Chapter 7: Contraception Discussion Topics Discussion 7.1: Contraception in the US Today In the 19th and early 20th centuries, those who opposed the use of contraceptives passed federal laws making it illegal even to distribute information about it. Some people were brave enough to oppose this law despite the threat of being imprisoned, but believe it or not, that law was not repealed until 1965. In the past election this was one of the hot issues. Republicans called women “sluts” for using birth control, argued that insurance companies shouldn’t have to pay for birth control and tried to cut funding for planned parenthood. Many felt this constituted a war on women. Based on this, how do you see the history of contraception in the United States affecting how we think about contraception today? In what ways do you see contraception and sexual health care changing in the future? The history of contraception in the United States has deeply influenced contemporary attitudes and policies surrounding sexual health and contraception. The long-standing stigma and legal restrictions on contraceptives, including the prohibition on distributing information about them until as late as 1965, have left a lasting impact on how contraception is perceived and accessed today. The opposition to contraception in the past, including recent controversies such as the derogatory language used by some political figures towards women using birth control, has contributed to a broader conversation about women's rights, reproductive health, and access to healthcare. These debates have highlighted the importance of contraception not just as a means of family planning but also as a fundamental aspect of women's autonomy and well-being. Looking to the future, it is likely that contraception and sexual health care will continue to evolve. There may be advancements in contraceptive technology, making options more effective, convenient, and accessible. Additionally, ongoing advocacy efforts are likely to focus on ensuring that contraception remains affordable and available to all who need it, regardless of their socioeconomic status or political beliefs. Overall, the history of contraception in the United States serves as a reminder of the importance of reproductive rights and the ongoing need to advocate for comprehensive sexual health care for all individuals. Discussion 7.2: Abortion is Not Contraception Contraception is any method that we use to prevent conception and unintended pregnancy. Additionally, many contraceptive methods prevent the transmission of STIs. Because contraception is used to prevent pregnancy, abortion does not fit the definition of contraception. It may seem obvious but it is important to underline that only after conception has occurred can abortion take place. The purpose of contraception is to prevent conception. Abortion is among the biggest and longest-running controversies in all of sexuality in the United States. Abortion is a painful and personal decision, and none of the groups in the debate over abortion recommend it as a birth control method. Abortion decisions sometimes come into play late in the process of pregnancy, and may result from a true lack of sexual literacy, including the absence of positive resources, such as quality health care, that might have resulted in the use of contraceptives in the first place. Healthy sexuality and sexual well-being depend on understanding these processes. The distinction between contraception and abortion is crucial in understanding reproductive health and decision-making. Contraception refers to methods used to prevent conception and unintended pregnancy, as well as to reduce the transmission of sexually transmitted infections (STIs). On the other hand, abortion is the termination of a pregnancy after conception has occurred. While both contraception and abortion are related to pregnancy prevention, they serve different purposes and operate at different stages of the reproductive process. Contraception aims to prevent conception from taking place, thereby avoiding the need for abortion. It is an essential component of sexual health care, empowering individuals to make informed decisions about their reproductive lives and helping to prevent unintended pregnancies and STIs. However, despite the availability of contraception, abortion remains a contentious and highly debated issue in the United States. Abortion is a deeply personal and often complex decision, influenced by a variety of factors such as access to healthcare, knowledge about contraception, and individual circumstances. It is not considered a form of contraception, and it is not recommended as a primary method of birth control by any group involved in the debate over abortion. In conclusion, understanding the distinction between contraception and abortion is important for promoting sexual literacy and well-being. Access to comprehensive sexual health education, quality healthcare, and a range of contraceptive options is essential for individuals to make informed choices about their reproductive health and prevent unintended pregnancies. Discussion 7.3: How Effective Is Breastfeeding as a Contraceptive? Many people believe that breast-feeding acts as a contraceptive; interestingly, this is found cross-culturally. The Kung Bushmen of Southern Africa believe that breastfeeding delays conception. In their culture, the space between the births of siblings is about every 4 years, which tends to support this belief (Shostak, 1991). The Sambia of Papua New Guinea likewise believe that breastfeeding delays pregnancy. Also like other groups, they