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6. 節育 , 懷孕 , 與產娩 : 掌握你的生育計劃. 生育控制的方法. 避孕 Contraception Prevents conception Perfect failure rate Typical use failure rate (See Table 6.1) 障礙法 Barrier methods. Table 6.1, part 1. Table 6.1, part 2. How to Use a Condom. Figure 6.1. Methods of Fertility Management. Hormonal Methods - PowerPoint PPT Presentation
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Copyright © 2005 Pearson Education, Inc., publishing as Benjamin Cummings
PowerPoint® Lecture prepared by Jan Campbell
T H E B A S I C S
SIXTH EDITION
節育 , 懷孕 , 與產娩 :掌握你的生育計劃 66
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
生育控制的方法
• 避孕 Contraception
• Prevents conception
• Perfect failure rate
• Typical use failure rate (See Table 6.1)
• 障礙法 Barrier methods
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin CummingsTable 6.1, part 1
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin CummingsTable 6.1, part 2
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
How to Use a Condom
Figure 6.1
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Methods of Fertility Management
• Hormonal Methods
• Oral contraceptives
• Pills
• Depo-Provera
• Ortho-Evra
• Nuva Ring
• Lunelle and Norplant (currently off the market)
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Methods of Fertility Management
• Surgical Methods of Sterilization
• Female
• Tubal ligation
• Hysterectomy
• Male
• Vasectomy
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Methods of Fertility Management
• Other Methods of Contraception
• IUDs
• Progestasert
• ParaGuard
• Withdrawal
• Emergency contraceptive pills
• ECPs
• Emergency minipills
• Abstinence and “Outercourse”
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
The Fertility Cycle
Figure 6.4
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Fertility Awareness Methods
• Cervical Mucus Method
• Body Temperature Method
• The Calendar Method
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Contraceptive Research
• New Barrier Methods
• Lea’s Shield
• Vaginal Sponge (Protectaid)
• FemCap
• Contraceptives for Men
• “Male Pill”
• Injectable Contraceptive
• Synthetic Testosterone
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin CummingsTable 6.2
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Contraceptive Research
• Implant Refinements
• Population Council – Single Rod Implant Delivery System
• Biodegradable Implants
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Contraceptive Research
• Injections and Vaccines For Women
• Oral or injectable vaccine
• Unisex Contraception
• New group of drugs as gonadotropins
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Abortion History and Methods
• Landmark case Roe vs. Wade 1973
• What are the main arguments on both sides of this debate?
• Methods of Abortion
1) Vacuum aspiration – 1st trimester
2) Dilation and Evacuation (D&E) – 2nd trimester
3) Dilation and Curettage (D&C) – 2nd trimester
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Vacuum Aspiration Abortion
Figure 6.5
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Abortion History and Methods
• Methods of Abortion (continued)
4) Prostaglandin or induction abortions – 2nd trimester
5) Hysterotomy – removal of the fetus surgically
6) Intact dilation and extraction (D&X) – late term abortion
7) Mifepristone (RU-486) – induces abortion by blocking progesterone used with Misoprostil (a Prostaglandin)
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Planning a Pregnancy
• Emotional Health
• Maternal Health
• Preconception care
• Smoking and drinking
• Caffeine
• X-rays
• Healthy weight
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Planning a Pregnancy
• Paternal Health
• Klinefelter’s syndrome
• Prader-Willi syndrome
• Financial Evaluation
• Contingency Planning
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Pregnancy
• Prenatal Care
• 30% don’t receive adequate care
• Choosing a Practitioner
• Ob-Gyn
• Family practitioner
• Midwife
• Alcohol and Drugs
• Birth defects
• Fetal alcohol syndrome
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Pregnancy
• X-Rays
• Nutrition and Exercise
• Normal weight gain is 25-35 pounds in a normal weight woman
• Obese women can gain less, 15-25 pounds recommended
• Underweight women recommended 35-45 pounds
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Pregnancy
• Other Factors
• Avoid toxic chemicals
• Avoid pesticides
• Toxoplasmosis – cat feces, raw meat, can have harmful organisms
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Facts
• Woman menstruate for about 40 years
• After 35, birth defects do rise
• Down syndrome is NOT markedly increased with age, 80% are born to moms under 35
• Pregnancy Test and Process
• Pregnancy tests measure human chorionic gonadotropin (HCG)
• Fertilization
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Fertilization
Figure 6.6
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Pregnancy Testing
• HCG (Human Chorionic Gonadotropin found in urine and blood)
• Early Signs of Pregnancy
• Breast tenderness
• Emotional upset
• Nausea
• Sleeplessness
• Vomiting
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• First Trimester
• Embryo
• Fetus – start of third month
• Second Trimester
• Placenta well established
• Notice changes in mother
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Third Trimester
• 6-9th month
• Greatest growth
• 85% of calcium and iron to fetus
• Pregnancy is 40 weeks gestation total
• Fourth Trimester
• Postpartum period – 6 weeks after the birth occurs
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Amniocentesis
Figure 6.7
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Prenatal Testing and Screening
• Amniocentesis – draws fluid from amniotic sac
• Ultrasound or sonography – uses high-frequency sound waves
• Fetoscopy – small incision and optical viewer
• Chorionic villus sampling – remove tissue from around fetal attachment to the mother
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
The Birthing Process
Figure 6.8, part 1
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
The Birthing Process
Figure 6.8, part 2
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Childbirth
• Choose a place – home or hospital
• The birth process
• Episiotomy
• A slight incision in perineum
• Some use pain-killers
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Perineum
• Area between vulva and anus for incision if needed
• Afterbirth
• Placenta delivery during last stage of birth
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Managing Labor: Nonmedical Approaches
• Birth Alternatives
• Lamaze
• Harris method
• Childbirth without fear
• Leboyer method
• Bradley method
• Water birth
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Breast-Feeding and Postpartum Period
• Colostrum
• Precedes milk
• Thick yellow substance
• Contains vital antibodies
• Breast milk provides perfect nutrition
• Postpartum Depression
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Complications
• Cesarean Section
• 26.1% in 2002
• CDC hoped to reduce to 15% by 2000 but did not meet goal
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Complications (continued)
• Miscarriage
• 10% of pregnancy
• Failure of egg to divide correctly
• Ectopic pregnancy
• Genetic abnormalities
• Maternal illness
• Maternal hormonal imbalance
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
A Woman’s Reproductive Years
• Complications (continued)
• Stillbirth
• Sudden Infant Death Syndrome (SIDS)
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Infertility
• Facts
• Men and women affected equally
• One in 6 people are infertile
• Causes in Women
• Endometriosis
• Pelvic inflammatory disease (PID)
• Causes in Men
• Low sperm count
• Mumps virus
• Varicose veins above testes
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Infertility
• Treatment
• 90% treatable
• 30-70% success
• Expensive and time consuming
• Fertility drugs and side effects
• Alternative insemination
• In vitro fertilization
• Gamete intrafallopian transfer (GIFT)
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Infertility
• Treatment (continued)
• Intracytoplasmic sperm injection (ICSI)
• Embryo transfer (surgical and non-surgical types)
• Embryo freezing
• Embryo adoption
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Infertility
• Options Beyond Treatment
• Surrogate motherhood
• Adoption
• What are some important considerations with surrogate mothers?
• Which of these alternatives seem best to you and why?