1:00:01 <b>So now let's get into some of our choices. So we're going to</b> <b> break these into categories so</b> <b>that it's a little bit easier to sort of keep it altogether.</b> <b> We'll first going to talk about</b> <b>non-hormonal methods and then we're going to talk about </b> <b>hormonal methods. That will make</b> <b> it simple. So let's talk about the barrier methods first. </b> <b>Barrier methods can include</b> <b>spermicides, the male condom, the female condom, or </b> <b>diaphragm, or cervical cap. Let's look</b> <b>at condoms first. So condoms basically work by keeping the </b> <b>sperm away from the vagina,</b> <b>pretty simple. So, there are several types of condoms though</b> <b> and we want to make sure</b> <b>that our clients understand so they can make a choice about </b> <b>which one. So, latex is the</b> <b>most common. So, this prevents pregnancy and it also </b> <b>prevents HIV and other STD infection.</b> <b>There are also synthetic condoms that are not made up of </b> <b>latex for clients that might have</b> <b>an allergy to latex. This also will prevent pregnancy and </b> <b>HIV and other STDs. The final</b> <b>condom we'll talk about, however, is a natural or lamb-skin </b> <b>condoms. This is made up of a</b> <b>different sort of membranous material that's not latex and </b> <b>it's not synthetic. So it still</b> <b>prevents pregnancy but not as consistent at preventing HIV </b> <b>and some other STDs and</b> <b>that's because it is poorest. So, sperm are actually pretty </b> <b>large in comparison to viruses</b> <b>so it can keep the sperm from getting through but it's a </b> <b>little dicey on the others. So I</b> <b>wouldn't recommend this except for a client who feels barely</b> <b> comfortable they are in a safe</b> <b>relationship in terms of transmission of HIV or other STDs. </b> <b>Okay. The typical failure rate,</b> <b>remember we're talking about humans, is around 13%. Now, </b> <b>along with the condom, we</b> <b>want to think about lubricants. So first let's talk about </b> <b>some lubricants that might not be a</b> <b>good idea. So, massage oils, baby oils, lotion, petroleum </b> <b>jelly. They are lubricants, yes;</b> <b>however, they weaken the condom and they may cause it to </b> <b>tear or break. So when you talk</b> <b>to your clients about using a lubrication with their </b> <b>condoms, you want to make sure you</b> <b>tell them what not to use, not just what to use, and tell </b> <b>them why because the why</b> <b>sometimes helps you remember. Now let's talk about </b> <b>spermicides. Spermicides are often</b> <b> used also with condoms. What do spermicides do? They kill </b> <b>sperm. Get it cide, kill sperm,</b> <b>spermicide altogether. It comes in a form of jelly or a foam</b> <b> like a mousse or it can come in a</b> <b>film that looks like one of those Listerine breath mist, or </b> <b>a suppository. So it can look sort</b> <b>of like a little capsule. So those are all the ways that a </b> <b>spermicide might look. And again,</b> <b>it's used typically with some other methods, so any of these</b> <b> other barrier methods the one</b> <b>we talked about, the condom, and a few we're getting ready </b> <b>to talk about also can be used</b> <b>along with the spermicide to get that failure rate down just</b> <b> a little bit. Speaking of female</b> <b>condom, this is what it looks like. So, I hope you can </b> <b>appreciate this on the graphic, but a</b> <b>female condom is much larger than a male condom because it </b> <b>actually is inserted into the</b> <b>vagina. So there is an applicator often that goes with it </b> <b>and the ring is squeezed and then</b> <b>pushed up into the vagina and it sits right up underneath </b> <b>the cervix. It helps to keep the</b> <b>sperm from getting into the uterus, just like the condom </b> <b>does but a little bit closer to the</b> <b>cervix. It can be inserted up to 8 hours before sexual </b> <b>intercourse, which might be a benefit</b> <b>if you think about it. This could be placed before a night </b> <b>out rather than during the actual</b> <b>event. The failure rate during typical use for a female </b> <b>condom is around 21%. Now let's talk</b> <b>about the diaphragm. So the diaphragm is a round, latex dome</b> <b> that actually goes inside of</b> <b>the vagina. It has a metal ring around the perimeter to help</b> <b> it keep its shape and then it's</b> <b>filled with spermicide and that spermicide is usually a </b> <b>jelly or cream or a foam and that has</b> <b>to be used with a diaphragm to achieve its full </b> <b>effectiveness. And the diaphragm is placed</b> <b>in the vagina all the way next to the cervix, so it creates </b> <b>a seal with the spermicide so that</b> <b>the sperm not only are unable to get through because the </b> <b>diaphragm is in the way, but it</b> <b>can even get around