Comfort, care, communication are key for sexual health
From cramming for the next midterm to maintaining relationships, a university students’ to-do list is ever-growing. That little checkmark scribbled next to each item feels victorious. As budding relationships (with oneself and others) may grow to be more prominent, another item on the list may also grow more demanding: contraception.
With knowledge and availability of contraception lacking, students often find it difficult to navigate their contraceptive options. Jennifer Gibson, coordinator of community services at Island Sexual Health, says that education can be a powerful tool to overcome stigmas around contraception and ultimately find the option that works best.
Gibson teaches sexual health with the 4 C’s: comfort, care, communication, and consent. When engaging with contraception, it is considered an element of care.
“I think that any opportunity to give people education to teach them how their bodies work, to teach them what choices they have, really is not just a tool of health literacy that every person deserves, but it is a tool of autonomy and it’s a tool of empowerment,” says Gibson.
Emma Makhakhe, a registered nurse at UVic Health, agrees that education can be empowering.
“I think that the more people know about the options, the better,” Makhakhe said. “A lot of people are familiar most often with the oral contraceptive pill and that’s a great option. And there are lots of other methods out there. And so just giving people the options, making sure it’s the right option for them.”
When it comes to contraception, there is an abundance of options available.
Hormonal contraception introduces synthetic hormones (estrogen and/or progesterone) into the system. These hormones inhibit ovulation, thicken the cervical mucus, and thin the lining of the uterine wall. The birth control pill, taken orally daily, the Evra patch is placed on the skin and replaced weekly, the Nuva ring (5.4 cm in diameter) inserted into the vagina and replaced monthly, and the Depo-Provera injection, a shot delivered every 12 weeks by a healthcare provider.
Intrauterine devices, long acting reversible contraceptives (LARC), are devices inserted into the uterus. LARC’s are identified and endorsed by the Canadian Paediatric Society as first-line contraception for youth. Copper IUD is non-hormonal and lasts 5 – 10 years depending on model, while the Mireena, and Kyleena IUD use levonorgestrel, a type of progesterone, and last up to five years. According to Planned Parenthood IUDs are the most effective in preventing pregnancy, and copper IUDs can be used as a form of emergency contraception.
Barrier methods consist of items that are physical barriers such as condoms, internal condoms, femcaps, and diaphragms. Condoms, are used for vaginal, anal, and oral sex, can help prevent pregnancy and protect against sexually transmitted disease. Internal condoms are a latex free barrier that can be used for vaginal and anal sex and also protect against sexually transmitted disease. Femcaps and diaphragms are inserted before intercourse and are most effective when used with spermicide. Femcaps are a type of cervical cap that fits to the cervix , while a diaphragm covers the cervix and is larger in size.
Natural birth control methods, such as Fertility Awareness Method (FAM) requires tracking of biological functions such as basal body temperature, cervical mucus, and cervix position. By tracking these, the user is able to track their fertile window. According to Options for Sexual Health, FAM is 76 per cent effective on its own. Typically it is important to educate yourself prior to use, depending on the method.
Other behavioural methods are abstinence and withdrawal. Abstinence takes on a different meaning for everyone and can be based on a variety of reasons such as religious, social, and personal choice. Withdrawal, also known as coitus interruptus or pulling out, has been used for years. However, its effectiveness is not dependable in pregnancy and STD prevention.
In depth contraception information and prescriptions can be provided for students by a healthcare provider.
A review of 17 contraception studies from January 1985 through to March 2015 concluded that “educational intervention,” by a variety of means (written, audio, computer games), increases contraception knowledge.
Gibson notes that when making decisions about contraception to keep in mind effectiveness, cost, lifestyle, physical compatibility, and your feelings about the method.
Alongside education, cost is a significant barrier to accessing contraception. AccessBC, a group that campaigns for universal access to no-cost prescription contraception in B.C. advocates for maximized access to prescribed contraception and works to eliminate barriers for people in need of contraception.
“When people don’t know about contraception options, then they don’t seek them out,” says Devon Black, co-founder of Access BC. “But if they’re concerned that the price for accessing contraception is going to be such a big obstacle that they can’t get it in the first place, then, in that case, it often shuts them off from going to talk to their doctor about options at all.”
According to Canadian Paediatrics Society the cost of birth control for youth bears a significant impact depending on how and if their pharmaceutical insurance coverage meets the needs of their contraceptive desires.
“I think one of the benefits of providing education to university students at this time in their life is it’s helping them realize their own expertise,” says Gibson, “and it’s helping them take control over an aspect of their life that they absolutely deserve control over.”