have a postpartum taboo of sexual activity that lasts for the first 2 years of a child’s life as well as during nursing (Herdt, 2006). The American Academy of Pediatrics (2011) states that under certain conditions breastfeeding can be effective in preventing pregnancy. Here are the conditions: If you are exclusively breastfeeding If your menstrual periods have not resumed If your baby is less than 6 months old. Once your baby is 6 months old and has begun sampling solid foods, breastfeeding is no longer a reliable form of birth control. If you do not want to become pregnant, you will need to consider what kind of contraception you will use. It’s best to consult your gynecologist for advice on which types to use while breastfeeding, but in general, condoms, a diaphragm, a cervical cap, and spermicidal are considered the most preferable forms of birth control for a breastfeeding mother, because they are least likely to interfere with milk supply. Low-dose birth control pills should not have a significant impact on your milk supply when begun at this age. Breastfeeding is believed to have contraceptive effects in many cultures, including the Kung Bushmen of Southern Africa and the Sambia of Papua New Guinea. These cultures observe that breastfeeding can delay the return of fertility after childbirth, leading to longer intervals between the births of siblings. This belief is supported by the American Academy of Pediatrics (2011), which states that under certain conditions, breastfeeding can be effective in preventing pregnancy. The effectiveness of breastfeeding as a contraceptive method depends on several factors, including exclusive breastfeeding, the absence of menstrual periods, and the age of the baby. The lactational amenorrhea method (LAM) is most effective when the baby is less than 6 months old, breastfeeding is the sole source of nutrition, and the mother's menstrual periods have not resumed. However, once the baby is 6 months old and begins to consume solid foods, breastfeeding may no longer be a reliable form of birth control. For women who do not want to become pregnant while breastfeeding, it is recommended to consider other forms of contraception. Condoms, diaphragms, cervical caps, and spermicides are considered preferable options because they are less likely to interfere with milk supply. Low-dose birth control pills are also an option and should not significantly impact milk supply when started at this stage. Consulting with a gynecologist is advisable to determine the most suitable contraceptive method while breastfeeding, taking into account individual health factors and preferences. Discussion 7.4: Russia and Contraception The former Soviet Union (now Russia) was committed to being a global superpower and its domestic policy reflected that in its total lack of support for contraceptives. Many Russian women during the Soviet era had five or more abortions as a functional way to cope with the lack of access to condoms and other forms of contraception (Kon, 1995). Since the fall of the Soviet regime in 1991, abortions have fallen but the abortion rate in Russia remains very high. The former Soviet Union, particularly Russia, had a domestic policy that lacked support for contraceptives, which led to significant challenges in accessing birth control methods. As a result, many Russian women during the Soviet era resorted to having multiple abortions as a way to manage the lack of access to condoms and other forms of contraception. This trend highlighted the critical need for comprehensive sexual health education and access to a variety of contraceptive options. Since the fall of the Soviet regime in 1991, there have been some improvements in contraceptive access and education in Russia. The availability of contraceptives has increased, and there has been a slight decline in the number of abortions. However, the abortion rate in Russia remains relatively high compared to other countries, indicating that there are still challenges to be addressed in promoting effective contraception and family planning. Efforts to reduce the abortion rate in Russia have included initiatives to improve access to contraception, increase awareness about contraceptive methods, and provide comprehensive sexual education. These efforts are crucial in helping women make informed choices about their reproductive health and reducing the need for abortion as a method of birth control. Overall, the history of contraception in Russia reflects the broader challenges and complexities surrounding reproductive health care and highlights the importance of access to affordable, effective contraception in promoting healthy sexual practices and reducing unintended pregnancies. Discussion 7.5: Access to Contraception and Abortion Services for Minor Adolescents The question of whether contraception should be freely available to adolescents without parental consent has been a hot topic for years for parents, teachers, health practitioners, and health educators. In fact, many states allow adolescents to acquire contraceptive care without parental consent. However, many states do not allow minor adolescents to undergo an abortion without the consent of a parent or legal guardian. It appears that even though many lawmakers agree that minors should have privacy for contraceptive care, they want parents involved in an adolescent’s decision about abortion. The question we consider, then, is this: Should minor adolescents have access to contraceptive and abortion services without parental consent? How might we strike a balance between parents’ desires to be involved in their minor