## Assignment 19 - Studying Contraception

Comprehensive Sexual Health Education stresses that abstinence is the preferred sexual behaviour for teens. Abstinence is the choice to avoid any and all sexual contact that involves bodily fluids or genital contact. You are still growing into becoming an adult, so you are not physically, mentally and emotionally ready to make decisions about sexual activity that could permanently affect your life. It is best to choose not to do it at all and not take any chances. This is the only 100% no risk and no danger decision and it is likely the best one for you at this time.

This lesson will focus on safer sex options that you could take if you do decide to become sexually active. It has been proven in studies that sexual health programs that only discuss abstinence and don't teach anything else are not effective at helping teens make good decisions about sex. If teens aren't taught about how to be safe, sometimes they end up making bad choices because they do not have the information that they need. If teens aren't taught how to look at consequences and make an informed decision, they don't develop the skills that will be necessary for them to make good choices in the future. Even if you don't plan on being sexually active now, in a few years, or ever in your life, it's still important to be informed.

# What is abstinence?

• Abstinence is a pretty general term. It just means that you do not engage in sexual contact. But where you draw the line at what contact between two partners is okay and what is not okay can mean different things to different people.
• Some people think that to be abstinent there should be no physical contact of any kind between two partners.
• Some people think that holding hands and kissing is okay, but touching over or under clothing is not staying abstinent.
• Some people think that kissing and touching is okay, just as long as the genitals aren't touched or seen.
• Some people think that kissing and being completely naked is okay, but there shouldn't be any oral sex.
• Some people think that all of those things are okay and they are still staying abstinent as long as they do not have actual sexual intercourse.
• It will be up to you and your partner to decide what is best for both of you, based on your own personal beliefs. If you don't share exactly the same opinions as your partner, you need to talk about it and come up with an agreement that works for both of you and respects each person equally.
• We think of abstinence as being the only 100% guaranteed way to prevent unwanted pregnancy and STIs. But this is only true if you are strict about it. Some STIs can be spread by just kissing (herpes). And it is possible to get pregnant if sperm is ejaculated near the vagina but not inside. Cases of this are rare, but certainly not impossible.

# So, you can only be abstinent if you're a virgin?

• virgin is a person who has never had sexual intercourse before. There are areas for debate around the true definitions of this word and what things you could do to "lose your virginity", but that is the general idea. If you're a virgin that means you've never had sex before, so you are abstinent. That makes sense.
• However, just because you've had sex before doesn't mean you can't be abstinent now. Sometimes people make a decision to be sexually active, but then they decide to change their mind later on. This is a choice that you should feel free to make if you think it's the right decision for you. If your partner knows that you have had sex before, that does not matter. If you know now that you want to be abstinent, then they should not pressure you into doing anything you don't want to do.

# Are there pressures for teens to have sex?

• Not every teen will experience pressure to have sex, but it's possible that it might happen to you. Some possible example could be:
• In a relationship (You have a girlfriend, and she wants to take your relationship "to the next level")
• To keep a relationship (Your boyfriend says that he will break up with you if you don't have sex)
• Under the influence (You have consumed drugs or alcohol, so your judgement is impaired)
• The most important way for you to prepare yourself is to be sure of yourself and know exactly what you are comfortable with. Know for sure what you want to do and what you don't want to do. Don't be afraid to tell your partner about it, even if they don't agree with you. Be assertive! It's your body and only you should be able to say what your body should and shouldn't do.

# What can you do to resist the pressures to have sex before you are ready?

• Communication is key! If you are in a relationship, make sure your partner knows your thoughts and opinions about sex. Talk about it. If your partner knows that you want to stay abstinent, they should respect that and not put you in a situation where you have to fight with them about having sex or not.
• Avoid situations where you might be pressured to have sex. Consumption and over-consumption of drugs and alcohol can impair your judgement. You may be more likely to do things that you would never do when you were sober. In the moment, you may feel like you want to do something, but once you become sober you realize what you have done and regret it. The safest is to not put yourself in that position in the first place.
• Be assertive. When you are expressing your thoughts and feelings about sex, be clear about what you want. Use powerful words to let your partner know exactly what you think. There should be no doubt or debate about what you feel is right. Here are some examples:
• Weak: "I don't know ... I just don't feel ready to have sex."
• Strong: "I'm not ready to have sex yet. I just want you to understand that."
• Weak: "I do care about you, but I'm not sure."
• Strong: "I care about you, but if you care about me, you need to respect my choices."
• Weak: "I'm just not in the mood today."
• Strong: "I don't want to do it. If I ever do want to have sex, I will let you know - loud and clear."

