Unintended Pregnancy

Question 1

Tier 1 birth control options (99% efficacy)

Answer 1

The implant
Hormonal IUD
Non-hormonal IUD
Sterilization

Question 2

Tier 2 birth control options (92% efficacy)

Answer 2

The pill
The patch
The ring
The shot

Question 3

Tier 3 birth control options (20% failure rate)

Answer 3

Withdrawal
Fertility awareness
Internal condom
Condom

Question 4

Early surgical abortions

Answer 4

Suction aspiration (D&C)
Takes 5-8 minutes
Local anaesthetic +/- sedation
Up to 14 weeks gestational age
Manual vacuum aspirator vs electrical pump aspirator

Question 5

Surgical abortion over 14 weeks

Answer 5

Dilation and evacuation
Almost half of these are fetal indications
Cervical preparation is essential! (dilators, misoprostol)
Induction of fetal demise the day prior if > 18 weeks
Fragmentation of fetus with removal so cannot hold after

Question 6

Early medical abortion

Answer 6

Mifepristone and misoprostol
Mife to stop fetus from growing
Miso 24 hours later to induce miscarriage
Can use methotrexate instead of mife if needed

Question 7

Late medical abortion

Answer 7

Induction medical abortion
Minimum 16 weeks but usually over 18
Fetal demise induced prior to induction (KCl, digoxin)
Misoprostol and mifepristone after