PURPOSE STUDENT LEARNING OBJECTIVES LESSON SUMMARY

Transcription

1 Pregnancy Prevention 7 PURPOSE The knowledge of how a pregnancy happens can help debunk myths, clarify uncertainties and empower young people to make healthy decisions. Understanding how birth control methods work and where to access services gives young people the knowledge, skills and tools they need to avoid unintended pregnancy, whether they are sexually active now or not until sometime in the future. STUDENT LEARNING OBJECTIVES Participants will: 1. Explain the process of how a pregnancy happens. 2. Identify available birth control methods, including abstinence: how they work, their effectiveness and their advantages and disadvantages. 3. Identify valid web resources and locations where one can obtain sexual health information and services. LESSON SUMMARY Activities Minutes Materials and Preparation Checklist A What Do 10 Review and choose a polling activity method You Think? B How a 15 Set up projector if using the How a Pregnancy Pregnancy Happens graphics available at Happens Review and review the scipt. Copy the How a Pregnancy Happens handout, one for each student. Copy and cut the How a Pregnancy Happens Cards (make multiple sets for small groups). C Birth Control 30 Review the Keep It Simple motion graphic Methods found on Copy the Keep It Simple Quiz for each student. Copy Birth Control Methods Definition Cards. Copy the Birth Control Methods Worksheet for each student. Optional: Birth Control Methods Kit D Assessment and 5 Journal or notecards Closure L E S S O N Lesson 7 Pregnancy Prevention 153

2 INTRODUCE THE LESSON Ask, What are two effective ways to prevent STDs and pregnancy? (abstinence and condoms) We have talked about what we need to make abstinence work and how condoms can prevent both STDs and pregnancy. Today we re going to look at additional ways to prevent pregnancy. Other than not having sex, using both condoms and a hormonal method is the most effective way to prevent pregnancy and STDs at the same time. FACILITATOR NOTE Activity 7A can be done either as a Polling or Forced Choice activity. Polling activity: You can have students give a thumbs up (Agree), or thumbs down (Disagree) after each statement you read. Or you can use one of many online polling sites that allow students to agree or disagree electronically. The online version allows students to remain anonymous, while the thumbs up/thumbs down is a more public disclosure of student responses. There are benefits to both techniques and each can allow for rich discussion. There are several online polling sites you can use in your classroom, including free versions on and Google+. Forced Choice: This option is great if you want your students to get up and move around the room. Write or post AGREE and DISAGREE signs on two sides of the room, allowing space for students to walk to and stand next to their respective answer. The essential learning of this activity is the discussion, not coming to consensus on a right or wrong answer. 154 Lesson 7 Pregnancy Prevention

3 ACTIVITY 7A: WHAT DO YOU THINK? 10 Say, Before we start, we re going to take a short poll about your thoughts on birth control. Procedure for both polling and forced choice: 1. Read the following statements and ask students to either AGREE or DISAGREE. If they feel in between tell them they should go with their gut and choose one or the other. 2. Ask for volunteers to briefly share why they chose their response. 3. Reinforce the positive messages listed under each statement below. FORCED CHOICE AND POLLING STATEMENTS 1. Males should be responsible for condoms and females should be responsible for getting a hormonal method (like the pill). Do you agree or disagree? Ideally, both males and females should learn about the different methods so that a couple can talk through which method is best for them. 2. Birth control methods are affordable and easy to access. Do you agree or disagree? There may be challenges to getting birth control methods, like lack of transportation, no clinic or health center nearby and the perception that birth control is too expensive. 3. People who identify as gay or lesbian don t need to learn about birth control. Do you agree or disagree? Sometimes people may have sex with both male and female partners regardless of how they identify. In fact, teens identifying as LGBTQ have higher rates of teen pregnancy (12-17%) than their peers who identify as straight (2-5%). They may not think of pregnancy as a risk. Or they could be having sex with opposite gender partners to avoid the stigma of being labeled as gay or to experiment in finding their own true sexuality. SUMMARIZE In summarizing the activity, include these key points: Everyone is responsible for their own health, so girls could carry condoms and guys could help support a female partner using a hormonal method. Ideally both partners are involved in making the decision on how to protect against STDs and unintended pregnancy. Pregnancy can happen to anyone who has unprotected vaginal sex. Whether you are gay or lesbian, female or male, having sex now or not, everyone could benefit from learning about preventing pregnancy. Lesson 7 Pregnancy Prevention 155

