HDE 012 - UC Davis - Midterm 2

what % of pregnancies unintended

51%

anthony comstock

passed the "Comstock Law" which prohibited access to knowledge of sexual health and contraceptive knowledge

Margaret Sanger

Founded the first birth control clinic in the U.S. (coined "birth control")

comstock act

passed in 1873, banned all sex education, birth control, and abortion information, and made it illegal to send these materials through the mail.

was comstock act constitutional

no, it invaded privacy

how long has birth control existed

thousands of years, since ancient times (sea sponges, dung plugs)

is there a male birth control pill

not yet, but coming soon

Types of male contraceptives

condoms and vasectomy

how does a condom work

keeps semen from entering the vagina, prevents STIs

How does a vasectomy work?

Cutting and litigating ductus deferens; nearly 100% effective form of birth control

who has historically carried the burden of contraception

women

ancient forms of birth control

sea sponges, barrier method (dung), coitus interruptus (pullout), coitus obstructis (pressure on testicles shoots sperm into bladder FAIL), coitus reservatus (avoid all ejaculation), douching, pessary (barrier), condoms, and breastfeeding

contraception

Intentionally preventing pregnancy from occurring

conception

when a sperm fertilizes an egg and forms a zygote

to become pregnant what happens

ovulation, fertilization, implantation

Is abortion a form of contraception?

no, it is a back-up plan if other contraceptive methods failed

what is consent

permission for something to happen or agreement to do something.

what makes up consent

informed, voluntary, revocable, and ongoing

what is coercion

the practice of persuading someone to do something by using force or threats (pregnancy coercion, birth control sabotage, stealthing, and controlling pregnancy outcome)

pregnancy coercion

Forcing a woman to keep a baby or abort a baby

birth control sabotage

purposely, non-consensual sabotage of birth control methods

stealthing

Removing condom without permission during a act (jail time, fine)

why birth control is great

allows ability to control reproductive outcomes, many health benefits

controlling pregnancy outcome

behavior that interferes with the autonomous decision-making of a woman, with regards to reproductive health

what two contraceptives should never be used together

internal condom and external condom

bodily integrity

the right of each human being, including children, to autonomy and self-determination over their own body. It considers an unconsented physical intrusion as a human rights violation.

best forms of contraception

implant, IUD, sterilization

what should be considered when choosing a contraceptive

- ability to be consistent?

- prevent STDs?

- effectiveness?

- health/comfort level?

- want to have children eventually?

most effective to least effective contraceptives

STERILIZATION, implant, IUD, pill, patch, ring, shot, condoms, diaphragm, contraceptive gel, spermicide, fertility awareness, PULLOUT

barrier method category contraception

condom (internal/external) (effective)

cervical barrier category contraception

diaphragm w/ spermicide (ineffective)

intrauterine category contraception

IUD (very effective)

hormonal category contraception

patch, shot, ring, pill (effective)

surgical category contraception

sterilization (male/female) (very effective)

fertility awareness contraception

know when ovulation occurs (ineffective)

what contraceptive prevents pregnancy and STIs

condoms

types of abstinence

continuous abstinence (often religious), selective abstinence (fluid-free sexual behavior, good for teens)

why is it difficult to rely on abstinence

unrealistic, should know of other methods in case situation arises

what type of method would condoms/dental dams be

barrier method (external), to prevent STIs

how would an internal condom be used?

place into vagina, so it covers cervix and lines vaginal wall (can be placed inside hrs in advance)

what lubricant should not be used with condom

oil based

contraceptive methods that prevent pregnancy but not STDs

sterilization, implant, IUD, pill, patch, ring, shot, diaphragm, contraceptive gel, spermicide, fertility awareness, pullout (all except condom)

best contraceptive combinations

pill and condom, IUD/implant/patch/ring with condom, fertility awareness with condom, diaphragm with spermicide and condom

how do hormonal contraceptives prevent pregnancy

preventing ovulation, thinning uterine lining, thicken cervical mucus

how do emergency contraceptives prevent pregnancy

stopping or delaying the release of an egg from the ovary, or by stopping sperm from fertilizing the egg

what is LARC

Long-acting reversible contraception (LARC) is a type of birth control that is highly effective and can prevent pregnancy for several years (IUD and implant)

what happens if already pregnant and take emergency contraception

Plan B is not effective after pregnancy has occurred and cannot interrupt it. Plan B won't harm a developing fetus

types of emergency contraception

plan B (levonorgestrel) 3-5 days, Ella (ulipristal acetate) 5 days, or copper IUD 5 days

does emergency contraception cause abortion

no, it does not, it prevents ovulation/sperm fertilization

sterilization females

tubal ligation

sterilization males

vasectomy

what method most effective in preventing pregnancy

sterilization

do contraceptives terminate pregnancy

no, they prevent pregnancy

how are parenthood decisions influenced

pronatalism, the ideal that all must reproduce

pronatalism

An attitude or policy that encourages childbearing

5 steps to healthy pregnancy (CDC)