teen’s health care while ensuring safe options for sexual health care for them? The issue of whether minor adolescents should have access to contraception and abortion services without parental consent is complex and has been a subject of debate among various stakeholders. While many states allow adolescents to access contraceptive care without parental consent, the situation is different when it comes to abortion, with many states requiring parental consent for minors seeking abortion services. One argument in favor of allowing minors access to these services without parental consent is based on the understanding that adolescents may be more likely to seek these services if they can do so confidentially. This can help prevent unintended pregnancies and reduce the risk of unsafe abortions. Additionally, minors may be facing sensitive or abusive family situations where involving parents could lead to further harm. On the other hand, some argue that parents have a right to be involved in their minor child's healthcare decisions, including those related to contraception and abortion. They believe that parental involvement can help ensure that minors receive appropriate counseling and support during these processes. Striking a balance between these perspectives involves considering the rights and needs of both parents and minors. One approach could be to provide minors with access to contraception and abortion services without parental consent, but to also encourage open communication between parents and children about sexual health. This could involve education programs that emphasize the importance of family communication and provide resources for parents to support their children's sexual health decisions. Overall, the goal should be to ensure that minors have access to safe and confidential sexual health care while also recognizing the importance of parental involvement in their children's lives. Balancing these interests requires careful consideration of the rights and responsibilities of all parties involved. Discussion 7.6: Lubricants for Sex Lubricants are used in sexual activity for a variety of reasons. They can increase pleasure when used with sex toys or when a little extra lubrication is warranted (e.g. when a woman’s vagina is a little too dry). However, knowing what kinds of lubricant are available is important because some can be used with contraceptive devices such as condoms and others cannot. Virtually all lubricants on the market today fall into one of three categories: Water-based Silicone-based Oil-based Water-based lubricants are just that: water-based. They tend to be fairly thin and are easily removed from the skin with a little water and soap. Because they are water-based, they tend to be absorbed into the skin and mucous membranes easily, and if intimate behavior continues for a significant time, reapplication may be necessary. The main advantage of water-based lubricants is that they are completely compatible with condoms. Silicone-based lubricants are similar to water-based lubricants, but they are generally a lot greasier and last much longer than water-based products. Their main advantage is that there is virtually no need for reapplication because they do not dry out as quickly as a water-based lubricant. The main disadvantage is that the cleanup takes more time because they are water resistant. Oil-based lubricants should be considered only for sexual activities of a solo nature, for which penetration or use with a condom is not a consideration. Oil-based lubricants corrode latex so they should not be used with condoms. In addition, they are bad for a woman’s vaginal health in a variety of ways and so should not be used in intercourse with a woman. Finally, they tend to be very slimy, messy, and difficult to clean up. Discussion 7.7: Ensuring Contraceptive Success While on the Pill Despite the popularity of the birth control pill, it is important to have detailed knowledge of how to use it and to know when to use a backup method to prevent pregnancy. If the birth control pill is your contraceptive choice, read this information for guidelines to help ensure its effectiveness. 1. Start your first pack on the first Sunday after your period begins. If your period begins on Sunday, start your pills that day. 2. Use a BACKUP METHOD (foam, condoms, sponge) with the pills for the first month. 3. Take a pill every day until you finish a pack, then start a new pack. Do not skip any days between packs. 4. It is very important to take your pills every day at the same time. If you miss or take any pills late, you may spot or bleed and should use a backup method until you start the next pack of pills. 5. IF YOU ARE LATE with a pill by 4 hours or more, be sure to use a back-up method until you start the next pack of pills. 6. IF YOU MISS ONE PILL, take it as soon as you remember it, then take today’s pill at the regular time. USE A BACK-UP METHOD until you start the next pack of pills. 7. IF YOU MISS TWO PILLS IN A ROW, take 2 pills as soon as you remember and 2 pills the next day. EXAMPLE: If you forget pills on Monday and Tuesday, take 2 pills on Wednesday and 2 pills on Thursday to catch up. USE A BACK-UP METHOD until you start the next pack of pills. 8. IF YOU MISS THREE PILLS IN A ROW, start using a back-up method right away. Start a new pack of pills on the next Sunday after the last pill you took. Use your back-up method until you finish the new pack of pills. If you have been sexually active before starting your new pack of pills, you must wait for your next period before starting. You need to use another form of birth control for the month and for the next cycle of pills. 