Chapter 10 Planning Children And Contraception. Chapter Outline Do You Want to Have Children? How Many Children Do You Want? Teenage Motherhood Infertility

Chapter 10

Planning Children And Contraception

Chapter Outline

• Do You Want to Have Children?• How Many Children Do You Want?• Teenage Motherhood• Infertility• Adoption• Foster Parenting • Contraception• Abortion

True or False?

• Most men of partners who had an abortion tended to regret the abortion.

Answer: False

• Researchers conducted interviews with men 4 and 12 months after their partners had had an abortion.

• Overwhelmingly, the men were happy with the decision of their partners to have an abortion.

• About a third were not using contraception a year later.

True or False?

• Children of donor sperm want to find more about their father due to economic motives.

Answer: False

• Researchers studied individuals conceived through a sperm donor.

• 80% indicated a moderate interest in learning more about the donor.– None reported wanting money.– 7% reported wanting a father-child

relationship.

5. Government

6. Economy

7. Cultural Observances

Social Influences Motivating Individuals to Have Children

• Family• Friends• Religion• Race

Pronatalism

• Attitudes that encourage childbearing.• Family, friends, religion, and government help

develop positive attitudes toward parenthood. • Cultural observances reinforce these

attitudes.

Individual Motivations for Having Children

• Conscious motivations include:– the desire for love and companionship with

one’s own offspring.– the desire to be personally fulfilled as an

adult by having a child.

Companionship as a Motivator of Parenthood

• This father of two sons has shared experiences with his children since they were young. Here, the father and son are on a trip to New Zealand.

• Pg. 277 Bottom left

Question

• Pronatalism refers to which of the following?

A. sanctifying children to their religion

B. encouraging childbearing

C. encouraging stability regarding overpopulation

D. sexual values

Answer: B

• Pronatalism refers to encouraging childbearing.

Older Parents

• There are advantages and disadvantages of having a child as an older parent. – Primary advantage is the amount of

attention the parents can devote to their offspring.

– The primary disadvantage is that the parents are likely to die before, or early in, the child’s adult life.

Older Parents

• Aleta St. James was 57 when she had these twins.

• How old is too old to become a parent?

• Pg. 277 Upper right

Lifestyle Changes and Parenthood

• Daily living routines become focused around the children.

• Living arrangements change to provide space for another person in the household.

• Some parents change their work schedule to allow them to be home more.

• A major lifestyle change is the loss of freedom of activity and flexibility in one’s personal schedule.

Financial Costs of Parenthood

• An uncomplicated birth, with a 2-day hospital stay, may total $10,000.– A cesarean section birth may cost $14,000.

• Annual cost of a child less than 2 years old for middle income parents ($41,700 to $70,200), including housing, food, transportation, clothing, health care, and childcare, is $9,840. – For a 15- to 17-year-old the cost is $10,900.

Childfree Marriage

• Reasons for not having children include: – freedom to spend time and money as they

choose– ability to enjoy their partner without

interference– pursue their career– avoid health problems – avoid passing on genetic disorders.

Childfree Marriage

• This married couple delight in their childfree lifestyle.

• They own a nice home on a golf course, travel extensively, and have a network of close friends.

• They do have two dogs and a cat.

• Pg. 280

How Many Children?

• One in five women aged 40 to 44 has a single child.

• The most preferred family size in the United States is the two-child family.

• Couples are more likely to have a third child if they already have two girls rather than two boys.

Teenage Motherhood

• Problems:– Stigmatized and marginalized – Poverty among single teen mothers and

their children– Poor health habits– Lower academic achievement– Deficit nurturing skills– Anxious/depressed teen father

Types of Infertility

1. Primary • A woman has never conceived though she has

had regular sexual relations for 12 months.2. Secondary

• A woman has previously conceived but is currently unable to do so even though she has had regular sexual relations 12 months.

3. Pregnancy wastage.• A woman has been able to conceive but has

been unable to produce a live birth.

Infertility

• 40% of infertility problems are attributed to the woman.

• 40% of infertility problems are attributed to the man.

• 20% of infertility problems are attributed to both the man and woman.

Causes of Male Infertility

• Low sperm production• Poor semen motility• Effects of sexually transmitted diseases• Interference with passage of sperm through

the genital ducts due to an enlarged prostate

Causes of Female Infertility

• Blocked fallopian tubes• Endocrine imbalance that prevents ovulation• Dysfunctional ovaries• Chemically hostile cervical mucus that may

kill sperm• Effects of sexually transmitted diseases

Assisted Reproductive Technology

• Hormone Therapy• Artificial Insemination• Artificial Insemination of a Surrogate Mother• In Vitro Fertilization• Ovum Transfer

INSERT VIDEO

• 8. Sperm Donors: The Aftermath(Run Time: 6:01)

Adoption

• Demographic characteristics of those who typically adopt: white, educated, and high-income.

