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Slide Notes

Before you begin:
Pass out notecards for students to write questions on that they can put in the question bag during your discussion. Have a question bag on each table or passed around at multiple points during the lesson so that students can enter their questions. Let students know that questions will be answered at the end of class or at the beginning of the next lesson.

Pregnancy: Facts and Prevention

Published on Apr 26, 2017

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PRESENTATION OUTLINE

Pregnancy: Facts and Prevention

Before you begin:
Pass out notecards for students to write questions on that they can put in the question bag during your discussion. Have a question bag on each table or passed around at multiple points during the lesson so that students can enter their questions. Let students know that questions will be answered at the end of class or at the beginning of the next lesson.
Photo by Got Credit

Untitled Slide

[Abstinence: 5 min]

Script:
The only way to 100% protect against sexually transmitted diseases and pregnancy is abstinence. Choosing to abstain from some or any or all sexual behaviors is a valid choice that many people decide is the best for them.

Teacher note:
If you're teaching this unit and the STD prevention unit, you only need to cover abstinence one time.
Photo by nisuspi

Untitled Slide

People choose to abstain from sex for all sorts of reasons.

Discussion:
What reasons might someone choose to abstain from sexual behaviors?
[possible answers: not ready, religious reasons, aren't interested]

Script:
Abstinence also isn't an everything or nothing deal. Some people choose to participate in some sexual behaviors and decide they would rather not do that again. Just like consent, abstinence is an on-going decision.
Photo by Brooke Cagle

Masturbation

Script:
Some people view solo sex as a safe alternative to partnered sex. Masturbation doesn't have the risk of pregnancy and comes with benefits like improved sleep, stress relief, and relief for menstrual cramps. There are some myths about frequent masturbation. You won't damage your genitals or go blind.

However, masturbation isn't for everyone. This is just another sexual activity that some people will choose to engage in and some people won't.

Masturbation is a private activity (unless there is a consenting partner who wants to join you). Just like any other activity in life, you know that you're doing it "too much" when it starts to get in the way of other important things in your life like school, homework and relationships.

Planned Parenthood (2019). Masturbation. Retrieved from https://www.plannedparenthood.org/learn/sex-and-relationships/masturbation.

Untitled Slide

[2:32 min]

Script:
Before we talk about how to prevent pregnancy, let's review how pregnancy occurs.

Link to Video: https://www.youtube.com/watch?v=OejdOS4IqeE

Pregnancy Myths/Facts

[Pregnancy myths: 15 min]

Script:
Let's check your knowledge!

If you decide to have sex, knowing how to prevent pregnancy is critical.

Myths and Facts come from:
Godfrey, B. & Brown, N. L. (2013). Pregnancy myths. Retrieved from http://www.pamf.org/teen/sex/pregnancy/myths.html.
https://stayteen.org/ask/series/sex-myths

Myth or fact?Contraception isn't just an issue for the people who might get pregnant.

FACT

Script:
Everyone who wants to participate in the sexual behavior gets to deal with the consequences of the sexual behavior. So if there is someone who would like to participate in the sexual behavior but doesn't want to raise a child, contraception is an issue for them as well. They should be aware of the options even if they have a penis.

Myth or fact?
You can't get pregnant your first time having vaginal sex.

Photo by love.jsc

MYTH

Script:
There isn't anything magical about the first time that protects you from pregnancy. You will need to use protection for your first time, and every time.

Myth or fact?
You can't get pregnant when you're on your period.

Photo by Q-BEE

MYTH

Script:
You can also get pregnant if you haven't had your first period. You will need to use protection, every time, even when you're on your period.

You can't get pregnant if you remove the sperm after sex by jumping or peeing or douching.

Photo by Caucas'

MYTH

Script:
The vagina is created to keep sperm inside. Also sperm can live in the body for up to 5 days. There's no realistic way you would be able to get every microscopic sperm out of you.

Choi, J. (2017). How long does sperm live outside the body. Retrieved from https://www.healthline.com/health/how-long-can-sperm-live-outside-the-body.

Myth or fact?
Anytime you have sex, you could get pregnant.

Photo by Heather Mount

FACT

Script:
This is why it's important to use 2 methods of protection.