9. MISSED PERIODS IF YOU HAVE TAKEN ALL PILLS CORRECTLY and have a very light period or miss a period, keep taking your pills. IF YOU MISS TWO PERIODS in a row, call your health care provider. IF YOU MISS ANY PILLS AND MISS A PERIOD, call your health care provider. You may need a pregnancy test. 10. If you are sick and experience diarrhea or vomiting within 2 hours of taking the pill, use a back-up method until you start your next pack of pills. Keep taking your pills. 11. Anytime you see a doctor or nurse, be sure to mention you are on birth control pills, especially if you may be hospitalized. 12. Certain medicines, such as antibiotics, may cause your pills to be less effective. Call your health care provider to find out if you need to use a back-up method. From the University of Iowa Hospitals and Clinics. (2004). Birth control pill fact sheet: http://www.uihealthcare.com/depts/med/obgyn/patedu/birthcontrol/pillfacts.html Discussion 7.8: Female College Students and Emergency Contraception Despite the wide availability of emergency contraception (EC), many women know little about it. This may help explain why the incidence of unintended pregnancies in the United States is so high compared to other nations. Recent studies found that 60–80% of pregnancies in women aged 18–24 were unplanned (Vahratian et al., 2008). And it has been over 10 years since the FDA approved two different forms of EC: mifepristone (RU-486) and Plan B. In fact, women have only a general awareness about the existence of EC and approve of it as a means to prevent unintended pregnancies. They do not know about its effectiveness, safety, availability, and side effects, however. Also, in findings from previous research, it is clear that many women don’t know the difference between Plan B and mifepristone, an oral medication that can induce spontaneous abortion in the first trimester of pregnancy (Hickey, 2009). It is also clear from these studies that health care providers have not received adequate information and counseling about EC. Many women reported that their information about EC came from friends, peers, or the Internet and that they would be more likely to use EC if a health care provider had informed them about it. Women’s knowledge, perceptions, and use of EC have not been adequately investigated since it became available over-the-counter in 2006 (Hickey, 2009). The research done on EC highlights both the need for health care professionals to share their knowledge of available resources and the need for women to be proactive about their own health care. Polling Questions Polling 7.1: Contraception Use Today In the 19th and early 20th centuries, those who opposed the use of contraceptives passed federal laws making it illegal even to distribute information about it, that law was not repealed until 1965. In the past election this was one of the hot issues. Republicans called women “sluts” for using birth control, argued that insurance companies shouldn’t have to pay for birth control and tried to cut funding for planned parenthood. Many felt this constituted a war on women. How many of you use birth control? Do you think use of birth control connotes that you are “easy” or a “slut”? Do you think that birth control should be available over the counter? The history of contraception in the United States has been marked by challenges and controversies, including legal restrictions and stigmatization. Despite the repeal of laws prohibiting the distribution of contraceptive information in 1965, debates over birth control continue to be contentious, as seen in recent political discourse. The question of whether birth control connotes promiscuity or being "easy" is subjective and reflects societal attitudes towards sexuality. However, it is important to recognize that the use of birth control is a personal choice and a responsible decision for many individuals to manage their reproductive health. Regarding the availability of birth control over the counter, opinions may vary. Some argue that making birth control more accessible could improve contraceptive use and reduce unintended pregnancies. Others may have concerns about safety and proper use without medical supervision. Ultimately, the accessibility of birth control should be based on comprehensive evaluation of its benefits and risks. In summary, the use of birth control is a personal decision that should not be associated with moral judgments. Access to birth control should be considered in a way that promotes reproductive health and autonomy, taking into account safety and individual needs. Polling 7.2: Access to Contraception and Abortion Services for Minor Adolescents The question of whether contraception should be freely available to adolescents without parental consent has been a hot topic for years for parents, teachers, health practitioners, and health educators. In fact, many states allow adolescents to acquire contraceptive care without parental consent. 1. Do you believe that teenagers should have access to contraceptive care without parental consent? What about access to abortion services? 2. Do you believe that granting teenagers confidential contraceptive and reproductive care encourages sexual activity and promiscuity? 