1. Talk to your healthcare provider

2. Get 400 micrograms of folic acid daily (1 month before as well)

3. Stop drinking alcohol, smoking, and using certain drugs

4. Avoid toxic substances and contaminants

5. Reach and maintain a heathy weight

teratogens

agents such as drug, chemicals, and viruses, that can reach the embryo or fetus during prenatal development and cause harm

fetal alcohol syndrome

physical and cognitive abnormalities in children caused by a pregnant woman's heavy drinking

teratogen involved in FAS

alcohol

what teratogen affected Dr. Rapalyea's hearing

rubella (german measles)

how does nutrition and exercise help with pregnancy

faster recovery, support fetal growth

risks when pregnant later in life

After age 35, there's a higher risk of pregnancy-related complications that might lead to a C-section delivery. The risk of chromosomal conditions is higher. Babies born to older mothers have a higher risk of certain chromosomal conditions, such as Down syndrome. The risk of pregnancy loss is higher

can pregnant women still have sex

yes, will not affect fetus

how is pregnancy detected

Blood or urine test for human chorionic gonadotropin (hCG) hormone

first signs of pregnancy

- light period, no period or spotting at implantation

- fatigue; tender breasts

- nausea/vomiting; appetite change

- Excess (hCG) Human chorionic gonadotropin is detected in blood or urine as early as 7 days after conception

why might pregnancy signs be ignored

- lack of sex ed

- pregnancy unplanned

- contraceptive failure

- unpredictable menstrual cycle

- unwanted/forced sexual intercourse

periods of pregnancy measured in

trimesters

what is germinal period

first two weeks after fertilization, during which the zygote moves down to the uterus and begins to implant in the lining

what is embryonic period

conception to 8 weeks, cardiac flutter, neural tube develops

what is fetal period

weeks 9-38, sex organs become visible, body parts become visible and movable, rapid development

what structure implants during pregnancy

blastocyst

trimester 1 development

baby's brain and spinal cord have begun to form.

The heart begins to form.

Arm and leg buds appear.

baby is now an embryo and one-twenty-fifth inch long.

sense of touch develops

trimester 2 development

fetus has now developed all its organs and systems and will now begin to grow in length and weight. You may be able to feel the movement of the fetus for the first time at around 20 weeks, taste develops

trimester 3 development

The lungs are still maturing, and the fetus begins to position itself head down. By the end of the third trimester, the fetus is about 19 to 21 inches long and weighs, on average, 6 to 9 pounds. Fetal development during the third trimester includes: The fetus can see and hear.

morning sickness

nausea during the first few months of pregnancy due to increased estrogen and progesterone

couvade

a sympathetic pregnancy in which a man experiences a variety of symptoms associated with pregnancy or childbirth while his partner is pregnant

what is "best" trimester

second trimester

racial disparities in pregnancy

black (3x mortality rate) and Hispanic women are nearly four times and two times respectively to receive 0-5 prenatal care visits as compared with white women. Insurance status, availability of transportation, and other social factors likely play a role in receipt and timing of prenatal care.

why is maternal mortality so high in the US

Lack of providers

Lack of postpartum support

Age

Chronic health conditions

Racism

Cesarean sections

what methods are used to detect pregnancy problem

fetal ultrasound and maternal blood testing

likelihood of pregnancy fail trimester 1

80%

likelihood of pregnancy fail trimester 2

between 1% and 5%

likelihood of pregnancy fail trimester 3

1% or less

spontaneous abortion (miscarriage)

the spontaneous expulsion of the fetus from the uterus early in pregnancy, before it can survive on its own (sometimes failure to implant, genetic abnormality)

what group of blastocyst cells support fetus

outer cells (make implant and sac)

what group of blastocyst cells create fetus

inner cells (make embryo)

what is stillbirth

infant born dead after 20 weeks gestation

what is fetal age of viability

22 wks - very low survivability

26 wks - 50% survivability, CNS complications

28 wks - 95% survival rate, but must be 3 lbs

stages of childbirth

1. Dilation and effacement of the cervix (10 cm, water breaks)

2. Delivery of the baby

3. Delivery of the placenta

how can labor be induced

natural: sex, walking, nipple stimulation

medical: strip membranes, manual sack breakage, misoprostol (encourage cervical dilation)

birthing options in US

1) Vaginal birth at home or at hospital

2) Cesarean section at home or at hospital

vaginal birth

a birth in which the child is pushed out of the mother's uterus via the vagina

cesarian section

delivery through an incision in the abdominal and uterine walls

is hospital birth safer

yes, more medical equipment and staff

postpartum depression

a new mother's feelings of inadequacy and sadness in the days and weeks after giving birth

treatment for postpartum depression

antidepressants and psychosocial therapies

When is it healthy to resume sexual intercourse after birth and why?

6 weeks, need to wait for lochia (postpartum bleeding) to cease

spontaneous abortion vs elective abortion

spontaneous: happens naturally

elective: you choose for this to happen

% abortions occur before 20 weeks

99%

% abortions occur after 20 weeks

less than 1%