• Adoptees in the highest demand are healthy, white infants.

• Those who are older, of a racial or ethnic group different from the adoptive parents, of a sibling group, or with physical or developmental disabilities are more difficult to place.

Adoption

• Transracial Adoption– Adopting children of a race different from

that of the parents.• Open Adoptions

– In an open adoption, the biological parent can stay involved in the child’s life.

Question

• Demographic characteristics of people who typically adopt are

A. white, educated, and high-income.

B. young, flexible, and idealistic.

C. families who want a child of a different sex than their own child.

D. older, gay, and single.

Answer: A

• Demographic characteristics of people who typically adopt are white, educated, and high-income.

INSERT VIDEO

• 9. Gay Adoption (Run time: 3:32)

Foster Parenting

• A foster parent, also known as a family caregiver, is a person who takes care of and fosters a child taken into custody.

• About 600,000 children are in foster care.

Hormonal Contraceptives

• Oral Contraceptive Agents– Birth control pill

• Jadelle® – Silicone implants inserted under the skin in

the upper inner arm provide time-release progestin into a woman’s system.

• Implanon®– A system that provides pregnancy

protection for 3 years after insertion.


• Depo-Provera®– A compound similar to progesterone injected into

a woman’s arm or buttock that protects a woman against pregnancy for three months.

• Vaginal Ring– A soft, flexible, and transparent ring that is worn

inside the vagina and provides month long pregnancy protection.


• Transdermal Applications– Ortho Evra® is a transdermal patch that delivers

hormones to a woman’s body through skin absorption.

• Male Hormonal Methods– Numerous studies have found that administration

of testosterone to men reduces sperm count and is a very efficient method of contraception.

Condoms

• Male Condom– The condom is a thin sheath made of latex,

polyurethane, or natural membranes.• Female Condom

– The female condom resembles the male condom except that it fits in the woman’s vagina to protect her from pregnancy, HIV infection, and other STDs.

Female Condom

• Pg. 296

Contraception

• Spermicides– A chemical that kills sperm.

• Intrauterine Device (IUD)– Inserted into the uterus by a physician to

prevent the fertilized egg from implanting on the uterine wall or to dislodge the fertilized egg if it has already implanted.

Contraception

• Diaphragm– A shallow rubber dome attached to a

flexible, circular steel spring.• Cervical Cap

– A thimble-shaped contraceptive device made of rubber or polyethylene that fits tightly over the cervix and is held in place by suction.

Contraception

• Natural Family Planning– Refraining from sexual intercourse during

the seven to ten days each month when the woman is thought to be fertile.

Nonmethods of Contraception

• Withdrawal is the practice whereby the man withdraws his penis from the vagina before he ejaculates.

• Douching refers to rinsing or cleansing the vaginal canal.

Emergency Contraception

• Combined Estrogen-Progesterone– The most common morning-after pills are

combined estrogen-progesterone oral contraceptives taken to prevent pregnancy.

• Postcoital IUD– Insertion of a copper IUD 5 to 7 days after

ovulation in a cycle when unprotected intercourse has occurred.

Mifepristone (RU-486)

• A synthetic steroid that inhibits implantation of a fertilized egg.

• The so-called abortion pill, approved by the FDA in the United States in 2000 can be given to induce abortion within seven weeks of pregnancy.

• Side effects may include cramping, nausea, vomiting, and breast tenderness.

• More than 90% of U.S. women who tried RU-486 would recommend and choose it over surgery again.

Question

• Which of the following is not a form of birth control?

A. vasectomy

B. salpingectomy

C. douching

D. laparoscopy

Answer: C

• Douching is not a form of birth control.

Methods of Contraception

MethodEffectiveness

RatesSTI

ProtectionCosts

The Pill 92% No $10–42/month

Jadelle® 99.95% No $300–600

Depo-Provera ®

97% No $45–75/injection

Transdermal patch

92% No $15–32/month


MethodEffectiveness

RatesSTI

ProtectionCosts

Vaginal Ring

92%No

$15–48/month

Male condom

85% Yes $2-10/box

Female condom

79% Yes $4-10/box


MethodEffectiveness

RatesSTI

ProtectionCosts

Spermicide 71% No $8–18

Today®

Sponge68-84% No

$3-5/sponge

Diaphragm/Cervical cap

68-84% No$50 to $200 +spermicide


MethodEffectiveness

RatesSTI

ProtectionCosts

IUD 98.2%-99% No $150–300

Withdrawal 73% No $0

Periodic abstinence

75% No $0

Emergency contraception

75% No $10–32

Abstinence 100% No $0


Method Benefits Disadvantages

The Pill Highly effective.24-hour protection.Menstrual regulation.

