Teaching Guide:
Choices for Controlling Birth

OBJECTIVES

Participants will:

realize that when, or if, to become a parent is one of the most important choices they will ever make; understand that not having intercourse is an option and that it is the surest way to avoid pregnancy; know some of the questions they need to think about as they choose a contraceptive method; understand how the common contraceptive methods work and the effectiveness of each; know which methods of contraception don't work; and know who can help them make informed, responsible contraceptive choices.

MATERIALS

• copy of "Choices for Controlling Birth" for each participant
• container for written, participant questions
• flip chart and markers, chalk board and chalk or overhead projector
• VCR and "It Only Takes Once" video (optional)
• samples of a variety of contraceptive methods (e.g., birth control pills, condom, diaphragm, contraceptive foam) (optional)

PRESENTATION GUIDE

This lesson is straightforward. For most presentations, you can simply go over the material found in the fact sheet. This guide provides comments on how you might present the material, suggestions for eliciting participant discussion and descriptions of supplementary material and activities you may want to use. Don't feel like you have to follow or use everything in it. You know your audience better than anyone else, you know how much time you have to make your presentation and you have your own unique ways of presenting material you're most comfortable with.

INTRODUCTION

Begin this lesson by making the point that one of the most important choices participants will ever make is when, or if, to become a parent. Point out that becoming a parent has a dramatic effect on what a teenage can do and accomplish. Go over the questions in the first paragraph of the fact sheet and encourage participants to really think about them. (If an overhead projector is available, use "Questions to Consider" to make a transparency.) Continue by pointing out that the information you will be covering in this session will help those who do not want to become parent make an informed decision about the strategy for controlling birth that is best for them. End your introductory comments by stressing the points made in the third paragraph of the fact sheet. Since discussions of birth control involve sex and intimate relations, there are various ideas of what is good or bad or right or wrong. Some people's moral or religious values will lead them to view some of the topics you'll be talking about as unacceptable. Be sure to acknowledge the fact that how participants view them and whether they ever practice them is their own personal decision. Young people simply need to have information about the options available to them. Tell participants that the information you'll be covering will help them make their own decisions about what is best for them.

If you think you'll have time, consider using the video "It Only Takes Once" before moving on to the next section of the fact sheet. It combines humor with serious stories of teenagers who had to grow up "real fast." It is designed to teach teens and preteens about responsible sexual choices from saying "no" to using effective contraception. If you use it, be sure to allow time for discussion after it is over.

You also may want to consider using the following exercise. Divide the large group into groups of no more than four or five people. (Try to have a mixture of males and females in each group.) Assign each group one method for controlling births (e.g., abstinence, condom, birth control pill, diaphragm, contraceptive foam). You can do this in one of two ways. You can simply write the names of the methods on cards and hand each group one card. If you are able to obtain them, you also can give each group an actual sample of the method they are assigned. (Free samples may be available through your local Health Department. Share the fact that you are using them for teaching purposes. If you plan to teach this lesson a number of times, you may want to put together a contraceptive "teaching kit.") Don't forget abstinence if you utilize samples. Write it on a card and give it to one group instead of a sample. After each group receives their assigned method, ask the groups to answer the following questions:

• What is it?

• How does it work?

• How effective is it?

Many participants may not know the answers. That's okay. Encourage them to use their imagination. In addition to allowing participants to have some fun, this exercise can help "break the ice." It can help them get started talking about contraception. After about five minutes, have each group make a report. When a group isn't able to answer the questions or presents something that is simply wrong, point out that you'll be covering factual information about various contraceptive methods a little later.

NOT HAVING INTERCOURSE IS AN OPTION

It's important to really emphasize this short section. Make the point that not having sexual intercourse is the surest way to avoid pregnancy. It's also the best way to avoid sexually transmitted diseases. Point that it's the only viable option for many unmarried young people who believe either that they are not ready for sexual intercourse or that sex outside of marriage is wrong. Tell participants that they should make up their minds to say "no" and stick with it if they feel that way. Bring in the idea of sexual integrity by reminding participants that acting out your values is a characteristic of sexual integrity. Continue by making the point that, despite what participants may have heard, everyone is not "doing it." Also mention the fact that it's possible to say "no" at any time. Just because someone has had sex in the past doesn't mean they have to continue.

IF YOU ARE SEXUALLY ACTIVE

Begin this section by making the point that teens who are sexually active need to know key facts about the most common methods of contraception. Go over the four questions that they need to ask themselves as they consider each method. (Use "Questions to Ask When Choosing a Contraceptive Method" to make a transparency.) Emphasize the need for sexually active teens to talk about these issues with their partners. Encourage participants who would feel uncomfortable discussing contraception with their partners to really think about whether or not they should be having sex with someone they cannot talk to. If you want to engage participants in a discussion of these points, ask who they think should be responsible for contraception. Offer the following three options: primarily the female, primarily the male, and the female and male equally. Ask participants to explain their answers. If group members say it should be the male and female together, point out that often isn't the case. In reality, it's often the female who ends up being responsible. Ask participants why they think this is the case. Conclude this section by emphasizing the point that contraception works best when the male and female choose and use it together.

THE BIRTH CONTROL PILL, DIAPHRAGM OR CERVICAL CAP, NORPLANT, DEPO PROVERA INJECTIONS, INTRAUTERINE DEVICE (IUD), MALE CONDOM, FEMALE CONDOM, SPERMICIDES, FERTILITY AWARENESS

These nine sections present basic information about different contraceptive methods. Simply go over the content of each. As you do, be sure to describe the method, its effectiveness and whether or not it provides protection from STDs. ("Birth Control Average Effectiveness and STD Protection" can be used to make a transparency summarizing the average effectiveness and STD protection of each method.) Be sure to encourage questions and comments. You may want to involve participants by asking what they think are some of the "roadblocks" or "barriers" to teens using each method as well as how teens might overcome or deal with them.

METHODS THAT DON'T WORK

Cover this short section by mentioning the fact that there are a lot of myths about sexuality that result in people relying on methods to control births that simply don't work and go over the four listed in the fact sheet. (Use "Contraceptive Methods That Don't Work" to make a transparency.) Ask participants if they've heard of any other "ineffective methods."

MAKING YOUR CHOICE

Begin this concluding section by restating the fact that there are many choices for controlling births. The first choice is whether or not to have sexual intercourse. If participants decide not to, they don't have to worry about controlling births. If they decide to have intercourse and don't want to become pregnant, remind them they need to practice one or more of the contraceptive methods you have discussed during this session. Continue by acknowledging the fact that deciding which method to use is not easy. While some methods are readily available in local stores, stress the fact that some of the most effective methods must be prescribed or fitted by a medically qualified person. Encourage participants to talk with someone trained in helping others make contraceptive choices. Encourage them to visit their private doctor, county health department's family planning clinic, or a Planned Parenthood affiliate. Stress the fact that these caring medical professionals can help them make the type of informed, responsible choice that characterizes those who act with sexual integrity.

AUTHOR: Gary L. Hansen, Ph.D., Extension Specialist in Sociology, Cooperative Extension Service, University of Kentucky; and William W. Mallory, Fayette County Extension Agent for 4-H/Youth Development, Cooperative Extension Service, University of Kentucky.