First we will cover birth control options, starting with the least effective. Then we will cover barrier methods.

Myth or fact?
The only reason people take birth control is because they don't want to get pregnant.

MYTH

Script:
The hormones in birth control methods can help with a lot of medical issues including really heavy or painful periods, acne, and reduces risk of uterine cancer and ovarian cysts. Birth control can also help manage menstrual migraines and endometriosis.


Ernst, H. (2018). 10 benefits of birth control beyond preventing pregnancy. Retrieved from https://www.healthline.com/health/birth-control-benefits.

Notes on birth control

  • No birth control protects from STDs
  • 99% effective means less than 1 person per year got pregnant while on that method
  • Certain antibiotics make birth control pills less effective
Script:
It will get redundant with how often we say it, but birth control will not protect you from STDs. It will protect you from pregnancy only.

Also, when looking at effectiveness rates, these are calculated by seeing how many people got pregnant each year that were using that method. But some methods have a greater risk of user error. We will make a distinction between methods you have to take on a schedule and ones that do the hard work for you.

Birth control methods that require some sort of the schedule (the ring, the pill, the shot) are usually really effective (up to 99%) when used perfectly, but the effectiveness rates in these slides reflect the reality of user error.

Be sure to list birth control as a medication you are on. It will be important with how a doctor prescribes you or talks to you about a medication like antibiotics.

Anderson, L. (2018). Antibiotics and birth control pill interactions: Fact or fallacy. Retrieved from https://www.drugs.com/article/antibiotics-and-birth-control.html.
Photo by blmurch

Fertility Awareness
76-88% effective

[Birth control methods: 25 min]

Script:
Fertility Awareness Based Methods (rhythm) involves daily tracking of the menstrual cycle to determine when fertile. You don't have sex while you are ovulating. There are different methods and they are between It 76-88% effective because cycles aren't always predictable.

Pros:
- Not hormonal
- Approved by many religions
- Person gets to know their body and menstrual cycles

Cons:
- Need to figure out when ovulating for each month, since this can differ from one month to the next and young people often have irregular periods
- Requires a lot of work- need careful instruction and the person needs to figure out when ovulating
- Can’t have sexual intercourse for at least a week each month (during ovulation and several days before and after)
- Anyone with irregular periods should not use- failure rate is high

Planned Parenthood (2019). Fertility awareness methods. Retrieved from https://www.plannedparenthood.org/learn/birth-control/fertility-awareness.
Photo by pouwerkerk

Vaginal Ring- 91% effective

Script:
The ring is about a two-inch ring that a woman inserts into her vagina up to the cervix. It is left in for 3 weeks, taken out, and then a week later a new one inserted. It is 91% effective.

Pros:
-Decreases menstrual cramps and acne
- Makes people less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia

Cons:
- Rare side effects include nausea, increased appetite, headaches, and increased risk of blood clots
- Need a prescription
- You need to remember to put it in on time.

Planned Parenthood (2019). Birth control ring. Retrieved from
https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal...

Birth Control Pills

91% effective
Script:
The birth control pill, which must be taken every day, is 91% effective.

Pros:
- Decreases menstrual cramps and acne
- Makes women less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia.
- May be free.

Cons:
- If days are missed, effectiveness is compromised. Couples have to decide what to do when a pill is missed.
- Need to remember to take every day at the same time
- Can occasionally cause side effects such as nausea, increased appetite, headaches, and, very rarely, blood clots
- Need a prescription


Planned Parenthood. (2019). Birth control pill. Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-pill.

Patch- 91% effective

Script:
The patch is a thin, square, plastic patch with hormones that is placed on the belly, arm, upper
torso or buttocks. After 3 weeks it is taken off. One week later a new one is put one. 91%
effective.

Pros:
- Decreases menstrual cramps and acne
- Makes women less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia

Cons:
- Can occasionally cause side effects such as nausea, increased appetite, headaches, and irregular bleeding in the first few cycles
- Increased risk of blood clots
- Need a prescription

Planned Parenthood. (2019). Birth control patch. https://www.plannedparenthood.org/learn/birth-control/birth-control-patch

Depo Shot- 94% effective

Script:
Depo-Provera is a hormonal shot that must be taken every 3 months on schedule. It is 99% effective if you get your shot every 12 weeks exactly. In reality, because people get their shot late occasionally, It is 94% effective.

