Contraception Health Article

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Post-Pregnancy Contraception: What Are a Woman's Options?
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Definition

Contraception (birth control) prevents pregnancy by interfering with the normal process of ovulation, fertilization,

and implantation. There are different kinds of birth control that act at different points in the process.

Purpose

Every month, a woman's body begins the process that can potentially lead to pregnancy. An egg (ovum) matures, the mucus that is secreted by the cervix (a cylindrical-shaped organ at the lower end of the uterus) changes to be more inviting to sperm, and the lining of the uterus grows in preparation for receiving a fertilized egg. Any woman who wants to prevent pregnancy must use a reliable form of birth control.

Birth control (contraception) is designed to interfere with the normal process and prevent the pregnancy that could result. There are different kinds of birth control that act at different points in the process, from ovulation, through fertilization, to implantation. Each method has its own side effects and risks. Some methods are more reliable than others.

Although there are many different types of birth control, they can be divided into a few groups based on how they work. These groups include:

  • Hormonal methods—These use medications (hormones) to prevent ovulation. Hormonal methods include birth control pills (oral contraceptives), Depo Provera injections and Norplant.
  • Barrier methods—These methods work by preventing the sperm from getting to and fertilizing the egg. Barrier er methods include the condom, diaphragm, and cervical cap. The condom is the only form of birth control that also protects against sexually transmitted diseases, including HIV (the virus that causes AIDS).

Types Of Contraceptives
Effectiveness Predicted (%) Actual (%)
Birth control pills 99.9 97
Condoms 98 88
Depo Provera 99.7 99.7
Diaphragm 94 82
IUDs 99.2 97
Norplant 99.7 99.7
Tubal sterilization 99.8 99.6
Spermicides 97 79
Vasectomy 99.9 99.9
  • Spermicides—These medications kill sperm on contact. Most spermicides contain nonoxynyl-9. Spermicides come in many different forms such as jelly, foam, tablets, and even a transparent film. All are placed in the vagina. Spermicides work best when they are used at the same time as a barrier method.
  • Intrauterine devices—Intrauterine contraceptive devices (IUDs) are inserted into the uterus, where they stay from one to 10 years. An IUD prevents the fertilized egg from implanting in the lining of the uterus, and may have other effects as well.
  • Tubal sterilization—Tubal sterilization is a permanent form of contraception for women. Each fallopian tube is either tied or burned closed. The sperm cannot reach the egg, and the egg cannot travel to the uterus.
  • Vasectomy—is the male form of sterilization, and should also be considered permanent. In vasectomy, the vas defrens, the tiny tubes that carry the sperm into the semen, are cut and tied off. Thus, no sperm can get into the semen.

Unfortunately, there is no perfect form of birth control. Only abstinence (not having sexual intercourse) can protect against unwanted pregnancy with 100% reliability. The failure rates, which means the rates of pregnancy, for most forms of birth control are quite low. However, some forms of birth control are more difficult or inconvenient to use than others. In actual practice, the birth control methods that are more difficult or inconvenient have much higher failure rates because they are not used faithfully.

Description

All the different forms of birth control have one thing in common. They are only effective if used faithfully. Birth control pills will work only if taken every day; the

diaphragm is effective only if used during every episode of sexual intercourse. The same is true for condoms and the cervical cap. Some methods are automatically working every day, no matter what. These methods include Depo Provera, Norplant, the IUD, and tubal sterilization.

There are many different ways to use birth control. They can be divided into several groups:

  • By mouth (oral)—Birth control pills must be taken by mouth every day.
  • Injected—Depo Provera is a hormonal medication that is given by injection every three months.
  • Implanted—Norplant is a long-acting hormonal form of birth control that is implanted under the skin of the upper arm.
  • Vaginal—Spermicides and barrier methods work in the vagina.
  • Intra-uterine—The IUD is inserted into the uterus.
  • Surgical—Tubal sterilization is a form of surgery. A doctor must perform the procedure in a hospital or surgical clinic. Many women need general anesthesia.

The methods of birth control differ from each other in the timing of when they are used. Some methods of birth control must be used specifically at the time of sexual intercourse (condoms, diaphragm, cervical cap, spermicides). All other methods of birth control must be working all the time to provide protection (hormonal methods, IUDs, tubal sterilization).

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Author Info: Amy B. Tuteur MD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Medicine, 2002
 
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