4 ACTIVITY 7B: HOW A PREGNANCY HAPPENS REVIEW 15 Say, Before we learn about the many birth control methods, it s important that everyone has the same basic knowledge of how a pregnancy happens. Pass out a copy of the How a Pregnancy Happens Handout to each student. Explain how a pregnancy happens by using one of the following options: Option 1: Use the How a Pregnancy Happens Graphics while reading the script aloud. You can access the graphic by visiting Option 2: From the How a Pregnancy Happens Handout, ask for volunteers to read the descriptions of ovulation, fertilization and implantation. After completing one of the two options above, ask the students to get into small groups. Give each group a set of How a Pregnancy Happens cards. Have each group put the cards in the order of how a pregnancy happens. Keep in mind that the ovulation card can occur before or after ejaculation. Alternatively, have the whole class arrange one set of cards. Give them a few minutes to work and then review the correct order as a large group. Use the How a Pregnancy Happens Facilitator Key to check the proper order, provide additional information and answer questions. 156 Lesson 7 Pregnancy Prevention

5 HANDOUT HOW A PREGNANCY HAPPENS Female Reproductive System Fallopian Tubes Ovary Uterus Ovary The female reproductive organs include the ovaries which contain eggs, the fallopian tubes and the uterus which is where a pregnancy can develop. Cervix Vagina Ovulation: Each month, an egg is released from one of the ovaries. It travels through the fallopian tube and into the uterus. This is called ovulation. If the egg is not fertilized by a sperm, it simply dissolves and leaves the body with the menstrual blood also known as a period. If the egg is fertilized by a sperm, a pregnancy can happen. Ejaculation: When a male ejaculates inside or around the vagina, millions of sperm swim up the vagina through the cervix, the uterus and into the fallopian tubes where they may find an egg if ovulation has occurred. Sperm can live for 3-5 days inside the female body, so the female can become pregnant even if she ovulates after unprotected vaginal sex. Lesson 7 Pregnancy Prevention 157

6 HANDOUT HOW A PREGNANCY HAPPENS Fertilization: Usually one sperm, though sometimes more, joins with and fertilizes the egg. Cell Division: The fertilized egg, now called a zygote, divides into many cells and travels down the fallopian tube to the uterus. During this time, the zygote becomes a ball of cells. Implantation: After 3 or 4 days, the fertilized egg attaches to the lining of the uterus. This is called implantation and is the point when a pregnancy begins. If all of this happens successfully, the female will not get her period. This missed or late period is one of the signs of early pregnancy. 158 Lesson 7 Pregnancy Prevention

7 How a Pregnancy Happens Cards Ejaculation: The male ejaculates semen in or around the vagina. Sperm swims up through the cervix, the uterus and into the fallopian tube. Ovulation: One ovary releases an egg into the fallopian tube Egg Lesson 7 Pregnancy Prevention 159

8 How a Pregnancy Happens Cards Fertilization: One sperm fertilizes the egg. Cell Division: The fertilized egg, now called a zygote, divides into many cells & travels to the uterus. Implantation: After a few days, the fertilized egg implants in the uterine lining. The pregnancy has begun. 160 Lesson 7 Pregnancy Prevention