Pros:
- Each injection provides 3 months of protection against pregnancy
- Many women stop getting their menstrual period while getting injections and menstrual periods usually return 6-18 months after you stop taking injections.
- Helps protect against uterine cancer

Cons:

- Need to see your health care provider every 3 months for an injection
- May have side effects such as weight gain, tiredness, and possibly a decrease in bone density

Planned Parenthood. (2019). Birth control shot. Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-shot
Photo by justmakeit

IUD- 99% effective

Script:
The IUD (intrauterine device) is inserted through the cervix by a health care professional and
can be removed at any time. There are hormonal IUDs (they release progestin) and a copper IUD.

Pros:
Depending on type, it can last for 3-12 years.
It is also 99% effective
Comfortable- you and your partner cannot feel the IUD, although you partner may feel the string
Can be removed at any time and you can get pregnant right after removal

Cons:
Doesn’t protect against STIs and shouldn’t be selected if high risk of STI
Needs to be inserted by a health care provider
Can fall out or can rarely puncture the uterus
The copper IUD can have side effects such as menstrual cramping, longer and/or heavier menstrual periods, and spotting between menstrual periods

Planned Parenthood. (2019). IUD. Retrieved from https://www.plannedparenthood.org/learn/birth-control/iud.
Photo by Sarah Mirk

Implant- 99% effective

Script:
The implant is a hormonal contraceptive that is a tiny rod the size of a matchstick that release progestin, a hormone that keeps you from getting pregnant. It is inserted into the upper inside arm by a healthcare professional. It lasts for up to 5 years and is 99% effective. It can be removed at any time.

Pros:
Long-term method of birth control-no chance of messing it up and it's really effective
May cause light or no menstrual periods
Only uses one hormone-some people can't take estrogen

Cons:
Doesn’t protect against STIs
Requires minor surgery and insertion of the tiny rod(s) underneath the skin
Requires minor surgery to remove device
Rare side effects include nausea, headaches, and weight gain
Slight chance of infection at insertion site

Planned Parenthood. (2019). Birth control implant. Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-implant...

The withdrawal method or "pulling out"

Script:
Withdrawal requires the penis to be removed from the vagina every single time, without fail, before ejaculation. This method is only about 78% effective. This method also requires a lot of trust between partners. It is best to be used in conjunction with another method because of high user error especially because it doesn't protect against STDs.

Planned Parenthood. (2019). Withdrawal/pull out method. Retrieved from
https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-m...
Photo by Kris Krug

Talking to Parents

Script:
Some of these contraception options require a prescription. In that case, your parents may need to go with you.

What are ways to bring up your desire to practice safe sex with your parents?

(brainstorm ideas with group)

Barrier methods

[Barrier methods: 10 min]

Script:
The options we have talked about so far will all work to prevent pregnancy but they provide NO PROTECTION from STDs or STIs. For that you will need to use a barrier method.

The best pregnancy prevention is to use a barrier method in conjunction with a hormonal method.

Teacher note:
If you're also teaching the STD unit, you can skip barrier methods section.

Foam Sponge, diaphragm, cervical cap

76%-88% effective
Script:
All the birth control methods we have covered have used hormones to prevent pregnancy. The foam sponge, diaphagm and cervical cap are all barrier methods to prevent pregnancy. They don't protect against STDs. They are combined with spermicide, a chemical that kills sperm, to increase effectiveness. They are 76% to 88% effective.

They are inserted in similar ways though there are some differences in how long you can wear them.