1. The issue of whether teenagers should have access to contraceptive care without parental consent is complex and has been debated among various stakeholders. On one hand, providing teenagers with access to contraceptive care without parental consent can help prevent unintended pregnancies and reduce the risk of sexually transmitted infections (STIs). It can also empower teenagers to take control of their reproductive health and make informed decisions about their bodies. However, some argue that parental involvement is important in teenagers' healthcare decisions, including those related to contraception and abortion. Regarding access to abortion services, opinions may vary. Some believe that teenagers should have access to abortion services without parental consent to ensure their safety and well-being, especially in cases where involving parents may not be possible or may pose a risk to the teenager's health or safety. Others argue that parental involvement is important in such decisions, as abortion is a significant medical procedure with potential emotional and physical consequences. 2. The belief that granting teenagers confidential contraceptive and reproductive care encourages sexual activity and promiscuity is a misconception. Research suggests that access to comprehensive sexual health education and services, including contraception, does not increase sexual activity among teenagers. Instead, it can help teenagers make responsible decisions about their sexual health and reduce the risk of unintended pregnancies and STIs. In conclusion, the debate over access to contraceptive care and abortion services for teenagers without parental consent involves balancing the rights and responsibilities of parents, teenagers, and healthcare providers. It is important to consider the best interests of teenagers' health and well-being while also respecting their autonomy and rights to make informed decisions about their bodies. Activities Activity 7.1: Conception over History The text describes several ancient forms of birth control. For example, Egyptian records dating back to 1850 BCE describe a form of contraception that involved placing a device in a woman’s vagina made of crocodile dung and fermented dough. Such an unlikely combination was certainly meant to create a hostile environment for sperm. The Egyptians also placed plugs of gum, honey, and acacia in the vagina. The ancient Romans used a highly acidic concoction of fruit and nuts in the vagina. In fact, they may have been the first society to invent a barrier method in which wool was placed over the cervix to stop the movement of sperm to the fallopian tubes. Society and medicine have come a long way in the effort to invent and apply effective contraception since that time. What other inventive forms of contraception have been used over historical time? What were some of the risks associated with them? Have students perform a review of the literature on this topic and share their findings either in class, in a short written assignment or via discussion board. Throughout history, various inventive forms of contraception have been used, reflecting the creativity and resourcefulness of different cultures. Some examples include: 1. Silphium: A plant used in ancient Greece and Rome as a contraceptive and abortifacient. It was so popular that it was eventually harvested to extinction. 2. Mercury: Used in ancient China as a contraceptive, but it was highly toxic and could lead to mercury poisoning. 3. Jumping: Some cultures believed that jumping backwards seven or nine times after sex could prevent pregnancy, but this method is obviously not effective. 4. Lemon halves: Women in the 18th century were advised to place half a lemon in their vagina after intercourse as a form of contraception. The acidity of the lemon was thought to kill sperm, but this method had no scientific basis and could lead to infections. 5. Condoms made from animal intestines: Used since ancient times, these condoms were often ineffective and could lead to infections due to their porous nature. 6. Lysol douching: In the early 20th century, Lysol disinfectant was marketed as a feminine hygiene product and contraceptive. However, it was ineffective and could cause irritation and harm to vaginal tissues. 7. Rhythm method: Also known as natural family planning, this method involves tracking a woman's menstrual cycle to determine when she is most likely to ovulate. While it can be effective when used correctly, it is less reliable than other modern methods of contraception. Many of these historical methods were not only ineffective but also dangerous, highlighting the importance of modern, scientifically-based contraceptive methods. The risks associated with these methods include toxicity, infections, and damage to reproductive organs. Activity 7.2: Access to Contraception and Abortion Services for Minor Adolescents The question of whether contraception should be freely available to adolescents without parental consent has been a hot topic for years for parents, teachers, health practitioners, and health educators. In fact, many states allow adolescents to acquire contraceptive care without parental consent. However, many states do not allow minor adolescents to undergo an abortion without the consent of a parent or legal guardian. It appears that even though many lawmakers agree that minors should have privacy for contraceptive care, they want parents involved in an adolescent’s decision about abortion. The question we consider, then, is this: Should minor adolescents have access to contraceptive and abortion services without parental consent? YES: Allowing minor teenagers access to contraception may help decrease the number of unintended pregnancies that occur every year in the United States. Granting access to contraception allows teens to be proactive in their sexual health and can have the effect of preventing abortions. Minors may not seek