9 FACILITATOR KEY HOW A PREGNANCY HAPPENS Instructions: Use this Facilitator Key along with the How a Pregnancy Happens Cards to ensure the proper order and to provide additional information. 1. Ejaculation. The male ejaculates semen in or around the vagina. Sperm swims up through the cervix, the uterus and into the fallopian tube. It s worth stating that a female can become pregnant if a male ejaculates around the opening of the vagina sperm can still make it to the fallopian tubes. **Interesting fact: This diagram shows the sperm going in one direction. How do they know where to go? Scientists believe sperm cells find a waiting egg cell because they swim toward higher concentrations of molecules released by the egg and toward the high-temperature areas of the woman s reproductive tract. Only a few hundred will make it close to the egg, and usually only one will actually join with the egg. The rest of the sperm will dissolve. 2. Ovulation: One ovary releases an egg into the fallopian tube. (This card can also come before ejaculation). Sperm can live for 3-5 days inside the female body, so a pregnancy can happen even if ovulation takes place after unprotected vaginal sex. The egg can only be fertilized for about 24 hours after it is released from the ovary. 3. Fertilization: One sperm fertilizes the egg The combined sperm and egg is called a zygote. The zygote contains all of the genetic information (DNA) needed to become a baby. Half the DNA comes from the egg and the other half from the sperm. Sometimes fraternal twins form when there are two (or more) eggs released. Each one is fertilized by a separate sperm. Genetically, fraternal twins are no more alike than siblings. Identical twins start off as one fertilized egg. 4. Cell Division: The fertilized egg, now called a zygote, divides into many cells and travels to the uterus. The fertilized egg, now called a zygote, spends a few days traveling down the fallopian tube. During this time, it divides to form a ball of cells. 5. Implantation: After a few days, the fertilized egg implants in the uterine lining. The pregnancy has begun. If all of the previous steps happen successfully, the female will not get her period. This missed or late period is one of the signs of early pregnancy. Lesson 7 Pregnancy Prevention 161

10 ACTIVITY 7C: BIRTH CONTROL METHODS 30 KEEP IT SIMPLE 10 Introduce the 4-minute Keep it Simple motion graphic by saying: Many teens are waiting to have sex. Even so, it is still helpful to have information about safer sex and birth control for a future time when they may be sexually active. We have talked about the importance of abstinence. Now we ll watch a video that introduces a variety of other ways someone can protect themself from STDs and pregnancy. This video also describes clinical services that are available at family planning clinics. Stream Keep It Simple from Pass out the Keep It Simple Quiz to each student. They can fill in the answers either individually or in small groups after watching the video. You may also use the quiz as a way to assess their current knowledge if you do not show the motion graphic. After completing the quiz, have students read the questions and share their answers aloud in the large group. Use the Keep It Simple Quiz Facilitator Key as a guide. 162 Lesson 7 Pregnancy Prevention

11 KEEP IT SIMPLE QUIZ 1. Circle all of the hormonal methods and underline the barrier methods pills male condom patch vaginal ring depo-provera shot implant IUD EC (emergency contraception) female condom dental dam 2. What are some factors you need to consider in picking a birth control method? Answer True or False: 3. Other than abstinence (not having sex), using both condoms and a hormonal method is an effective way to prevent both pregnancy and STDs. 4. A teen can start a birth control method or be tested for STDs for low or no cost. 5. You must have a parent s permission to go to a family planning clinic. 6. Females can start most birth control methods (except the IUD) without taking off clothes. 7. The test for chlamydia and gonorrhea is usually a simple urine test (pee in a cup). 8. Emergency Contraception (brand name Plan B) can be obtained at a family planning clinic or pharmacy by someone of any age or gender without a prescription. T or F T or F T or F T or F T or F T or F Lesson 7 Pregnancy Prevention 163

12 FACILITATOR KEY KEEP IT SIMPLE QUIZ 1. Circle all of the hormonal methods and underline the barrier methods pills male condom patch vaginal ring depo-provera shot implant IUD EC (emergency contraception) female condom dental dam 2. What are some factors you need to consider in picking a birth control method? Possible answers: Cost Where you can get it How easy is it to use or how often do you need to remember to take it/use it How private is it Are there any side effects Religion or cultural factors Cooperation with your partner Answer True or False: 3. Other than abstinence (not having sex), using both condoms and a hormonal method is an effective way to prevent both pregnancy and STDs. 4. A teen can start a birth control method or be tested for STDs for low or no cost. 5. You must have a parent s permission to go to a family planning clinic. 6. Females can start most birth control methods (except the IUD) without taking off clothes. 7. The test for chlamydia and gonorrhea is usually a simple urine test (pee in a cup). 8. Emergency Contraception (brand name Plan B) can be obtained at a family planning clinic or pharmacy by someone of any age or gender without a prescription. T or F T or F T or F T or F T or F T or F 164 Lesson 7 Pregnancy Prevention

