Women's Health Exam 2

Oral Contraceptive Pill

A modern method of birth control that significantly changed women's reproductive health and autonomy.

Comstock Law

A law enacted in 1873 that prohibited the distribution of contraceptive devices and information, defining them as obscene.

Roe v wade

A landmark Supreme Court decision that established a woman's legal right to have an abortion, later overturned by Dobbs v. Jackson.

egypt 1850 bce

used arcadia leaves and honey and animal dung

greece 4th century

used spermicides: olive and cedar oil

pre-industrial US

douches, elixir to miscarry

condoms

used in the 17th century

goodyear

improved condom manufacturing through the vulcanization of rubber in 1839

early 1870s

contraceptives became available by mail, vendors, and pharmacies (condoms, douching materials, vaginal sponges, cervical caps, “womb veils”

lysol

used as a douche that led to poisonings of the body

massachusetts

anyone disseminating contraceptives, or information about contraceptives faced a fine and imprisonment

connecticut

the act of using birth control is prohibited, married couples could face one year in prison, locked away in many cases, but laws on the books

margaret sanger

arrested for opening the first birth control clinic in the US

1 in 111 or 380,000

between april 1917 and december 1919, this many soldiers were diagnosed with syphilis, gonorrhea, or chanchroid

50 million

by the end of WWI, it cost the US over ___ in treatment

7 million

VD was blamed for ____ lost days of active duty

therapeutic

1918- women could use birth control for these purposes

across state lines, relaxing

1936 amendment, physicians could now send contraceptives ____. paved the way for more ____ of birth control laws

margaret sanger

grew up in poverty, mother had 18 pregnancies, 7 miscarriages, died at 49 from TB and cervical cancer, 1916 founded the first birth control clinic in Brooklyn, coined the term “birth control,” Women Rebel 1914, dream of creating the pill

gender inequalities, higher efficacy, empowerment for women, sexual revolution

why do we need the pill?

sexual revolution

enter the workforce, control over motherhood, sexual freedom

gregory pincus

harvard scientist, 1934 in-vitro fertilization of rabbits, Brave New World recently published, was labeled “Dr. Frakenstein,” denied tenure

john rock

medical doctor, seen as skeptical at first by sanger, later critical advocate, believed the pill should be accepted by the church, took great risk to his career, witnesses problems in his practice, taught birth control to med students in the 1940s

katherine mccormick

graduated from MIT with a degree in biology, married stanley mccormick, heir to international harvester fortune, suffrage movement, committed to birth control with sanger, financed the pill research

no comstock laws, dense population, science seen as a good thing

why was an initial large scale study conducted in puerto rico?

progesterone, ovulation

pincus first conducted animal trials with ____ and inhibited ____

the hormones were the same as in the woman naturally

when the catholic church rejected the pill, rock argued that

The Time Has Come: A Catholic Doctor’s Proposals to End the Battle Over Birth Control

rock authors ___ after rejection

Of Human Life

the church released ___ as a response to john rock’s book

1960

fda approved the pill in

500,000

within 2 years, this many pills were prescribed

6 million

by 1965, this many women were on the pill

two-thirds and three-quarters

by 1970, ___ of all catholic women and ____ of those under 30 were using the pill and other birth control methods banned by the church

side effects

by the late 1960s, thousands of women were complaining of ____ from the pill

barbara seaman

1969 expose

no women to represent women

1970 hearings

alice wolfson

“why are 10 million women being used as guinea pigs?”

phillip ball

“they used a sledgehammer to drive a small nail”

education access and quality, health care access and quality, neighborhood and built environment, social and community context, economic stability

social determinants of health

improved birth outcomes

research indicates that family planning, including planning, delaying and spacing pregnancies, is linked to ____ for babies, either directly or through healthy maternal behaviors during pregnancy

pregnancy-related morbidity and mortality, certain reproductive cancers, menstrual related

contraception reduces _____, the risk of developing _____, and is used to treat many _____ symptoms and disorders

services to prevent, screen for and treat diseases

in addition to contraception, a range of other beneficial health services are available to clients at family planning clinics. ______ and conditions such as chlamydia, gonorrhea, HIV, HPV and cervical cancer, as well as to address intimate partner violence, benefit both female and male clients who visit these clinics

because not all women have equal access

_______ to the many benefits of contraception and other health services, there is more work to be done in implementing programs and policies that advance contraceptive access and improve health outcomes for all women

51%

percent of pregnancies that are intended in the US

29%

percent of pregnancies that are unintended (occur earlier than desired) in the US

20%

percent of pregnancies in the US that are unintended (occur after women have reached their desired family size)

70%

there are 61 million US women of reproductive age (15-44). about 43 million of them (__) are at risk of unintended pregnancy- that is, they are sexually active and do not want to become pregnant, but could become pregnant if they and their partners fail to use a contraceptive method correctly and consistently

85% chance

couples who do not use any method of contraception have approx. an ____ of experiencing a pregnancy over the course of a year

three decades

in the US, the average desired family is two children. to achieve this family size, a woman must use contraceptives for roughly ____

99% of women aged 15-44

more than _____ who have ever had sexual intercourse have used at least one contraceptive method

