Health Care Ethics (Bioethics)

Contraception 02
CONTRACEPTION
Refers to direct and positive method of preventing
conception before, during or after the act of sexual
intercourse.
Direct Method → Contraception is directly
willed either as an end of the
means or a means to attain
another end
→ Distinct from an indirect act,
which is not willfully
employed as a means or
and of thwarting
→ Potential Side Effects
conception.
• Nausea and vomiting, headache and weight
Positive Method → By a positive method is gain or loss
meant the means used is • Hypertension and impaired vision
deliberately arbitrary and • Increased risk of stroke or heart attack
determine, and as such, is • Possible link to cancer of reproductive organs
not a part of the natural and of the breast
processes of sexual system, • Increased risk of gall bladder disease and liver
causing frustration of the tumors
generative faculty for • Difficulty in conceiving after its use is
conception. discontinued.
→ Not part of the natural • Reduced blood levels of essential vitamins
design of the generative • Development of depressive personality
structure. It is different from changes
the negative method, which
2 Norplant
there is nothing that is
→ Kinds of Norplant
arbitrarily done to suppress
• Norplant is a series of six rubber "rods" or
the generative power or
capsules that are implanted under the skin in the
faculty so that the process
inside portion of a woman's upper arm. The
goes on as naturally
contraceptive effects can last for five years.
designed.
• Norplant 2 differs in number and size of rods
whose contraceptive effects can last even for
BEFORE, DURING, AND AFTER SEXUAL INTERCOURSE
seven years.
Contraception can be done based on the nature and
functions of its different methods before, during or
after the act of sexual intercourse in an effort to
preclude the possibility of conception.

DIFFERENT METHODS OF CONTRTACEPTION

1 The Pill
→ Kinds of Pill
• Combined Pill: contains two female hormones -
estrogen and progestin.
• Mini-pill: contains only the progestin which is
taken continuously → Mode of Action
• Suppresses ovulation in only about 50% of the
cycles. Progestin causes thickening of the
cervical mucus making it difficult for the sperm
to go through.
• May also induce early abortion. It alters the
lining of the uterus barring the fertilized egg from
implanting itself.
→ Mode of Action
• Suppresses ovulation, the process by which the
ovum is produced.
• Thickens the cervical mucus making it not
capable of being penetrated by the sperm
• Alters the endometrium so that the uterus
becomes not receptive or "inhospitable" to the
fertilized egg. In which case, the pill prevents
implantation and can be construed as
abortifacient. Abortifacient refers to that which → Potential side effects
is used at early gestational age upon fertilization • Severe lower abdominal pain
directed towards pregnancy termination. • Prolonged or heavy vaginal bleeding; or
amenorrhea as experienced by more than 2/3
of all users
• Arm pain and infection, migraine, headache or
blurred vision

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025

Health Care Ethics (Bioethics)
Contraception
• Changes in lipid metabolism
• Ovarian cysts (experienced by 1 in 10 users)
• Hypertension, increased risk of heart attack and
nervousness
• Hair loss, liver tumors and gall bladder disease
3 Contraceptive Injection (Depo-Provera)
→ Known as "couple's choice" is injected every 3-6
months.
02
4 IUD
→ A plastic device placed in the uterus through the
cervical canal which may contain trace metals or
hormones to increase efficacy.
→ Mode of action
• Quite uncertain but it seems to serve as
abortifacient by preventing implantation.
• May also interfere with tubal function and
prevent the passage of ovum or sperms favoring
the development of ectopic pregnancy.

→ Mode of Action
• Prevents pregnancy by inhibiting ovulation
• Prevents implementation since the normal
functioning of endometrium is altered. Hence, it
has an abortifacient action.
→ Potential Side Effects
• Major disturbance of menstrual pattern
• Prolonged and unpredictable delay in → Potential side effects
occurrence of fertility period • May create chronic inflammation of the
• Mild deterioration of carbohydrate tolerance endometrium.
• Decrease in breast milk production • Occasional perforation of uterus or cervix
• Depression and reduction of libido requiring surgery
• If the 1st and/or 2nd injections are received by • Pelvic inflammation that can cause sterility.
a mother before she knows that she is pregnant, • Anemia due to excessive menstrual bleeding
then fetal abnormalities may develop. • Embedding, migration or fragmentation of IUD
4 Condoms • Spotting or prolongation of menstrual flow
→ A thin rubber or latex sheath worn over an erect • Presence of actinomyces in pap smears of 90%
penis before the intercourse. of users. Infection of reproductive organs
→ Stored in a cool, dry place to prevent rubber caused by actinomyces may be rare; but it is
deterioration. typically found in long-term IUD users.
→ Has limited "shelf life" as it may corrode over some 5 Spermicides
time. → Available in many forms including creams, jellies,
suppositories, aerosol foam and foam tablets.
→ Mode of Action
• Traps the
ejaculated
sperm at the tip
thereby
preventing it
from coursing
through the
vaginal canal
towards the
fallopian tube
where the ovum
is.
→ Potential side
effects
• Effective only
84-85% of the → Mode of action
time, at best (chance of pregnancy over a year • Form a chemical barrier at the opening of the
of use is 1 in 6) uterus that prevents the sperm from reaching
• Pregnancy rate of 18.4% among women below the egg.
18 years old • Damage and even destroy sperm cells.
• May not be as effective as it is believed to be → Potential side effects
preventive of HIV-AIDS transmission. HIV is 500 • If ever human sperm survives to unite with the
times smaller than a human spermatozoon. ovum and conception occurs, greater
• Condoms have flaws or holes. Average hole-size incidence of congenital disorders among
is five microns while a sperm is only 2.5 microns children conceived during the use of
and virus causing AIDS is only 0.1 micron. spermicides include Down's Syndrome, limb