health services if they are required to inform their parents (Dailard & Richardson, 2005). Allowing minor teenagers the right to have an abortion without parental consent may mean they can have an abortion earlier in the pregnancy, which poses less serious risks to their reproductive health, for two reasons: They may detect pregnancy earlier than they currently do. They may face fewer legal obstacles earlier in the pregnancy. Forcing minor teens to inform parents that they are seeking an abortion may place some at risk of physical violence or abuse (Dailard & Richardson, 2005). NO: Teens with access to birth control think they have a ticket for sexual freedom. Many parents believe that they need to retain the legal authority to make medical decisions for their minor teens because teens often lack the maturity and judgment to make fully informed decisions (Dailard & Richardson, 2005). Laws requiring parental consent or knowledge reduce abortion and pregnancy rates among teenagers for two reasons: If parents are able to guide their pregnant teens, more would choose childbirth (and potentially adoption) over abortion. Teenagers who have to inform parents about a pregnancy to obtain an abortion will think twice before having sex in the first place (Dailard & Richardson, 2005). You can then assign students to write a brief paragraph describing their perspective. 1. Do you believe that teenagers should have access to contraceptive care without parental consent? What about access to abortion services? The issue of whether teenagers should have access to contraceptive care without parental consent is multifaceted. Here are arguments from both perspectives: Yes, teenagers should have access to contraceptive care without parental consent: 1. Preventing unintended pregnancies: Access to contraception can help reduce the number of unintended pregnancies among teenagers, which can have long-term implications for their health and well-being. 2. Empowering teenagers: Granting access to contraception allows teenagers to take control of their sexual health and make informed decisions about their bodies. 3. Barriers to seeking care: Requiring parental consent may discourage teenagers from seeking contraceptive care, leading to higher rates of unprotected sex and unintended pregnancies. 4. Early detection of pregnancy: Allowing teenagers to access abortion services without parental consent can lead to earlier detection of pregnancy and safer abortion procedures. 5. Safety concerns: Forcing teenagers to inform their parents about seeking an abortion may put them at risk of physical violence or abuse. No, teenagers should not have access to contraceptive care without parental consent: 1. Perception of sexual freedom: Some argue that easy access to birth control may lead teenagers to believe they have a ticket for sexual freedom, potentially leading to riskier sexual behaviors. 2. Parental authority: Many parents believe that they should retain the legal authority to make medical decisions for their minor teenagers, as teenagers may lack the maturity to make fully informed decisions. 3. Reduced abortion and pregnancy rates: Laws requiring parental consent or knowledge for abortion have been shown to reduce abortion and pregnancy rates among teenagers, as they may choose childbirth or think twice before having sex. In conclusion, the question of whether teenagers should have access to contraceptive care without parental consent is complex and involves balancing the rights of teenagers with parental responsibilities. It is important to consider the potential consequences and implications of both sides of the argument when making decisions about adolescent reproductive health care. 2. Do you believe that granting teenagers confidential contraceptive and reproductive care encourages sexual activity and promiscuity? The belief that granting teenagers confidential contraceptive and reproductive care encourages sexual activity and promiscuity is a contentious issue with arguments from both sides: Yes, granting teenagers confidential contraceptive and reproductive care encourages sexual activity and promiscuity: 1. Perceived sexual freedom: Some argue that easy access to contraception may give teenagers the impression that they have a ticket for sexual freedom, potentially leading to riskier sexual behaviors. 2. Parental involvement: Many parents believe that they should retain the legal authority to make medical decisions for their minor teenagers, as teenagers may lack the maturity to make fully informed decisions about their sexual health. 3. Reduced accountability: Critics argue that confidential care reduces the accountability of teenagers for their actions and may lead to a lack of responsibility in sexual decision-making. No, granting teenagers confidential contraceptive and reproductive care does not encourage sexual activity and promiscuity: 1. Preventing unintended pregnancies: Access to contraception can help reduce the number of unintended pregnancies among teenagers, which can have long-term implications for their health and well-being. 2. Empowering teenagers: Granting access to contraception allows teenagers to take control of their sexual health and make informed decisions about their bodies, which may actually lead to more responsible sexual behavior. 