Contraception Voice Over

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Human Sexuality & Fertility:

Human Sexuality & Fertility Pamela Dennis RNC-OB MSN

Sexuality and Reproductive Health Care:

Sexuality and Reproductive Health Care Community based perspective – majority of women’s health care is given outside acute care Reproductive implications relate to pregnancy, birth control, STDs, other health concerns Nurse’s role: educator, counselor, care provider

Providing Contraceptive Care :

Providing Contraceptive Care Methods of Contraception 1. Medication free methods 2. Barrier methods 3. Hormonal methods

Medication-Free Methods:

Medication-Free Methods Natural Family Planning Fertility Awareness Coitus Interruptus Lactational amenorrhea methos Abstinence

Barrier methods:

Barrier methods Inexpensive Some protect against STDs Must be used prior to intercourse Water-based lubricant – NOT oil-based Few side effects Key: consistent and correct use

Barrier Methods:

Barrier Methods Diaphragm

Barrier Methods:

Barrier Methods Cervical Cap

Barrier Methods:

Barrier Methods Spermicides Male and female condoms

Hormonal Methods:

Hormonal Methods Oral Contraceptives - ACHES DepoProvera Transdermal contraceptiive patch Vaginal contraceptive ring

Noncontraceptive Benefits :

Noncontraceptive Benefits 1. Regulate mentrual bleeding 2. Mediate menopausal symptoms 3. Premenstrual disorders

Contraindications:

Contraindications Smoking and age > 35 Moderate/severe hypertension Undiagnosed uterine bleeding Diabetes with vascular complications History of deep vein thrombosis

Troublesome Side Effects:

Troublesome Side Effects Headaches Breakthrough bleeding Nausea Breast Tenderness Cyclic weight gain

Intrauterine Device (IUD) :

Intrauterine Device (IUD) Mirena - progestin IUD Copper IUD Warning Signs: PAINS

Benefits:

Benefits No continued expense No daily attention No interference with intercourse May decrease risk of endometrial cancer

Side Effects/Contraindications:

Side Effects/Contraindications Irregular bleeding Amenorrhea Pelvic infections Current STD Genital tract cancer Uterine anomalies, fibroids

Sterilization:

Sterilization Female - bilateral tubal ligation Male - vasectomy

Emergency Postcoital Contraception:

Emergency Postcoital Contraception Hormonal Methods 1. Preven 2. Plan B First dose within 72 hours of unprotected IC, next dose 12 hours later, NAUSEA! Copper-releasing IUD

Nursing Care:

Nursing Care Assessment Emotional support Observe for complications Schedule follow-up appointment Discharge teaching

Infertility:

Infertility Defined as >12 months of actively attempting pregnancy without success Nurses’s role Educate Counsel

Assessments:

Assessments Female Thyroid function tests Glucose tolerance test Hormonal levels Ultrasonography Endometrial biopsy Hystrerosalpingogram Laparoscopy

Male:

Male Semen analysis Additional tests

Treatment Options:

Treatment Options Medications to induce ovulation Surgical options Therapeutic insemination Advanced reproductive technologies IUI IVF

Ethical/Legal Considerations:

Ethical/Legal Considerations Financial implications Donor confidentiality Factual information about advantages and limitations of techniques

Potential effect on Couple’s Relationship:

Potential effect on Couple’s Relationship Emotional stress Feelings of disappointment and failure Sense of loss and grief Intercourse changes to goal-oriented procedure

Additional Options :

Additional Options Surrogacy - gestational carrier Adoption Child-free lifestyle