13 BIRTH CONTROL METHOD FACTS Say, Birth control can be put into different categories 1) those that use Hormones, 2) those that depend on specific Behaviors and 3) those that act as a Barrier. Ask for three volunteers to read the Birth Control Methods Definition Cards aloud. After reading, thank the volunteers and have them return the cards. Pass out a Birth Control Methods Worksheet to each student. Have students form small groups. Give each group a method to research. If you have a kit, give the group the corresponding method sample. They can use one of the following resources to gather information about their method: stayteen.org/sex-ed/birth-control-explorer 20 Students can create a poster or a magazine or video advertisement that includes the information listed in the Birth Control Methods Worksheet. This can also be assigned as homework. Have each group present their method. As each method is presented, ask the remaining students to complete their Birth Control Methods Worksheet. Optional: If time and transportation allow, set up an on-site family planning clinic tour. You can also have students find the family planning clinic nearest them using Find a Clinic on the website. To find out about scheduling a clinic tour, outreach@mainefamilyplanning.org FACILITATOR NOTE The birth control methods covered in this activity include abstinence and withdrawal two behavioral methods used by teens. Studies show withdrawal is more effective than doing nothing to prevent pregnancy. It is also a method commonly used by teens, so it is worthwhile for teens to compare withdrawal to other, more effective methods. Fertility awareness is not included and is not recommended for teens. It is a method best used by someone ready to deal with a possible pregnancy. Lesson 7 Pregnancy Prevention 165

14 DEBRIEF THE ACTIVITY Once all of the methods are presented, debrief with the following questions: 1. What are the similarities among the methods? What are the differences? Possible answers: Similarities: Hormonal methods work pretty much in the same way by preventing ovulation. Teens can get all of the methods at low cost and confidentially. Most methods are used by females but both partners can work together to get and use any of the methods. Differences: Barrier methods prevent STDs and pregnancy Hormonal methods prevent pregnancy, but not STDs Some you can get without a prescription For others you need to see a health care provider or go to family planning. 2. What is the best way for someone to protect themselves from both pregnancy and STDs? Possible answers: Abstinence Dual use of a birth control method and condoms 3. Where can you go to get birth control information and services? Possible answers: Family Planning clinic Doctor s office School nurse or school based health center (in some schools) Condoms: drug store or grocery store 166 Lesson 7 Pregnancy Prevention

15 Birth Control Methods Definition Cards Hormonal Methods work by preventing ovulation (the release of an egg from the ovaries) Barrier Methods work by keeping the sperm from reaching the egg Lesson 7 Pregnancy Prevention 167

16 Birth Control Methods Definition Cards Behavioral Methods work by choosing actions that reduce the risk of pregnancy 168 Lesson 7 Pregnancy Prevention

17 ACTIVITY 7D: ASSESSMENT AND CLOSURE 5 ASSESSMENT To assess learning, ask students to write their answers to the following questions on a note card: 1. What is one thing you learned today about birth control? 2. What do you think is the best way for you to prevent both pregnancy and STDs? CLOSURE In closing the lesson, include the following key points: Ultimately, everyone is responsible for protecting themselves from pregnancy and STDs. Other than abstinence, using condoms as well as a hormonal method is the most effective way to prevent both STDs and unintended pregnancy. Ideally both partners are involved in making decisions about which methods would be best to use. Remember that people can access confidential family planning services at low or no cost. To find a clinic, or more information about birth control methods or sexual health, go to Whether you are gay or lesbian, female or male, having sex now, or not, everyone can benefit from learning about preventing pregnancy. Lesson 7 Pregnancy Prevention 169

18 Name of the birth control method IUD Implant Depo-Provera Shot Pill Patch Birth Control Methods Worksheet Name: Visit any of the following websites to research the methods: Is it a Hormonal, Barrier or Behavioral Method? How does it prevent pregnancy? How often do you need to remember to use it? Where can you get it? How effective is it at preventing pregnancy? Does it also protect against STDs? 170 Lesson 7 Pregnancy Prevention