3. Barriers to seeking care: Requiring parental consent may discourage teenagers from seeking contraceptive care, leading to higher rates of unprotected sex and unintended pregnancies. In conclusion, the impact of granting teenagers confidential contraceptive and reproductive care on sexual activity and promiscuity is complex and multifaceted. While some argue that it may encourage such behavior, others believe that it empowers teenagers to make responsible decisions about their sexual health. The issue requires a careful consideration of the potential consequences and the rights of teenagers to access confidential healthcare. 3. How might we strike a balance between parents’ desires to be involved in their minor teen’s health care while ensuring safe options for sexual health care for them? Striking a balance between parents' desires to be involved in their minor teen's health care while ensuring safe options for sexual health care requires a nuanced approach that considers both the rights of parents and the autonomy of teenagers. Here are some strategies to achieve this balance: 1. Education and Counseling: Provide comprehensive sexual health education to both parents and teenagers. This can help parents understand the importance of confidential sexual health services for teenagers and empower teenagers to make informed decisions about their health. 2. Confidentiality Policies: Develop policies that allow teenagers to access certain sexual health services, such as contraception and STI testing, without parental consent. Ensure that these policies comply with legal and ethical standards and protect teenagers' privacy. 3. Parent-Teen Communication: Encourage open and honest communication between parents and teenagers about sexual health. Provide resources and support services to help facilitate these conversations and address any concerns or misunderstandings. 4. Informed Consent: Ensure that teenagers are informed about the risks and benefits of sexual health services and have the capacity to consent to these services. Consider implementing a process for obtaining informed consent from teenagers, while also allowing for parental involvement when appropriate. 5. Healthcare Provider Training: Train healthcare providers to understand the unique needs of teenagers and to provide nonjudgmental and confidential care. Ensure that providers are aware of the legal and ethical considerations regarding adolescent healthcare. 6. Legal Framework: Review and update laws and regulations regarding adolescent healthcare to ensure that they protect teenagers' rights to confidential care while also considering parental concerns. Consider options such as allowing teenagers to consent to certain types of healthcare independently or providing avenues for parental involvement when deemed necessary. By implementing these strategies, we can work towards striking a balance between parents' desires to be involved in their minor teen's health care and ensuring safe options for sexual health care for teenagers. Activity 7.3: Contraception Check with your campus student’s services or student health to enquire if they do lectures for classes on campus on contraception use. Many campuses not only talk about contraception but also provide free condoms, lube and dental dams to students. Check with student health services to see if they can come to your class and demonstrate proper use of contraception. Contacting student services or student health on campus to inquire about lectures on contraception use is a proactive step towards understanding and promoting sexual health among students. Many campuses not only offer informative sessions on contraception but also provide free condoms, lube, and dental dams to promote safe sex practices. Inviting student health services to come to your class and demonstrate the proper use of contraception can be an engaging and educational experience for students. It can help dispel myths and misconceptions about contraception and empower students to make informed decisions about their sexual health. By taking advantage of these resources, students can learn about the variety of contraceptive options available to them and how to use them correctly. This knowledge is crucial for preventing unintended pregnancies and reducing the risk of sexually transmitted infections (STIs). Overall, promoting access to information and resources on contraception on campus can contribute to creating a culture of sexual health and responsibility among students. Activity 7.4: Birth Control Myths Have you ever felt caught in a whirlwind of misinformation about birth control methods, such as knowing which ones are effective and which ones don’t work? To help understand which ones do not work, let’s consider the following statements. Decide whether each statement is true or false. 1. You can’t get pregnant if you are breastfeeding. 2. Pregnancy is not possible if a woman doesn’t have an orgasm. 3. If a woman douches after sex, she won’t get pregnant. 4. A woman is only fertile one day a month so there’s no need for contraception if sex happens only during the “safe time.” 5. A woman can’t get pregnant if she has sex while on top or standing up. 6. If you don’t have a condom, you can use a balloon or plastic wrap. 7. If a man withdraws his penis from the woman’s vagina before he ejaculates, neither pregnancy nor an STI is possible. 8. You can’t get pregnant when having sex for the first time. 9. You can’t get pregnant if you shower, bathe, or urinate right after sex. 10. The birth control pill is effective as soon you begin taking it. 1. False: As we previously noted, breastfeeding tends to postpone ovulation, but breastfeeding alone is not a guarantee, because ovulation can still occur. A nursing mother should use birth control if she does not want to get pregnant. 