節育 , 懷孕 , 與產娩 : 掌握你的生育計劃

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


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


How to Use a Condom

Figure 6.1


Methods of Fertility Management

• Hormonal Methods

• Oral contraceptives

• Pills

• Depo-Provera

• Ortho-Evra

• Nuva Ring

• Lunelle and Norplant (currently off the market)



• Surgical Methods of Sterilization

• Female

• Tubal ligation

• Hysterectomy

• Male

• Vasectomy



• Other Methods of Contraception

• IUDs

• Progestasert

• ParaGuard

• Withdrawal

• Emergency contraceptive pills

• ECPs

• Emergency minipills

• Abstinence and “Outercourse”


The Fertility Cycle

Figure 6.4


Fertility Awareness Methods

• Cervical Mucus Method

• Body Temperature Method

• The Calendar Method


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



• Implant Refinements

• Population Council – Single Rod Implant Delivery System

• Biodegradable Implants



• Injections and Vaccines For Women

• Oral or injectable vaccine

• Unisex Contraception

• New group of drugs as gonadotropins


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


Vacuum Aspiration Abortion

Figure 6.5


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)


Planning a Pregnancy

• Emotional Health

• Maternal Health

• Preconception care

• Smoking and drinking

• Caffeine

• X-rays

• Healthy weight


Planning a Pregnancy

• Paternal Health

• Klinefelter’s syndrome

• Prader-Willi syndrome

• Financial Evaluation

• Contingency Planning


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


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


Pregnancy

• Other Factors

• Avoid toxic chemicals

• Avoid pesticides

• Toxoplasmosis – cat feces, raw meat, can have harmful organisms


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


Fertilization

Figure 6.6



• Pregnancy Testing

• HCG (Human Chorionic Gonadotropin found in urine and blood)

• Early Signs of Pregnancy

• Breast tenderness

• Emotional upset

• Nausea

• Sleeplessness

• Vomiting



• First Trimester

• Embryo

• Fetus – start of third month

• Second Trimester

• Placenta well established

• Notice changes in mother



• 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


Amniocentesis

Figure 6.7



• 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


The Birthing Process

Figure 6.8, part 1


The Birthing Process

Figure 6.8, part 2



• Childbirth

• Choose a place – home or hospital

• The birth process

• Episiotomy

• A slight incision in perineum

• Some use pain-killers



• Perineum

• Area between vulva and anus for incision if needed

• Afterbirth

• Placenta delivery during last stage of birth



• Managing Labor: Nonmedical Approaches

• Birth Alternatives

• Lamaze

• Harris method

• Childbirth without fear

• Leboyer method

• Bradley method

• Water birth



• Breast-Feeding and Postpartum Period

• Colostrum

• Precedes milk

• Thick yellow substance

• Contains vital antibodies

• Breast milk provides perfect nutrition

• Postpartum Depression



• Complications

• Cesarean Section

• 26.1% in 2002

• CDC hoped to reduce to 15% by 2000 but did not meet goal



• Complications (continued)

• Miscarriage

• 10% of pregnancy

• Failure of egg to divide correctly

• Ectopic pregnancy

• Genetic abnormalities

• Maternal illness

• Maternal hormonal imbalance



• Complications (continued)

• Stillbirth

• Sudden Infant Death Syndrome (SIDS)


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


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)


Infertility

• Treatment (continued)

• Intracytoplasmic sperm injection (ICSI)

• Embryo transfer (surgical and non-surgical types)

• Embryo freezing

• Embryo adoption


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?

Documents

節育 , 懷孕 , 與產娩 : 掌握你的生育計劃