A Psychological Perspective on Contraception - Essay Example

Sexual Health: A Psychological Perspective on Contraception Introduction: Sexual activity occurs in human beings not just for the purpose of procreation. When the purpose is not for procreation and the possibility of pregnancy is likely or for health reasons pregnancy needs to be avoided then means to prevent pregnancy needs to be employed during sexual intercourse. Contraception is the term used for the means to prevent pregnancy. There are several methods of pregnancy and an individual may choose the method depending on the life style of the individual, though no method singly employed may be said to be offer total protection from pregnancy. Different Forms of Contraception: Involvement of a male and female is the norm for sexual activity and therefore contraception methods may target either the male or the female or both, though it is the female individual that has to ensure proper contraception to prevent pregnancy. Coitus Interruptus: This is essentially a contraceptive method involving the male partner. The male withdraws the penis from the vagina just prior to ejaculation to prevent sperms from entering the vagina. Though this method has been employed by many couples at some stage of their relationship, it suffers from drawbacks. Seminal fluid can leak onto the vagina prior to withdrawal. In addition it calls for a lot of control on the part of the male partner and hence works best when there is understanding and commitment from the male partner on preventing pregnancy in the best interests of the female partner. It is also useful when other contraceptive methods are not available or employed (Twose, 2004). Condom: There are condoms available for both male and female partners and is a barrier method of contraception. It is the most commonly available and used contraceptive method. The advantage of the condom is that it offers protection against sexually transmitted diseases including HIV/AIDS. For this reason it needs to be used in addition to any other contraceptive means to prevent the spread of these diseases. It suffers from the drawback of interfering with the personal pleasure of the individual and the possibility of rupturing. However when there is strong belief in the prevention of pregnancy and the spread of dreaded diseases like HIV/AIDS, the use of condoms offer the best behaviour solution (Villarruel & Jemmot, Jemmott & Ronis, 2004). Other barrier Methods: Use of barrier methods among women is not new and has been known to have been used in the past. The diaphragm and the cervical cap are two barrier methods that are continued to be employed by women. Effective use of these barrier methods provides more than ninety percent efficiency in preventing pregnancy. In addition women remain in control and some protection is provided against cervical cancer and sexually transmitted diseases, though not against HIV/AIDS. It cannot be used when there is recurrent urinary tract infection and certain physical and physiological conditions of the vagina. It is most useful when the woman is not confident of the partner’s cooperation in preventing pregnancy (Everett, 1996). Spermicides: Spermicides inactivate the fertilization capacity of sperms by causing changes in the cell membrane of sperms. Spermicides are usually used in conjunction with condom or any other barrier method to increase the efficiency o contraception. Besides increasing efficiency, spermicides offer the benefit of providing lubrication, but are considered messy and may cause allergic reactions (Everett, 1996). Physiological Methods: Religious and cultural constraints may make it not possible for a female to indulge overtly in the use of contraception. Physiological methods offer a means for the women to maintain health behaviour to avoid pregnancy in such circumstances. The physiological method involves in the indulging of sexual intercourse only during the safe period in a menstrual cycle. This calls for exact determination of the safe period and the woman having a regular menstrual cycle of twenty-six to thirty-two days, for miscalculations could lead to pregnancy (Twose, 2004). Intrauterine Contraceptive Devices (IUCDs): Intrauterine devices have also come down from the past. Currently IUCDs used consist of small plastic devices with copper or silver threads placed in the uterine cavity. IUCDs function in a complex manner. Essentially they act as foreign sterile bodies in the uterine cavity with the resultant physiological action to prevent pregnancy enhanced by the presence of the copper or silver threads. It is a highly efficient contraceptive. It finds best use after a pregnancy to delay the possibility of a second pregnancy (Twose, 2004). Hormonal Contraception: Oral contraceptives have been in use for more than two decades and consist of an oral contraceptive pill containing just progesterone or a combination of progesterone and oestrogen. The use of these hormones is to inhibit ovulation and thereby pregnancy. Controversies have arisen over the safety of oral contraception with risk of venous thromboembolism for the users. Hormonal contraceptives have since seen development into a form of progesterone intra-muscular injections that give protection for nine months and progesterone slow release implants that provide protection against pregnancy for three years. However considering the risks involved, women need to have a through check up and find out if they are suitable for using hormonal contraceptive therapies (Twose, 2004). Tubal