# What is contraception and why do I have to learn about it?

• Contraception is the use of artificial methods to prevent pregnancy. There are many different types of contraception and they prevent pregnancy from occurring in different ways:
• Barrier methods prevent the sperm and egg from meeting up by physically blocking their path. Male and female condoms are examples of this method.
• Hormonal methods stop ovulation from happening in women so eggs are not released or they do not properly attach to the uterus to start growing into a fetus. The birth control pill and injection are examples of this method.
• Other methods attack the sperm when the enter the vagina. Some chemicals can damage or kill sperm so it isn't able to fertilize any eggs. Spermicides and copper IUDs are examples of this.
• Learning about contraception is important because it is always good to have the right information. Even if you aren't sexually active or don't plan on being sexually active, learning about how to protect yourself may be important for you in the future.

# I'm a guy ... what are my options?

• At the moment, guys have very limited options for birth control. This is due, in part, to male physiology. Sperm are constantly being created throughout a man's life, whereas women are born with a certain amount of eggs that are released one at a time on a fairly regular schedule. It's much easier to predict and control. Male birth control pills have been developed and tested, but they have a lot of negative side effects. There is research currently being done on different methods of male birth control, but there's not a lot of science money going into it because female birth control methods are so safe and effective.
• If you're a man, basically your only safe and reliable method of birth control is using condoms. A condom covers the penis and prevents the sperm from escaping. If used properly, it's over 90% effective at preventing pregnancy and most STDs. Condoms are easy to find and buy at any grocery store, convenience store, or drug store. Some health clinics even give condoms away for free if you can't buy them yourself.

# I'm a girl ... what are my options?

• Girls have many options to protect themselves. The most common one is the birth control pill. This is a pill that you take once a day that has hormones that prevent the eggs from meeting up with sperm. You need to get a prescription from a doctor for these pills, but your doctor does not have to tell your parents if you don't want them to because of doctor-patient confidentiality. Different types of pills have different price points but they're usually between $15 to$50 a month. If a woman takes these pills every day on a regular schedule it is more than 90% effective at preventing pregnancy.
• The same hormones that are in the birth control pill can also be delivered in different ways. The birth control patch is a sticky plastic patch that releases the hormones through your skin, sort of like the "stop smoking" patches you may have seen on TV. There is a birth control shot too, sort of like an immunization shot, that you get every 3 months. The birth control implant is a small plastic stick that gets implanted under the skin of your arm and the hormones last up to 3 years. There is even a small plastic ring that can be inserted into the vagina that contains the same hormones. There are some rings that you need to put in once a month and there are others that a doctor needs to put in, but last for 3 or more years. All of these methods require a visit to a doctor, whether it's your family doctor or one at a medicentre or sexual health clinic.
• If you can't visit a doctor, there are some methods that you can find at store that you can buy over the counter without a doctor's prescription. The female condom is one of these. It is a barrier method like the male condom where the thin plastic tube is inserted into the vagina. The added bonus of the female condom is that is also protects against STIs, which other female contraceptives don't. Vaginal sponges, diaphragms and cervical caps are some other methods that work by blocking the entrance of the uterus so sperm can't get inside to meet the eggs. You can get these from a store or from a sexual health clinic.
• With so many options available, there is no reason why a person (man or woman) should not be able to access contraceptives if you want or need them.

# I had protected sex, but I'm still afraid that I might be pregnant. What can I do?

• All of the methods listed above, for men and women, need to be done before or during sex. But what can you do if you have unprotected sex, or you are afraid that your protection didn't work?
• An emergency contraceptive is a special medicine that a woman can take to ensure a pregnancy doesn't occur. It stops an egg from being released, prevents fertilization, or stops the fertilized egg from attaching to the uterus. It is NOT an "abortion pill." There is no abortion of a pregnancy because no pregnancy has really occurred yet. It is more like a regular birth control pill medication, but it's just a bit stronger. Regular birth control pills can not be used as emergency contraception.
• If you think that you need this, you can go to a sexual health clinic or get this medicine at most drug stores. You do not need a prescription, but it might be kept in the pharmacy area behind the counter, so you will have to ask a pharmacist to get it for you. They may have a few questions to ask you just to ensure you use it correctly and don't need medical attention, but it can be done privately if you want. You can take this medicine up to 5 days after having sex, but it is more effective if you take it within 3 days.
• If you go to a sexual health clinic or medicentre you can get help with emergency contraception that is confidential. Your parents do not need to be informed. You can talk to counselors about it if you are scared to tell anyone else. However, if you are worried about yourself or your partner being pregnant, it is always a good idea to tell your parents about it. This is a serious event that may have consequences for your life, so having your parents' support, even though it might be scary, could be important to help you deal with the situation.

# If I have unprotected sex, will I for sure get pregnant or get my partner pregnant?

• Having sex without using any protection method doesn't necessarily guarantee that pregnancy will occur. But you're playing a game of chance - like rolling a dice. The odds are, for healthy young people, about 1 in 20. But you can't know what's going to happen. It's a blind chance. It's impossible to know whether or not an egg has been fertilized after sex. You can't feel it or see it. Even the most advanced doctor's exams can't tell for sure until a week or longer.
• A woman is more fertile at certain times of her cycle. Ovulation is the time when the egg is released and travels towards the uterus. This is the time when a woman is most likely to get pregnant, but a pregnancy can occur at any time, even during her period.