Planned Parenthood. (2019). Birth control sponge. Retrieved from https://www.plannedparenthood.org/learn/birth-control/birth-control-sponge

Planned Parenthood. (2019). Birth control cervical cap. Retrieved fromhttps://www.plannedparenthood.org/learn/birth-control/cervical-cap

Planned Parenthood. (2019). Birth control diaphragm. Retrieved from https://www.plannedparenthood.org/learn/birth-control/diaphragm

Outside Condoms

about 85% effective for pregnancy prevention
Script:
The external or outside condom is about 85% effective with typical use. You can increase effectiveness by combining with another birth control method

Pros:
- Provides the most protection against sexually transmitted infections (latex condoms are best)
- Don’t cost much (50 cents each) and can buy at almost any drug store (don’t need a prescription)

Cons:
- May disrupt/interrupt sexual activity as it needs to be put on just before penetration
- Can break--NEVER USE MORE THAN ONE, use with lube for comfort and to decrease chance of breakage
- People may be allergic to latex, there are non-latex options

Planned Parenthood (2019). Condom. Retrieved from https://www.plannedparenthood.org/learn/birth-control/condom.

Inside Condoms

79% effective for preventing pregnancy
Script:
The internal condom is a small pouch worn inside a vagina or an anus which collects semen. They are about 79% effective. Again, the more diligent you are, the more effective this method is.

Pros:
- Provides protection against STIs and pregnancy
- Can be inserted well before intercourse so less interruption of sexual activity
- Don't need to remove penis after ejaculation

Cons:
- May move, be noisy, or uncomfortable
- Can only use for one act of sexual intercourse
- Cost about $2.50 each

Planned Parenthood (2019). Internal condom. Retrieved from https://www.plannedparenthood.org/learn/birth-control/internal-condom.

Common Condom Mistakes

  • Late application
  • Using it inside out
  • Unrolling condom before putting it on
  • No space at the tip/not pinching out air
  • Damaging condom
  • No lubrication or wrong lubrication
  • Incorrect withdrawal
  • Incorrect storage
  • Reusing a condom
Script:
Late application - you want to get that condom on before sexual contact to prevent STDs
Using it inside out - if you realize it's inside out, don't flip it over. Just get a new one.
Unrolling before it goes on - place it over the tip and then unroll
No space - you want to leave some space at the tip to collect the semen, but you don't want a big air pocket. Pinching the end as you put it on will take care of both problems
Damaging condom - if something can get through the packaging it can get through the condom. Be careful about what you use to open the package (no teeth!) and be sure to check for abnormalities before sex.
No lube - Some condoms are pre-lubricated, but for comfort, and to reduce friction and risk of tearing, use some extra anyway. Don't use an oil-based lube with latex. The lube will break down the condom and make it more prone to breakage.
Incorrect withdrawal - Withdraw the penis quickly after ejaculation. Hold onto the base of the condom as you withdraw. Don't reuse it and be sure to get a new condom for another sex act.
Incorrect storage - condoms should not be kept in direct sunlight or in your wallet.

Haller, M. (2018). 15 common mistakes you might be making when using condoms. Retrieved from https://www.mh.co.za/sex-women/15-condoms-mistakes/.

CONDOM DEMONSTRATION

[Condom demonstration: 10 min]

Optional activity:
Demonstrate how to use an outside common using a banana or cucumber. Use the common mistakes on the previous slide to point out places where people often do it wrong.
Photo by stevendepolo

Be safe!

Script:
Choosing to abstain from sex is the only 100% effective way to avoid STDs and pregnancy, but there are lots of options to keep yourself safe if you choose to have sex.

A big sign of respect in a relationship is when both partners are actively working to make sexual behaviors safe. We will cover more of what to do if you find yourself with someone who is pressuring you into behaviors or activities you aren't comfortable with in a later unit.
Photo by rawpixel

Your Safe Sex Plan

[Sexual safety plan: 10 min]

Activity:
Your Plan.

Regardless of when you plan to have sex, it is important now to begin thinking about ways to protect you and your potential partner from STDs and pregnancy.

Your plans can change, but here are some questions to help you think through what your plan might look like when you decide it's the right time for you.


Teacher note:
If you're also teaching the pregnancy prevention unit, do this activity at the end of both units.
Photo by Retinafunk

Question Bag

Activity:

Pass around the question bag one more time for students to add last-minute questions. You as the teacher can choose to read through the questions and answer them right then or take time to look over the questions, think about your answer, research answers you're unsure of, and then answer the questions at the beginning of the next lesson.
Photo by Josiah Weiss