19 Name of the birth control method Vaginal Ring Emergency Contraception Male Condom Female Condom Abstinence Withdrawal Is it a Hormonal, Barrier or Behavioral Method? How does it prevent pregnancy? How often do you need to remember to use it? Where can you get it? How effective is it at preventing pregnancy? Does it also protect against STDs? Lesson 7 Pregnancy Prevention 171

20 Birth Control Fact Sheet IUD What is an IUD? An IUD is a small, sterile, flexible, T-shaped piece of plastic that is about an inch and a half long. It is placed in the uterus to prevent pregnancy. There are two types of IUDs: the Copper T and hormonal. How does it work? The IUD prevents pregnancy by affecting the way sperm move and from reaching an egg. Hormonal IUDs also prevent ovulation (the release of an egg from an ovary). About the Copper T May be safely left in the uterus for years. Provides a hormone-free birth control option. About hormonal IUDs May be safely left in the uterus for up to 3-5 years (depending on the brand). Can provide relief for people who experience heavy periods, bad cramps and PMS. Who uses the IUD? People who want a long-term, highly-effective, reversible method of birth control. How do you use the IUD? The IUD is placed into the uterus by a trained health professional. It can be left there from 3-12 years, depending on the type of IUD. Where do you get the IUD? IUDs are available at a local family planning clinic or doctor s office. How effective is the IUD? The IUD is 99% percent effective at preventing pregnancy. Does the IUD protect against STDs? An IUD does not protect against STDs. For STD protection a condom should also be used with this birth control method. How effective is the IUD? The IUD is a very effective form of birth control. It is about 99% percent effective meaning that if 100 women use the IUD, only one woman would become pregnant. Does the IUD protect against STDs? An IUD does not protect against STDs. You should also use a condom with this method. 172 Lesson 7 Pregnancy Prevention

21 Birth Control Fact Sheet IMPLANT What is an implant? The implant is a small, flexible rod that is inserted under the skin of the upper arm and releases hormones in order to prevent pregnancy. How does it work? The implant slowly releases a low dose of the hormone progestin into the bloodstream to prevent ovulation (the release of an egg from an ovary). It also thickens the mucus in the cervix so it is hard for sperm to enter the uterus. Who uses an implant? People who want a long-term, highly-effective, reversible method of birth control. How do you use an implant? A clinician inserts the implant into the upper arm. It can be left there for up to 3 years. Where do you get an implant? The implant is available at a local family planning clinic or doctor s office. How effective is an implant? An implant is 99% effective at preventing pregnancy. Does an implant protect against STDs? The implant does not protect against STDs. For STD protection a condom should also be used with this birth control method. Lesson 7 Pregnancy Prevention 173

22 Birth Control Fact Sheet THE PILL Birth Control Pills What is the pill? The pill, also called oral contraceptives, is a hormonal method of birth control taken every day. There are many different brands and types of pills, some have a combination of the hormones estrogen and progestin and others only contain progestin. How does it work? The pill works by releasing hormones that prevent ovulation (the release of an egg from an ovary). It also thickens the mucus in the cervix so it is hard for sperm to enter the uterus. Who uses the pill? People who want an effective birth control method and can remember to take a pill every day. How do you use the pill? A person needs a prescription from a health care provider. The pill is taken daily, around the same time of day, to prevent pregnancy. Where do you get the pill? The pill is available at a local family planning clinic or doctor s office. How effective is the pill? The pill has a 92% typical-use effectiveness rate at preventing pregnancy. Does the pill protect against STDs? The pill does not protect against STDs. For STD protection a condom should also be used with this birth control method. 174 Lesson 7 Pregnancy Prevention

23 Birth Control Fact Sheet THE DEPO-PROVERA SHOT What is the shot? The shot, or Depo-Provera, is a hormonal, long-acting form of birth control. It is given every 13 weeks to prevent pregnancy. How does it work? The shot contains the hormone progestin which prevents ovulation (the release of an egg from an ovary). It also thickens the mucus in the cervix so it is hard for sperm to enter the uterus. Who uses the shot? People who are not afraid of getting shots and are able to visit the clinic every 3 months. People who want to have a birth control method that s invisible. How do you use the shot? The shot is given every 13 weeks by a health care provider. Where do you get the shot? The depo shot is available at a local family planning clinic or doctor s office. How effective is the shot? The shot is 99% effective when given every 13 weeks. Does the shot protect against STDs? The shot does not protect against STDs. For STD protection a condom should also be used with this birth control method. Lesson 7 Pregnancy Prevention 175

