95751

Week 3
Contraception and
Preconception

Dr Abela Mahimbo
Acknowledgements Drs. C. Njue, K. Beek and UTS CRICOS 00099F
recap
• What is SRH
State of physical, emotional, mental, and social wellbeing in relation to
all aspects of sexuality and reproductive system and processes

The right to the highest attainable standard of health

Today’s lecture
― The life-cycle approach to SRHR and why is this important?
― The Human Rights Based Approach and it’s guiding principles
― Focus on key transition point over the life-cycle
 Preconception and contraception
Adopting a life-cycle approach to SRHR

• Continuity of health and wellbeing through a person’s life

Why the life cycle approach?
*Groups that have distinct SRHR needs
‘The health and well-being of population • Adolescents ages 10-19 years
groups* is of particular concern. For • Adults ages ≥ 50 years
example, girls because of their future • Sex workers

reproductive roles and the clear • Displaced people and refugees

intergenerational effects that poor maternal
health has on the health and development
prospects of their children.’
(World Health Organisation, 2009, Women and health, Today’s
Evidence, Tomorrows Agenda)
• People of diverse sexual orientations,
gender identities, and sex characteristics
• People with disabilities
• People who inject drugs
• Racial and ethnic minorities, immigrant
groups, indigenous peoples
• Disadvantaged: poor, rural, less educated,
living in urban slums

Dushyanthi, 2019
The Human Rights Based Approach
• What does a HRBA mean?
• What are the guiding principles of a HRBA?
1. Universality and inalienability
2. Indivisibility
3. Interdependence and inter-relatedness
4. Equality and non-discrimination
5. Participation and inclusion
6. Accountability and rule of law
 Consider different life-stages,
Apply the issues & population groups

HRBA to transition points such as

life-cycle
stages
• Childhood
• Adolescence
• Reproductive years
• Preconception health
• Women’s health
• Men’s health
Preconception health
Why should we consider contraception and
preconception when deliberating sexual,
reproductive, maternal and child health?

Pre-conception animation

A life course approach - GOV.UK

Preconception health
1. Critical point of intervention for improving:
• Birth outcomes
• Infant health
• Child health
• Adolescent health
• Adult health

2. Preconception care (PCC):

• Biomedical interventions
• Behavioural interventions
• Social health interventions

BEFORE CONCEPTION OCCURS Source: GOV.UK

 • The preconception period: From one year prior
to initiation of any sexual intercourse

Preconception Initial preconception issues:

• Decision making skills
• Freedom from coercion (religious, familial,
political or economic)
• Maternal education
 • Socio-economic & educational standing
• Nutritional conditions
• Vaccine-preventable diseases
Global issues • Genetic conditions
in • Environmental health
preconception • Infertility/ Sub-fertility
•
health: •
Pregnancies too early and/
or too soon
• HIV and other STIs
What are some key health
outcomes? • Interpersonal violence
• Mental health
• Substance use
https://www.gov.uk/government/publications/healthy-beginnings-applying-all-our-health/healthy-beginnings-applying-all-our-health
Preventing “Ultimately, a key task of the
preconception health movement is to
poor change social norms about the
importance of the health of women and
Preconception men and the impact it can have on future
reproductive goals”
Health: Mitchell & Verbiest (2013)
Contraception

https://youtu.be/DBlvWnzNeks
 https://www.ippf.org/contraception

• Family Planning versus Contraception versus

Birth Control
Contraception • A woman’s ability to control her own fertility
• Protection against sexually transmissible
infections
 Scope of the issue: Unmet Need

Contraception
 Contraception
Causes of unmet need: Apply AAAQ to meet needs
• Discriminatory policies, ignorance and
stigma
• Limited choice of methods
• Limited access- particularly amongst
young people, unmarried people and
other priority groups
• Fear or experience of side-effects
• Cultural or religious opposition
• Poor quality/ unreliability of services
• Bias amongst providers
 Meeting Needs:
https://www.youtube.com/watch?time_continue=135&v=Z00JmJeCx0I
https://www.youtube.com/watch?v=n_4BlV3D0jw
Watch one of the 2 videos showing a health intervention for contraception
We will discuss how the AAAQ framework was applied to that intervention
Consistent controversies
Contraception has been considered a highly
controversial topic
Abortion
• Surgical abortion
• Medical abortion
• Unsafe Abortion
• The debate
• Laws governing abortion-
• Australia
• India
• El Salvador
• Uganda
Summary :
Preconception
Health

A life course approach - GOV.UK

The preconception pathway
A targeted, proactive approach to managing and
mitigating risks early can be integrated as follows:

A life course approach - GOV.UK

Conclusion

A life course approach - GOV.UK

 Questions
Abela.Mahimbo@uts.edu.au

Bachelor of Health Science