Litigation and Vasectomy: Tubal litigation is the application of potentially removable clips on the uterine tubes of women to provide sterilization, till the decision to have another pregnancy, when the clips are removed. Vasectomy is the permanent sterilization of the male, through the application of litigation on the vas deferens. These temporary and permanent methods of sterilization are best suited for couples, who would like to delay the next pregnancy or have no more children (Twose, 2004). Factors that Determine Contraceptive Use: There are several factors that affect the use of contraceptive use. Religious and cultural backgrounds can have an impact on the use of contraceptives. This is particularly so in the developing world, where strong religious and cultural sentiments inhibit the use of contraception. (Tehrani, Farahani, & Hashemi, 2001). Awareness and literate levels are two other important factors in determining the use of contraception. Awareness of the different contraceptive benefits and the ability to read and understand the instructions for use play a part in the decision of use of contraception. Other factors involved include sex, age, marital status, perceptions on the risk factors involved in the use of contraception and societal view of contraceptive use. The main factor however is the health behaviour pattern of the individual and it is here that health psychology plays an important role. Pregnancy occurs in women and therefore it is the woman that is more concerned about contraception and its impact on her health. Use of contraceptives in women follows a developmental path. These are the natural stage, the peer stage and the expert stage. A female teenager seldom considers herself fully developed sexually and sex is not a planned activity, rather a chance occurrence and hence contraception seldom is a planned. In the peer stage the individual starts seeking advice from friends on the use of contraceptives, as sex becomes more a part of life. Advice of friends and lay experiences become the basis of the use of contraceptives. Coitus interruptus and physiological means become the more preferred contraceptive means. The expert stage is when sexual intercourse becomes a regular part of the individuals life and it is at this point that informed choices in the matter of contraception is taken after taking the advice of health professionals (Forshaw, 2002) Health Psychology and the Role of the Health Psychologist: Health psychology studies the manner in which individual’s think about their health and the manner in which their behaviours can be predicted through theoretical frameworks. One of the many theoretical frameworks is the Health Belief Model (HBM). According to HBM the health behaviour of an individual is impacted on by what the person perceives as the cost and benefits of the health behaviour. When there is a perception of a severe threat action is taken by the individual to modify behaviour to offset the threat. Thus in the natural stage the threat of unplanned pregnancy has not been fully understood and hence the negligence on the use of contraception. The health psychologist has a role to perform here in making the threat fully understood and to reinforce it with the threat of sexually transmitted diseases and HIV/AIDS, whereby condoms get to be used and as sex is an unplanned activity, use of condoms which are freely and economically available should become the behaviour pattern. (Forshaw, 2003). In the peer stage the individual becomes more conscious of the risks of pregnancy due to unprotected sex and this is reflected in seeking advice and the use of physiological means to prevent pregnancy. Application of the attribution theory here suggests that the individual is willing to act to control the behaviour. In this circumstance the role of the health psychologist is to encourage the belief, but to provide awareness of the possibility of pregnancy by the methods employed and also create awareness of other more effective means of contraception to nudge the individual to the more effective means of avoiding pregnancy and avoiding the possible contraction of diseases transmitted through sexual contact (Ogden, 1996). In the expert stage the individual is more aware of the risks of pregnancy and the various contraceptive methods. At this point the role of the health psychologist is to find out the goals of the contraceptive methods planned for use by the individual and guide the individual into using the one most appropriate for the goals of the individual and maybe the permanent partner that has become part of the individuals life (Ogden, 1996). Literary References Everett, S. (1996). Handbook of CONTRACEPTION AND FAMILY PLANNING. London: Bailliere Tindall. Forshaw, M. (2002). ESSENTIAL HEALTH PSYCHOLOGY. London: Arnold. Forshaw, M. (2003). ADVANCED PSYCHOLOGY: Health Psychology. Oxford: Hodder & Stoughton. Ogden, J. (1996). HEALTH PSYCHOLOGY: A TEXTBOOK. Buckingham: Open University Press. Tehrani, F.R., Farahani, F.K. & Hashemi, M. (2001). Factors influencing contraceptive use in Tehran. Family practice, 18(2), 204-208. Twose, R. (2004). Fertility and its Control. In Mayes Midwifery: A Textbook for Midwives. Thirteenth Edition. (Eds). Chris Henderson and Sue MacDonald. Edinburgh: Baillierre Tindall, 114-128. Villarruel, A.M.., Jemmot, J.B., Jemmott, L.S. & Ronis, D.L. (2004). Predictors of sexual intercourse and condom use intentions among Spanish-dominant Latino youth: a test of the planned behavior theory. Nursing research, 53(3), 172-181. Read More