24 Birth Control Fact Sheet THE PATCH What is the patch? The patch is a birth control method that is applied directly to the skin every week. It is a hormonal birth control method that uses both progestin and estrogen to prevent pregnancy. How does it work? The patch works by releasing hormones that prevent ovulation (the release of an egg from an ovary). It also thickens the mucus in the cervix so it is hard for sperm to enter the uterus. Who uses the patch? People who do not want to take a pill every day, but don t mind changing a patch once a week. How do you use the patch? The patch is placed on the skin and delivers hormones directly through the skin into the blood. A new patch is applied on the same day of the week for three weeks in a row and then there is one week without the patch to allow for a period. Where do you get the patch? The patch is available by prescription from a family planning clinic or a doctor s office. How effective is the patch? The patch has a 92% typical-use effectiveness rate at preventing pregnancy. The patch is less effective for women who weigh over 198 pounds. Does the patch protect against STDs? The patch does not protect against STDs. For STD protection a condom should also be used with this birth control method. 176 Lesson 7 Pregnancy Prevention

25 Birth Control Fact Sheet THE RING What is the ring? The ring is a flexible ring that is placed in the vagina monthly. It is a hormonal birth control method that uses both progestin and estrogen to prevent pregnancy. How does it work? The ring works by releasing hormones that prevent ovulation (the release of an egg from an ovary). It also thickens the mucus in the cervix so it is hard for sperm to enter the uterus. Vaginal Ring Who uses the ring? People who want a method they change monthly and are comfortable inserting the ring into their vagina. How do you use the ring? A person using this method inserts the ring into their vagina on the same day each month, taking it out for 5-6 days to allow for a period. Where do you get the ring? The ring is available at a local family planning clinic or doctor s office. How effective is the ring? The ring has a 92% typical-use effectiveness rate at preventing pregnancy. Does the ring protect against STDs? The ring does not protect against STDs. For STD protection a condom should also be used with this birth control method. Lesson 7 Pregnancy Prevention 177

26 Birth Control Fact Sheet EMERGENCY CONTRACEPTION What is emergency contraception? Emergency contraception (EC) is a pill someone can take if they ve had unprotected sex. It is a pill that uses hormones to prevent the release of an egg. It does not cause an abortion. How does it work? EC prevents pregnancy by stopping ovulation (the release of an egg from an ovary). It also thickens the mucus in the cervix so it is hard for sperm to enter the uterus. EC can be taken up to 5 days after unprotected sex, but it s more effective the sooner it s taken. If a person is already pregnant, EC won t hurt the pregnancy in any way. Who uses emergency contraception? People use EC when they ve had unprotected sex or their regular form of birth control failed. It works best if taken within 12 hours after unprotected sex, but can be taken up to 5 days. The effectiveness of (some forms of) EC is significantly decreased if a person has a BMI of 26 or greater. There are prescription options for people with a BMI of 26 or greater. How do you use emergency contraception? EC can be taken after unprotected sex or if a person s regular birth control method failed, such as a condom broke or slipped off, a person missed their birth control pills, etc. A packet of EC can be kept at home for emergencies. Where do you get emergency contraception? EC is available at a local family planning clinic. In addition, anyone can get EC at the pharmacy without a prescription there s no age or gender requirement. How effective is emergency contraception? EC is 75% effective at preventing a pregnancy after unprotected sex. It works best if taken within 12 hours, but still works up to 5 days after unprotected sex. The chance of becoming pregnant increases with each day after unprotected sex. Does EC protect against STDs? EC does not protect against STDs. If a person has had unprotected sex, they should get tested. 178 Lesson 7 Pregnancy Prevention

