!""# %& '())*")+ ,")-.*/0 12()"3"44+ (35 164-3"37"8!*/95)(2(.

:"/9;54
Contraception: Choices,
Culture, and Consequences
Jerusalem Makonnen,
RN, MSN, FNP
Obj ectives
o ldenufy varlous moderaLely eecuve
conLracepuve meLhods and behavlors
o Clarlfy how each meLhod works
o ulscuss sLraLegles Lo lmprove emcacy by dual
meLhod use
o ldenufy approprlaLe candldaLes who are able Lo
use each of Lhe meLhods and eecuvely counsel
Lhem
Abstinence and Withdrawal
Abstinence
o WhaL ls absunence?
lnLenuonally refralnlng from sexual acuvlLy versus
noL havlng sex"
o WhaL does lL mean Lo use absunence as a
conLracepuve meLhod?
o Can we Lalk abouL absunence fallure raLes or
emcacy?
Abstinence: Patient Education
o lmporLanL Lo learn negouaung skllls:
Pow Lo say no or noL now" and how Lo reslsL peer
pressure
8ecommend LhaL she ensure LhaL parLner expllclLly agrees
Lo absLaln
SLress LhaL absunence may [usL be a declslon Lo delay
lnLercourse, lL may mean noL now" lnsLead of never".
8emlnd her LhaL she may use or reLurn Lo absunence aL
any ume ln llfe
Abstinence: Patient Education
o CbLaln lnfo abouL conLracepuve meLhods for Lhe fuLure:
8e sure she Lhlnks abouL a meLhod Lo have on hand ln case
she wanLs Lo have sex aL some polnL
8e sure she goes home wlLh a 8x for Lmergency
ConLracepuon
o Counsellng on:
negouaung skllls, role playlng exerclses, couple's
counsellng
AlLernauve forms of sexual pleasurlng
ulscuss S1l rlsk
Withdrawal : Coitus Inter r uptus
o Lecuveness ls slmllar Lo male condom
!"#$% '() *"#+,-.$/0"#) 1223)
Withdrawal
o AdvanLages:
Laslly avallable meLhod, no provlder vlslLs or
prescrlpuon needed and lL's l8LL
no use of hormonal meLhods, devlces
Surprlslngly eecuve lf used correcLly
May reduce rlsk of uld-born lnfecuons
Withdrawal
o ulsadvanLages:
May noL be appllcable for couples wlLh sexual
dysfuncuon
8equlres man's cooperauon and lnsLrucuon
May reduce sexual pleasure of woman and lnLenslLy of
orgasm for man
8elauvely hlgh fallure raLe among Lyplcal users
uoes noL adequaLely proLecL agalnsL S1ls
Withdrawal : Patient Counsel ing
o racuce wlLhdrawal wlLh back-up meLhod unul
boLh parLner masLer Lechnlque
o Wlpe penls clean of pre-e[aculaLe uld prlor Lo
vaglnal peneLrauon
o use colLal posluons LhaL ensure man wlll be able
Lo wlLhdraw easlly aL approprlaLe ume
o use Lmergency ConLracepuon lf wlLhdrawal falls