the edges because the spermicide creates</b> <b> that seal, kind of like if</b> <b>you've ever seen dentures and they have that cream in the </b> <b>middle to keep the dentures</b> <b>in your mouth, it does the same thing. That's a weird visual</b> <b> but go with me on that. Now</b> <b>the diaphragm can be inserted up to 4 hours before </b> <b>intercourse, again which is nice if</b> <b>you're planning on an evening or morning or afternoon it </b> <b>doesn't have to be right before</b> <b>the intercourse actually happens. But here's the most </b> <b>important part. </b> <b>So what that means is that it doesn't matter how many times </b> <b>someone actually has</b> <b>intercourse, each time they would just put more spermicide </b> <b>into the vagina. They have to</b> <b>leave it in place so that that spermicide will actually kill</b> <b> all the sperm that are hanging out.</b> <b>Because those sperm, they really want to get inside the </b> <b>vagina and into the uterus and up</b> <b>to the eggs that might be there, so they are willing to </b> <b>wait. So we have to get rid of every</b> <b>single one of them or the diaphragm won't be particularly </b> <b>effective. So failure rate, if we</b> <b>use the diaphragm perfectly it would be around 6%, but again</b> <b> we're human so the typical</b> <b>use rate in terms of failure is more like 12%. Now let's </b> <b>look at the cervical cap. So the</b> <b>cervical cap has a little bit more structure than the </b> <b>diaphragm. So it's not as pliable. It's</b> <b>pretty hard when you compare the two. Now, instead of just </b> <b>going into the vagina, the</b> <b>cervical cap actually seals itself to the cervix. So it's a </b> <b>cap, like a hat. Now you also see the</b> <b>spermicide, so again we have to use spermicide along with </b> <b>the cervical cap in order to</b> <b>achieve full effectiveness. The cervical cap, as you can see</b> <b> in this diagram, fits really</b> <b>snugly right on top of the cervix like a kiss. Right? Just </b> <b>reaches all the way around it. So it</b> <b>creates a suction there with the cap. Both of these methods,</b> <b> the diaphragm and the cervical</b> <b>cap have to be fitted by a provider. You can't just borrow </b> <b>someone's. You have your own</b> <b>cervical cap and your own diaphragm that fit your body. So, </b> <b>the great thing is the cervical</b> <b>cap can be left in the body for up to 48 hours, which is </b> <b>great. Now it must stay in 6 hours</b> <b>after the last active sexual intercourse, maybe not so </b> <b>great. So when we think about the</b> <b>typical failure rate for a nulliparous client, never had a </b> <b>baby, it's around 14%. A client who</b> <b>has had a baby, however, that failure rate goes up to around</b> <b> 27%. Now the sponge is also a</b> <b>device that meets the criteria of a barrier method because </b> <b>it keeps the sperm from getting</b> <b>to the egg. Unlike the diaphragm and the cervical cap, </b> <b>however, this does not have to be</b> <b>fitted by a provider. So, the sponge is actually a sponge </b> <b>and there is spermicide already</b> <b>in it. So, once the spermicide is activated when it's placed</b> <b> into the vagina, then the spermicide</b> <b>is already there. So it fits over the cervix. Now because </b> <b>it's not fitted, it's going to be a</b> <b>little bit looser in terms of how it fits inside of the </b> <b>vagina. Again, it works for up to 24 hours.</b> <b>Yay, that's great but it still must be left in the vagina </b> <b>for at least 6 hours after the last</b> <b>active intercourse so that the spermicide that's contained </b> <b>within the sponge can kill all the</b> <b>sperm. Typical use for someone who's never had a baby is </b> <b>around 14%. Remember that's</b> <b>what nulliparous means. For a client who's had a baby, then </b> <b>it goes down to around 27%.</b> <b>So you may ask yourself why are they different depending on </b> <b>whether you've had a baby or</b> <b>not. Because if you've never had a baby, remember your </b> <b>cervix is a nice tight os that makes</b> <b>a circle and once you've had a baby before, the tone in the </b> <b>uterus and the changes in the</b> <b>cervix make it a little bit less likely it's going to work. </b>
The lecture Barrier Methods of Birth Control (Nursing) by Jacquelyn McMillian-Bohler is from the course Contraception (Nursing).
What are examples of barrier methods of birth control? Select all that apply.
The nursing student is counseling a client on barrier methods of birth control. Which student nurse statement causes the nurse instructor to intervene? Select all that apply.
When can a diaphragm be inserted?
Which birth control methods must be used with spermicide? Select all that apply.
Which barrier method of birth control has the highest typical use failure rate?
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