27 Birth Control Fact Sheet MALE CONDOMS What is the male condom? The male condom is a thin layer of latex, lambskin or polyurethane that covers an erect penis. Condoms are used to prevent pregnancy and protect from STDs during vaginal, anal or oral sex. Condoms come in a variety of colors, sizes and textures. Some condoms are lubricated, which makes them more comfortable to use during sex. Only water- or silicone-based lubricants can be used with latex condoms. How does it work? Male condoms provide a barrier that prevents direct contact with semen, thereby preventing sperm from reaching an egg, and also preventing STDs. Who uses the male condom? People who want an easy-to-use, affordable and accessible method of protection from both STDs and pregnancy. How do you use the male condom? It s best to plan on and talk to a partner about using a condom ahead of time. Before using a condom, make sure it unrolls the correct way. Pull back the foreskin (for an uncircumcised penis) and unroll the condom all the way to the base of the penis. Use a new condom for each act of oral, anal or vaginal sex. Remove the condom immediately after ejaculation. Withdraw the penis while holding the rim of the condom at the base to prevent any semen (cum) from spilling out. Where do you get the male condom? Male condoms are available at many supermarkets, pharmacies or at a local family planning clinic. You don t need a prescription and people of all ages can buy condoms. How effective is the male condom? When condoms are used correctly every time, they are 98% effective. When they are not used each time or used incorrectly, their effectiveness can be as low as 85%. Does the male condom protect against STDs? Yes. Condoms are the only birth control method that also protects against STDs. Using them along with another birth control method provides extra protection. Lesson 7 Pregnancy Prevention 179

28 Birth Control Fact Sheet FEMALE CONDOMS What is a female condom? The female condom is a thin polyurethane pouch inserted into the vagina or anus. It can be used by both men and women for safe vaginal and anal sex. It blocks sperm from reaching the egg to prevent pregnancy and also protects against STDs. How does it work? Female condoms provide a barrier that prevents direct contact with semen, thereby preventing sperm from reaching an egg. Who uses female condoms? People who want STD protection and pregnancy prevention. Female condoms are also used by people who may want to use condoms but are allergic to latex. How do you use female condoms? The female condom can be inserted into the vagina or anus before having sex. It is a tube-shaped condom with a flexible ring on each end. The inner ring at the closed end is used to insert the condom inside the vagina or anus and to hold it in place during sex. The outer ring at the open end of the pouch remains outside the vagina or anus. The penis is inserted into the open end of the condom. Where do you get female condoms? Female condoms are available at the supermarket, pharmacy or at a local family planning clinic, although they are not as common as male condoms. Female condoms do not require a prescription and people of any age can buy them. How effective are female condoms? When used correctly every time, the female condom is 95% effective for pregnancy prevention. When they are not used each time or used incorrectly, their effectiveness can be as low as 79%. Do female condoms protect against STDs? Yes. Condoms are the only birth control method that also protects against STDs. Using them along with another birth control method provides extra protection. 180 Lesson 7 Pregnancy Prevention

29 Birth Control Fact Sheet ABSTINENCE What is abstinence? Choosing to refrain from certain sexual behaviors for a period of time. For some this refers to vaginal intercourse only, for others it also includes oral and anal sex. And for some is may mean not engaging in any kind of sexual activity. Who uses abstinence? People who want STD protection and pregnancy prevention. How do I use abstinence? Abstinence is a method that relies on certain skills and attitudes in order to make it work effectively. Those may include: talking to your partner, commitment, partner cooperation, belief that pregnancy is possible, alternative ways to show affection, self-control to resist sex, taking time to pause, understanding of the risks, assertive communication skills, shared values with partner, and confidence. How effective is abstinence? When used correctly, abstinence is 100% effective for pregnancy prevention. Does abstinence protect against STDs? Yes, abstinence protects against STDs. Lesson 7 Pregnancy Prevention 181

30 Birth Control Fact Sheet WITHDRAWAL What is withdrawal? Withdrawal is another word for pulling the penis out of the vagina before ejaculation. Who uses withdrawal? People who want to prevent pregnancy. This method is best if the couple is ready and able to deal with a possible pregnancy. How do I use withdrawal? The male pulls his penis out of his partner s body before he ejaculates, making sure not to get semen near the woman s genitals. How effective is withdrawal? Withdrawal is very effective for men who can tell when they re about to ejaculate. It takes experience and a lot of self-control to be able to pull out completely in time. Does withdrawal protect against STDs? Withdrawal does not protect against STDs. 182 Lesson 7 Pregnancy Prevention