Contraceptive Technology

Contraceptive Technology

by Robert A. Hatcher

Hardcover(Older Edition)


Product Details

ISBN-13: 9780966490251
Publisher: Ardent Media, Incorporated
Publication date: 11/28/2004
Edition description: Older Edition
Pages: 871
Product dimensions: 9.00(w) x 12.00(h) x (d)

Read an Excerpt

Chapter 1: Expanding Perspectives Renrnductive Health

In recent years, reproductive health care in the United States, in parallel with other medical disciplines, has changed to meet the challenges of evolving market forces and broadened consumer expectations. As a result, integrated reproductive health care has expanded in concept. In many cases, shifting management and insurance schemes have placed reproductive health within the domain of primary care. For an increasing number of women, the clinician who provided only family planning now often serves as their health care provider for all primary care. For others, their primary care provider now delivers the family planning services they may previously have received elsewhere.

A broader scope of "family planning" services includes not only fertility but also infertility, not only sexually transmitted infections (STIs) but also reproductive tract infections (RTIs) overall, not only menstruation and fertilization but also the preconceptual and interconceptual periods and menopause, and finally, not only reproductive tract problems but the wide range of risk factors that influence a woman's health in general. As reproductive health care expands in scope, however, two goals are paramount. First, the planning, or preventive focus, of family planning must remain a central activity. Second, reproductive health must be recognized for its broader public health impact.

Preventive Health Services

Family planning has always rested on the notion of thoughtful prevention rather than emphasizing the curative orientation practiced in many other medical arenas. This notion of prevention must carry through the entire practice of reproductive health, from providing contraceptives and reducing exposure to STIs to improving a woman's general health so she can conceive and deliver a healthy infant and to minimizing her risk factors for the diseases and injuries that curtail her life or quality of life.

By knowing which conditions commonly afflict your patient's population group, you can make more efficient use of resources and better assess your patient's risk factors. For example, the most common causes of mortality among women in various age groups provide a starting point (Table 1-1). Simply by screening for the risk factors associated with these problems and counseling about prevention, you can provide a high level of care for a substantial proportion of the patient population. In addition, by knowing what other conditions are uncommon or exceedingly rare, you can limit excessive workups and better identify those cases that truly merit extensive and expensive approaches. Health care provision should be based on more than "Can the patient (or the third-party payor) pay for this?"

The U.S. Preventive Services Task Force has designed a recommended schedule of periodic health examinations that cover both general and reproductive health care (Table 1-2). The recommended services reflect only those areas reviewed by the Task Force or those interventions that have documented evidence of value .z3 While many approaches to periodic health screening have been proposed, the Task Force recommendations are considered the blueprint for screening guidelines. These guidelines were developed using an evidence-based methodology. Above all, the Task Force emphasizes that the most cost-effective approach to health is through primary prevention, and primary prevention is most likely met through focused risk assessment and counseling rather than through periodic "one-size-fits-all" laboratory testing and physical examinations. When and how often the preventive services are performed (or other services added) must be based on an individual patient's medical history, physical findings, and risk factors...

Table of Contents

2: Sexuality and Reproductive Health ..... 13
3: Female Genital Tract Screening ..... 43
4: The Menstrual Cycle ..... 69
5: Menopause ..... 77
6: Menstrual Problems and Common Gynecologic Concerns ..... 95
7: HIV/AIDS and Reproductive Health ..... 141
8: Reproductive Tract Infections ..... 179
9: The Essentials of Contraception ..... 211
10: Education and Counseling ..... 249
11: Selected Reproductive Health Resources ..... 263
12: Emergency Contraception ..... 277
13: Abstinence and the Range of
14: Coitus Interruptus (Withdrawal) ..... 303
15: Fertility Awareness Methods ..... 309
16: Male Condoms ..... 325
17: Vaginal Spermicides ..... 357
18: Vaginal Barriers ..... 371
19: The Pill: Combined Oral Contraceptives ..... 405
20: Depo-Provera, Norplant, and
21: Intrauterine Devices (IUDs) ..... 511
22: Female and Male Sterilization ..... 545
23: Postpartum Contraception and Lactation ..... 589
24: Future Methods ..... 615
25: Preconception Care ..... 623
26: Pregnancy Testing and Management of
27: Impaired Fertility ..... 653
28: Abortion ..... 679
29: Adolescent Sexual Behavior, Pregnancy, and Childbearing ..... 701
30: Dynamics of Reproductive Behavior and
31: Contraceptive Efficacy ..... 779
Index ..... 845

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