Daily administration.Side effects.

Jadelle® Highly effective. Long-term protection.

Side effects.Menstrual changes.



Depo-Provera ®

Highly effective. Long-term protection.

Can impact bone density. Not recommended for use longer than 2 years.Side effects.

Transdermal patch

Same as oral contraceptives.

Patch changed weekly.Side effects possible.60% more hormone exposure than pills.



Vaginal Ring

Lower hormone levels may mean fewer side effects than pills.

Must be comfortable with

body for insertion.

Male condom

Few or no side effects. Easy to purchase and use.

Can interrupt spontaneity.



Female condom

Few or no side effects. Easy to purchase and use.

Decreased sensation. Insertion takes practice.

SpermicideMany forms to choose. Easy to purchase and use.

Can cause irritation.Can be messy.



Today®

Sponge

Few side effects. Effective for 24

hours after insertion.

Spermicide irritation possible.

Diaphragm/Cervical cap

Few side effects.Can be inserted within 2 hours

Can be messy. Risk of vaginal/UTI

infections.



IUDLittle maintenance.

Longer term protection.

Risk of PID increased. Chance

of expulsion.

WithdrawalRequires little

planning. Always available.

Pre-ejaculatory fluid can contain sperm.



Periodic abstinence

No side effects. Widely accepted.

Requires a lot of planning.

Emergency contraception

Provides option after intercourse has occurred.

Must be taken within 72 hours. Side effects likely.

Abstinence No risk of pregnancy or

STDs.

Partners both have to agree to abstain.

Question

• Of the following, the most effective form of contraception is

A. the pill

B. an IUD

C. abstinence

D. a diaphragm and cervical cap

Answer: C

• Abstinence is the most effective form of contraception.

Female Sterilization

• Salpingectomy (tubal ligation), is often performed just after a woman has delivered a baby.– The operation takes about thirty minutes. – About 700,000 are performed annually.– Cost is around $2500.– A less expensive and quicker (15 minutes)

form of salpingectomy, performed is the laparoscopy.

Female Sterilization: Tubal Sterilization

Male Sterilization

• Vasectomies are the most frequent form of male sterilization.

• The physician makes two small incisions, one on either side of the scrotum, so a small portion of the sperm-carrying ducts can be cut out and tied closed.

• Sperm are still produced but since there is no tube to the penis, they remain in the epididymis and eventually dissolve.

Abortion

• An induced abortion is the deliberate termination of a pregnancy through chemical or surgical means.

• A spontaneous abortion (miscarriage) is the unintended termination of a pregnancy.

Abortion Rates and Ratios for Selected Years

Year Rate Ratio

Number of abortions per 1,000 women 15-

44)

Number of abortions per 1,000 live births

1980 25 359

1990 24 344

2002 16 246

Who Gets Abortions and Why

• 1209 pregnant women who reported having an reported the following reasons:– 74% - The child would interfere with

education, work, or ability to care for dependents.

– 73% - She could not afford a baby now. – 48% - She did not want to be a mother or

was having relationship problems.

The Abortion Issue

Abortion remains a controversial issue.

• Pg. 304

Pro-Life Advocates

• Advocate restrictive abortion or a ban on abortion.• They essentially believe the following:

– The unborn fetus has a right to live.– Abortion is an immoral solution to unintended

pregnancy.– The life of an unborn fetus is sacred and should be

protected, even at the cost of individual difficulties for the pregnant woman.

Pro-Choice Advocates

• Support the legal availability of abortion for all women.

• They essentially believe the following:– Freedom of choice is a central value.– Those who must bear the burden of their

choices ought to have the right to make these choices.

– Procreation choices must be free of governmental control.

Physical Effects of Abortion

• Postabortion complications include:– possibility of incomplete abortion– uterine infection– excessive bleeding– perforation or laceration of the uterus,

bowel, or adjacent organs– adverse reaction to a medication or

anesthetic

Psychological Effects of Abortion

• For most women, a legal first-trimester abortion does not create psychological hazards, and symptoms of distress are within normal bounds.

Should You Have an Abortion?

1. Consider the alternatives available, realizing that no alternative may be all good or all bad.

2. Obtain information about each course of action.

3. Talk with trusted family members, friends, or unbiased counselors.

4. Consider your own personal and moral commitments in life.

Documents

Chapter 10 Planning Children And Contraception. Chapter Outline Do You Want to Have Children? How Many Children Do You Want? Teenage Motherhood Infertility