 |
Barrier methods – This includes the male condom,
female condom, diaphragm, and cervical cap.
When used with a spermicide containing
nonoxoynol-9, latex condoms (not those made from animal
tissue) offer the best protection against STDs and
HIV/AIDS. |
|
Hormonal contraceptives – This includes the birth
control pill which is taken orally, the intrauterine
device (IUD), the Depo-Provera (“the shot”) – a
hormonal injection, and Norplant, a method in which is
six matchstick sized capsules inserted under the skin. |
|
Spermicides – This may come in the form of foam,
jelly, cream, and suppository. |
|
Sterilization (Tubal Ligation) – This is a surgical
procedure which prevents pregnancy by blocking the
fallopian tubes. |
|
Emergency Contraceptive Pill (the “morning-after
pill”) can be used in the event of unprotected sex,
contraceptive failure, and in cases of rape, or incest.
The Food and Drug Administration (FDA) has
approved a product for emergency contraception called
PREVEN which is currently available by prescription. |
|
Abstinence – This is the only 100% guarantee a woman
has against unwanted pregnancy and STDs. |
FACTORS IMPACTING CONTRACEPTIVE DECISIONS
Health Risks
Black women should insist on full and accurate
information from their health care provider about all
contraceptive options, including side effects, health risks
and benefits, costs to obtain and discontinue a method, and
procedures that are involved.
While all methods offer pregnancy prevention,
additional health considerations must be acknowledged in
deciding upon a method.
Oral contraceptives are highly effective for
pregnancy prevention. Individuals
should be carefully screened before considering oral
contraceptives, as there may be some negative health
indications for women with diabetes, high blood pressure,
heart disease, and sickle cell anemia, all of which
disproportionately affect Black women.
In addition, some women may experience the side
effects of nausea, weight gain, and depression.
A seminal issue for the reproductive health and rights of
African American women has been the marketing of two
long-acting contraceptives, Norplant and Depo-Provera.
While Depo is viewed as a drug of convenience, we
maintain that it exacerbates pre-existing disease
conditions. Depo has been linked with long-term irreversible effects such
as breast cancer and cervical cancer, both of which
disproportionately affect Black women.
Depo is also associated with a thinning of the bones.
This places young women who use Depo at a higher risk
for developing osteoporosis.
Other risks include increased depression, excessive
weight gain, excessive bleeding, and loss of sex drive.
Norplant has similar health risks such as weight
gain and depression. In
addition, issues with the surgical removal of the capsules
can result in keloid formation in Black women.
Weight gains which may be between 20-50 lbs are
significant, as more than half of Black women are
overweight. Additional
side effects include headaches, mood changes, and irregular
bleeding.
CONTRACEPTIVES OF THE
FUTURE
Efforts are underway to develop new, female-controlled
methods of pregnancy and STD/HIV prevention such as
inexpensive microbicide or virucide.
Microbicides and virucides are chemical compounds
that women could put in their vaginas before intercourse to
block HIV. A
woman could protect herself against STDs and HIV/AIDS.
Ideally, microbicides would be made with and without
spermicides so that women who want to get pregnant could do
so without worrying about contracting a disease.
Scientists are also pursuing several other options,
including hormone-releasing vaginal rings that would be
placed in the vagina for several weeks or months, skin
patches, and vaccines/ anti-fertility drug that generate a
temporary immune system reaction against eggs and sperms.
Research for a “male contraceptive” is also being
done which is examining two options, an implant and a
vaccine.