# How can you tell if a pregnancy has happened?

• All pregnancy tests, whether you buy them at a store or get a doctor to do them, measure a certain hormone in your body that only appears when a woman is pregnant. This hormone is called hCG. When a woman is pregnant, her body starts producing this hormone. A doctor can detect this hormone by taking blood. A test that you buy at a store measures this test from hormones in urine (pee). If this hormone is detected, the test will show that you or your partner are pregnant.
• The pregnancy tests you buy at a store are easy to do. You just need to collect a urine sample and test it with the things provided in the kit. Each kit is different, so read the instructions carefully. They are generally accurate, but it is possible that the test may give a false negative or false positive. False negatives on these tests are common because the levels of hCG may not be high enough to detect. Or, if you take the test too early the hCG may not have had time to build up in your body. If you are worried that you or your partner may be pregnant, you may need to get some emergency contraceptives or go to a doctor to get a more accurate test done.

# But I've heard that you can't get pregnant if you ... (insert myth here)

• Chances are if your sentence starts out with this statement, what you are about to say is not true. There are many, many, MANY myths and untruths surrounding pregnancy. They were probably created by people who didn't know or were too scared to ask someone for the real answer. The following are some common things that you may have heard can prevent pregnancy, but are totally untrue:
• You can't get pregnant ...
• ... the first time you have sex. - False. Pregnancy can occur at any time.
• ... if the woman is having her period. - False. The odds are less likely, but not zero percent.
• ... if you stand up or jump up and down afterwards. - False. Semen may come out of the vagina if you do this, but sperm can swim in any direction, so that won't work.
• ... if you have sex a certain way (standing up, woman on top). - False. For the same reasons as the one above. Sperm can swim in any direction.
• ... if you wash the vagina afterwards. - False. Some sperm may be washed away, but you can't completely clean away everything.
• ... if the man doesn't ejaculate inside. - False. Sperm are present in the fluids that are released before the actual ejaculation, so pregnancy can still happen.
• ... if the woman doesn't have an orgasm. - False. Whether the man or woman has an orgasm makes very little difference in whether a pregnancy occurs or not.
• ... if you have sex in water (shower or pool). - False. Sperm can swim through water. It's less likely, but it can still happen.
• ... if you eat or drink certain foods. - False. No foods have been proven to significantly increase or decrease fertility for men and women. It's possible that some foods or medicines might reduce your fertility, but you would have to eat a lot of them and likely make yourself sick to use it as a birth control method.
• ... if the sperm is exposed to air because it will die. - False. Sperm are strong organisms. They can live up to 5 days in the right conditions. They are only dead once they are completely dried out.
• The only thing that can prevent pregnancy is using a proven birth control method like condoms or female contraceptives. Anything else you read or see might lessen the odds of becoming pregnant, but not enough to rely on them. It is always safer to assume something doesn't work unless it has been medically proven otherwise.

# What about gay or lesbian people? Do they still need to use contraception?

• If two men or two women have sex, there is no chance of pregnancy occurring. There is no need to use birth control, because no eggs can get fertilized by sperm.
• Gay and lesbian people do still need to think about protection though. They need to use protection from STIs. Male condoms and female condoms can protect against STIs, so they will need to use this protection if they have sex.

• There are many places to go if you have questions about contraceptives. If you are comfortable talking to someone, go to a sexual health clinic and talk to a nurse or doctor there. These clinics can be found in most medium and large sized cities and they are confidential. You don't need to have a medical emergency to see them. They can give you advice too or answer any questions you have.
• If you aren't comfortable seeing a doctor, you can always call someone. Call a clinic and ask to talk with someone over the phone. There are also anonymous phone lines you can call.
• Kid's Help Phone: 1-800-668-6868
• The internet is another place you can go to ask questions. Be careful though because there are a lot of dishonest people on the internet, so choose your websites wisely. Here are a few that you can trust:

# Assignment 4 - Studying Contraception

For this assignment, you will be creating two posters: one about abstinence and one about contraception. The purpose of the poster is to be eye catching, informative, and give an important message about how important abstinence and contraceptives are. The audience is teens who are your age or slightly older.

Abstinence Poster

• Create a poster that explains why abstinence is important, talks about the benefits of abstinence, or shows how to resist the pressures to have sex before you are ready.
• Use words and pictures to emphasize your point of view.
• Pay attention to visual design elements (clarity, size of font, bullet points instead of paragraphs, etc.) because that can affect the way your message comes across to a person looking at your poster.

Contraceptive Poster

• Create a poster that explains why using contraceptives is important. You can refer to one or two methods specifically (like create a poster about condoms) or just discuss contraceptives in general.
• Use words and pictures to emphasize your point of view.
• Pay attention to visual design elements (clarity, size of font, bullet points instead of paragraphs, etc.) because that can affect the way your message comes across to a person looking at your poster.

You need to submit both posters to receive credit for this assignment.