2. False: Pregnancy occurs when a sperm and an egg unite, regardless of whether a woman has an orgasm during sex. 3. False: Douching is not an effective method of contraception. After ejaculation, the sperm enter the cervix and are out of reach of any douching solution. In addition, douching can irritate the vagina and is not a recommended practice. 4. False: Myths such as this may stem from not fully understanding the menstrual cycle. Certain hormones need to work together for ovulation to occur. While a woman’s cycle is more or less regular, various factors can disrupt this delicate balance of hormones, such as age, stress, or medications. Therefore, pinpointing the exact time of ovulation and predicting “safe days” can be difficult. 5. False: Some people falsely believe that having sex in certain positions will force sperm out of the woman’s vagina via gravity. Sexual positions have nothing to do with whether or not fertilization occurs. When a man ejaculates into a woman’s vagina, the sperm begin to move up through the cervix immediately. 6. False: While the ingenuity of these ideas is interesting, they are not good substitutes for condoms. They do not fit well and can be easily torn during sex. Condoms are made specifically to provide a good fit and therefore good protection during sex. 7. False: Pulling out before a man ejaculates, known as the withdrawal method, is not a foolproof method for contraception. Some ejaculate (fluid that may contain sperm, viruses, or bacteria that cause STIs) may be released before a man actually begins to climax. In addition, some men may not have the willpower or be able to withdraw in time. 8. False: A woman can get pregnant any time ovulation occurs, even if it is her first time having sex. 9. False: Washing or urinating after sex will not stop sperm that have already entered the uterus through the cervix. 10. False: In some women, one complete menstrual cycle is needed for the hormones in the pill to work with their naturally produced hormones to prevent ovulation. To make sure you do not get pregnant, use a backup method of contraception during the first month of taking the birth control pill. Did you previously believe any of these myths? Which ones did you have incorrect information about? Myths about birth control are common, and it is easy to believe something that we hear from media or from peers. It is important to make sure that we use trusted resources when considering any form of contraception to make sure we understand the method fully so we can use it correctly. Internet Resources http://www.fda.gov/ForConsumers/ConsumerUpdates/default.htm The FDA’s Site offers current research on various forms of birth control including methods that have been recalled for various problems. http://www.hhs.gov/opa/order-publications/ A variety of PDF downloads on contraception and STI’s. http://www.fhi360.org/en/RH/FAQs/index.htm FAQ on contraception including sterilization and barrier methods. http://www.thenationalcampaign.org/resources/pdf/AsianPacIs_2007.pdf An interesting fact sheet looking at sexual activity and pregnancy in Asian and Pacific Islander teens in the United States. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm Birth control method fact sheet. Has a PDF printable version that can be used as a handout. http://www.plannedparenthood.org/ Planned Parenthood Homepage. A great site that has information on contraception, STIs and anatomy, physiology. http://www.iwhc.org/ International Women’s Health Coalition homepage. Has a section on reproductive rights as well as sections on Africa, Asia and the Middle East. http://www.mhhe.com/socscience/psychology/psychonline/general.html McGraw Hill Higher Education General Resources for Students and Faculty. http://www.apa.org/ The APA website. http://www.apa.org/topics/sexuality/index.aspx APA site for research on sexuality. The Ten-Minute Test Name: __________ Answer the questions below utilizing the following terms: Abstinence Condom Contraception Hormonal Sanger Failure Rate Tubal ligation Sterilization Cervical barrier Intrauterine Methods 1. Any method we use to prevent pregnancy is known as _____. 2. Anthony Comstock and Margaret _____ are two historical individuals who were quite opposite in their stance on contraception and access to it, but both were critical players in the history of contraception in the United States. 3. The three most effective methods to protect against both unplanned pregnancy and transmission of STIs are _____, fluid-free sexual behaviors, and barrier methods such as condoms. 4. _____ methods to prevent pregnancy offer no prevention of STIs. These methods are oral contraceptives, the contraceptive patch, implants, the vaginal ring, and injections. 5. _____ methods used to prevent pregnancy include the diaphragm, cervical cap, Femcap, and Lea’s Shield. 6. Surgical sterilization is a relatively permanent method of contraception. In females this method is _____; in men, the vasectomy. 7. A popular contraceptive device worn by either a male or females is a _____. 8. _____ is the number of women out of 100 who will become pregnant within the first year of using a particular measure. 9. A small, T-shaped plastic device that a medical professional places in the uterus to prevent pregnancy is a _____. 10. Voluntary surgical contraception is also known as _____. Answers to the Ten-Minute Test 1. Contraception 2. Sanger 3. Abstinence 4. Hormonal 5. Cervical barrier 6. Tubal ligation 7. Condom 8. Failure Rate 9. Intrauterine Methods 10. Sterilization Solution Manual for Human Sexuality: Self, Society, and Culture Gilbert Herdt, Nicole Polen-Petit 9780073532165, 9780077817527
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