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025

Health Care Ethics (Bioethics)
Contraception 02
reduction malformation, malignant neoplasms NATURAL FAMILY PLANNING
(cancerous tissue growths) and severe 1 Rhythm Method (Calendar Method)
hypospadias. → Count the days in your menstrual cycle, starting
• Increased chance of vaginal infections with the first day of your period as day 1. Continue
because the absorption of spermicides alters counting each day of your cycle until your next
vagina's normal chemical environment. cycle starts.
6 Diaphragm → On days 1-7, you're
• A flexible metal ring covered with rubber in the not considered to
shape of a shallow dome. be fertile and can
have unprotected
sex, though you
may have
menstrual
bleeding on those
days.
→ On days 8-19, you're
considered to be
fertile. Avoid unprotected sex
or abstain from sex to avoid pregnancy. Or, if you're
trying to get pregnant, these are the days to have
unprotected sex.
→ On day 20 through the end of your cycle, you're no
→ Mode of action longer fertile and can have unprotected sex.
• Placed in the vagina to encircle the cervix → When you get your next period, start the counting
completely and to prevent the sperm from over at day 1.
entering the uterine cavity.
• Usually utilized with spermicidal jelly or cream 2 Basal Body Temperature Method (BBT)
applied to the side of the dome facing the
→ The basal body temperature method
cervix.
involves observing a woman’s temperature every
morning.
→ Because a woman’s temperature drops about 1°F
12 to 24 hours before her ovary releases an egg, this
indicates a period of high fertility.

→ Potential side effects
• There is an evidential link between diaphragm
use and toxic shock syndrome.
• Local skin irritation caused by sensitivity or
allergy.
7 Coitus Interruptus
• Act of withdrawing the male sex organ from the
vagina during intercourse before ejaculation
takes place.
• Has a Biblical original when Onan slept with the
wife of his deceased brother (Genesis 38:9-10).
→ Mode of action
• Prevents the sperm from entering the
reproductive system of the woman by making
ejaculation take place outside the vagina
→ Potential side effects
• Male may suffer from chronic congestion of his
prostate.
• Female may also suffer from chronic congestion
since tissues are not deplethorized for a period
of time.
• Both male and female may experience
emotional and psychological imbalances.
3 Symptothermal Method
→ The Sympto-Thermal Method (STM) is a natural and
healthy fertility awareness-based method (FABM)
of family planning that makes use of a woman’s
observations of her cervical fluid, basal body
temperature (waking temperature) and other
biological signs (e.g., changes in the cervix) in
order to identify the fertile and infertile times of her
cycle.
4 Billings Ovulation Method
→ The Billings ovulation method teaches yoWhen you
learn this method, you can track your individual
fertility pattern by analyzing your cervical mucus
each month.
→ Learning to consistently observe your secretions
and evaluate them is critical for this method.

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025

Health Care Ethics (Bioethics)
Contraception 02
MORAL TEACHINGS ON RESPONSIBLE PARENTHOOD
→ They must be open to procreation.
→ They must properly care for children already born.
→ When and as necessary, they must establish
appropriate limitations to their power to conceive.

POINTERS FOR A HEALTHCARE PRACTITIONER

1 With the knowledge of the morality of
contraception, be honest enough to tell your
clients who are asking for it about its adverse
effects and the moral questions it foments while
respecting their freedom of conscience.
2 While couples are allowed not to intend to
procreate in each martial act, they are not
allowed to frustrate by an action before, during or
after the marital act, the procreative aspect of the
marital act.
3 Actively take part in the education of your clients
along natural family planning with its different
methods. There is no moral objection as long as
they are motivated with valid reasons stipulated in
the chapter to give proper upbringing and
education to their children.
4 When married couples fruitfully exercise their
procreative power, they come to enjoy a certain
special participation in God's own creative work.
This is a dignifying task that needs to be inculcated
in one's mind and heath through family planning
seminars.

EVANGELISTA, E.M | BSN-2 | NCM 108 (FINALS)| RN 2025