauterine system (contains
a progestin)
Typical effectiveness rate is 99.8%
Comparing Birth Control Effectiveness

Abstinence 100%
IUC 99.8%
Depo Provera 94%
The Pill 91%
The Patch 91%
The Ring 91%
Female Condom 79%
Sponge and Spermicides 76-88%