60% of all women of reproductive age

some _____ are currently using a contraceptive method

10%

_____ of women at risk of unintended pregnancy are not currently using any contraceptive method

low-income women, women aged 18-24, women of color

unintended pregnancy rates are highest among ____ (i.e., women with incomes less than 200% of the federal poverty level), ____, cohabiting women and _____

more than five times the rate

the rate of unintended pregnancy among women with incomes less than 100% of the poverty level was 112 per 1,000 in 2011, _____ among women with incomes of at least 200% of poverty (20 per 1,000 women)

only 5%

among US women at risk of unintended pregnancy, the 68% who use contraceptives consistently and correctly throughout the course of any given year account for ____ of all unintended pregnancies

at all or have a gap in use

in contrast, the 18% who use contraceptives inconsistently account for 41% of unintended pregnancies, and the 14% who do not use contraceptives ______ of at least one month account for 54% of unintended pregnancies

40%

percent of women who reported problems accessing or using methods

19%

percent of women who reported infrequent sex

18%

percent of women who do not care if pregnancy occurs

7%

percent of women who underestimate pregnancy risk

1584

in dr. butler’s study among 2800 college students, ___ had used a condom in the last year

45%

percent embarrassed to ask a pharmacist about condoms

27%

percent embarrassed to purchase condoms at the drug store near campus

21%

percent embarrassed to acquire condoms at the health center

17%

percent embarrassed to acquire condoms at the local health department

among 15-19 year olds

some 5.5 million women rely on the male condom. condom use is most common (i.e., at least 25% greater than the national average of 15%) _______, those who report their religious affiliation as other, those born outside of the US, college graduates, those who are uninsured and those who are nulliparous or are expecting at least one (more) child

52% to 93%

ever-use of the male condom increased from ___ in 1982 to ___ in 2006-2010

dual method

__ use offers protection against both pregnancy and STIs. some 8% of women of reproductive age simultaneously use multiple contraceptive methods (most often the condom combined with another method)

one in nine

__ sexually experienced women of reproductive age have used emergency contraception, as of 2010. the majority of these women used emergency contraception only once (59%)

20-24 year olds and never married women

emergency contraceptive use is highest among ____, of whom 23% and 19%, respectively, report having ever used emergency contraception

17% cis men, 21.5% cis women, 21.3% trans/gender non-conforming

college students who reported having vaginal intercourse within the last 12 months were asked if they or their partner used emergency contraception in the last 12 months. the results:

0.9% cis men, 1% cis women, 1.9% trans/gender non-conforming

college students who reported having vaginal intercourse within the last 12 months were asked if they experienced an unintentional pregnancy or got someone pregnant within the last 12 months. the results:

title x

health policy started by richard nixon, specifically designed to subsidize family planning and health services, grants provided to 4,500 health centers serving 5 million people, designed to help low income families including those not eligible for medicaid

327 million

congress appropriated around this amount of money for the title x family planning program

90%

nearly __ also received preventive gynecological attention, and over 50% were treated for STIs or reproductive tract infections or related conditions from title x

no

can title x funds be used for abortions?

1.94 million

in 2006, publicly funded family planning services (medicaid, title x, and state funds) helped women avoid ___ unintended pregnancies, thus preventing about 860,000 unintended births and 810,000 abortions

two-thirds, double

without publicly funded family planning services, the number of unintended pregnancies and abortions in the US would be nearly ___ higher among women overall and among teens; the number of unintended pregnancies among poor women would nearly ____

net savings to the federal and state governments of $13.6 billion

altogether, the services provided at publicly funded family planning visits in 2010 resulted in a ____. the services provided at title x-supported centers accounted for 7 billion of that total

1 dollar invested in publicly funded family planning services saved $7.09

in 2010, every _____ in medicaid expenditures that would otherwise have been needed to pay the medical costs of pregnancy, delivery, and early childhood care

scabies

a mite which causes a skin rash, very itchy, burrows its way into the skin, contagious, spreads easily among partners, families, schools, nursing homes, prisons, etc.

true

true or false: typically, you treat everyone who may have been exposed to scabies

medicated skin creams or pills

kill the mites that cause scabies

many weeks

itching from scabies may not stop for ____ after treatment

close skin-to-skin contact, sharing clothing or bedding with a person who has scabies

what can scabies be transmitted by?

impetigo

an infection on the skin’s surface that’s caused most often by staph bacteria or sometimes by strep bacteria

wash all clothes and linen, starve the mites, clean and vacuum

ways to prevent scabies

squamous cell carcinoma

this type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. most cervical cancers are this type

adenocarcinoma

this type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal

4,290

about how many women will die from cervical cancer?

13,800

the american cancer society’s estimates for cervical cancer in the US for 2020 are about ____ new cases of invasive cervical cancer will be diagnosed

yes

are pre-cervical cancer conditions extremely common?

92%, 56%, 17%, 66%

5 year relative survival rates based on stage: localized ___, regional ___, distant ___, all stages combined ___

17 million

incidence of HPV

79 million

prevalence of HPV

no signs or symptoms

early-stage cervical cancer generally produces ___

many sexual partners, early sexual activity, other stis, a weakened immune system, smoking, exposure to miscarriage prevention drug, long term use of oral contraceptives

risk factors for HPV

35 and 44, 50

cervical cancer is most frequently diagnosed in women between the ages of ___ with the average age at __

pre-cancers

when the ____ are checked in the lab, they are graded on a scale of 1 to 3 based on how much of the cervical tissue looks abnormal

CIN1

also called mild dysplasia or low SIL, not much of the tissue looks abnormal, and it is considered the least serious cervical pre-cancer