Sexual & Reproductive Health 101
Overview
It’s important for those engaging clients in reproductive life goals conversations to have a basic understanding of sexual and reproductive health, and to have reliable sources on hand for more advanced information.
Some providers may need to know more than others depending on the workflow for RLG conversations and referrals developed by their organization. This page of the of the toolkit provides information on, and resources for, SRH topics that may come up with clients in an RLG conversation, including:
How pregnancy happens
Preventing pregnancy with birth control
Preconception care
Components of sexual and reproductive health beyond pregnancy and contraception
Getting Pregnant
How do you get pregnant?
Part of knowing about how pregnancy can be prevented is understanding how it happens beyond the meeting of sperm and egg. This video by Planned Parenthood provides a basic overview of the process.
Preventing Pregnancy
People who are not ready to parent or become pregnant right now, and are sexually active, should consider their options for preventing pregnancy.
Contraceptive counseling involves speaking with your clients about how pregnancy can be prevented, what birth control options are available, and what their best options might be.
Part of contraceptive counseling is talking through what is most important to your client in a birth control option, and based on those characteristics, what options are available.
In this toolkit, we use the terms contraception and birth control interchangeably.
How Contraception Prevents Pregnancy
Birth control prevents pregnancy in 3 ways:
By preventing the sperm from reaching the egg.
This type of birth control is called a barrier method. It includes condoms (internal and external), diaphragms, and cervical caps. The copper IUD also works this way, by impacting how sperm move.
By preventing the egg from releasing into the fallopian tubes (ovulation).
Without ovulation, there’s no egg for the sperm to fertilize. Birth control methods with the hormones estrogen and progestin prevent ovulation. This includes birth control pills, hormonal IUDs, the vaginal ring, the hormonal implant, birth control shots, and the patch. Sometimes, hormonal methods of birth control thicken cervical mucus which can prevent sperm from getting through.
By preventing a fertilized egg from attaching to the lining of the uterus.
Most hormonal methods of birth control cause the lining of the uterus to thin. This may prevent a fertilized egg from attaching to the uterus lining and developing into an embryo. There aren’t any methods that prevent pregnancy using only this strategy.
Understanding Different Types of Contraception
Emergency Contraception (EC)
Emergency contraception (EC) is different from other types of birth control. EC is used after unprotected intercourse. That’s why it’s sometimes called the morning-after pill. It’s meant to be used as a backup, like if a condom breaks, or you forget to take a pill. EC pills work by preventing or delaying ovulation, they don’t impact an existing pregnancy.
Have it before you need it.
We recommend suggesting your clients have a few doses of EC on hand just in case. If you’re in Texas, we offer EC free of charge. We also encourage organizations to engage clients in RLG conversations to have EC on hand, if possible.
Click the buttons below to learn more about EC.
Discussing Contraception with Clients
When clients make the decision to be on birth control there are a lot of things to consider. How effective it is, how frequently the client has to take it, issues around privacy, and side effects are all questions a client may have.
The sections below will give you tools and strategies to help you to discuss contraception with your client.
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Effectiveness
Discuss method effectiveness by explaining the rate of typical effectiveness within the first year of use. When explaining effectiveness try to use natural frequencies like “Less than 1 in 100 women get pregnant on IUD” or “9 in 100 women get pregnant on pill/patch/ring” versus using percentages, like “this is 95% effective”.
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Frequency of Using Methods
“There are methods you take once a day, once a week, once a month, or even less frequently. Is that something that makes a big difference to you?”
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Different Ways of Taking Methods
Discuss how to use the methods correctly to help a client decide between a method that is user dependent, like the pill, or not user dependent, like an IUD.
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Return to Fertility
Address any client concerns about their ability to become pregnant once they discontinue contraceptive use.
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(Specific) Side Effects
Discuss potential side effects and warning signs for rare adverse reactions to methods. This is also a good time to clarify any misconceptions a client may have about a method.
Ask the client about previous experiences and/or what they may have heard from their friends’ experiences, for example:
“Have you experienced any side effects from birth control?”
Be sure to respond to concerns in a respectful manner.
“That’s too bad your friend had that experience. I haven’t heard of that before, and I can tell you it definitely doesn’t happen frequently.”
According to the CDC and the U.S. Office of Population Affairs’ Providing Quality Family Planning Recommendations (QFP), side effects are a primary reason for method discontinuation. Providers should discuss ways the client might deal with potential side effects to increase satisfaction with the method and improve continuation.
In particular, when counseling on long-acting reversible contraception (LARC), providers should communicate the potential side effects including changes in menstruation, bleeding, and cramping. Sharing this information with the client may help alleviate their concerns after placement.
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Benefits
Discuss the benefits of each contraceptive method. For example, some methods can help reduce heavy bleeding or acne, which is a positive for some individuals.
Methods and Client Concerns
In the table below, we review some things to consider when talking to clients about birth control. For more in-depth information, The Bedsider Birth Control Finder is a great interactive resource for exploring options. It could be useful to explore with clients during RLG conversations.
| Does your client... | |
|---|---|
| have period pain? | Hormonal methods like hormonal IUD, shot, or pills, may reduce period cramps. |
| prefer to "set it and forget it?" | IUDs and the hormonal implant that goes in the arm are effective for 3-10 years, and vasectomies/tubal ligations are permanent. |
| mind getting a pelvic exam? | IUDs are inserted by a clinician and require a pelvic exam. |
| mind inserting something into the vagina themselves? | The vaginal ring stays inside the vagina and has to be changed monthly. The vaginal sponge and diaphragm are also self-inserted before having intercourse. |
| need a method that is private and may go unnoticed? | IUDs, the Depo-Provera shot, the implant and vasectomies/tubal ligation, can all be hidden. IUD strings can be cut very short so they won’t be felt during intercourse. |
| mind taking hormones? | Condoms, the copper IUD, and fertility awareness-based methods are hormone-free. |
| have a hard time making it to the clinic for appointments? | Sometimes an IUD or the implant can’t be inserted on the first visit. The Depo-Provera shot requires a visit every 3 months. |
Further Information & Resources
We shared a lot of information in this section. Here are a few more tools that may help you talk with clients about contraception and their options for preventing pregnancy.
- Your Birth Control Choices | Tus opciones anticonceptivas
- Birth Control Method Options, Methods Chart | Opciones de métodos anticonceptivos Methods are listed in order of effectiveness. Because effectiveness is not always the most important factor when choosing a method, we recommend only sharing this if a client specifies effectiveness as the most important characteristic to them
- Explaining Contraception Job Aid | Explicando los diferentes métodos anticonceptivos We highly recommend saving and reading this resource if you’ll be speaking with your clients about types of contraception. It is created specifically for providers having client-centered conversations and includes key facts about each birth control method.
- English/Spanish Glossary for Contraception | Glosario de Anticonceptivos
- Contraceptive Counseling for Transgender and Gender Diverse People
- Birth Control Across The Gender Spectrum | Métodos anticonceptivos para personas en el espectro del género
Preconception Care
Preconception Care
For clients that are trying to get pregnant or aren’t preventing pregnancy, there are some things they can do to prepare for a healthy pregnancy for themselves and their baby. Research shows that preconception care lowers the risk of poor pregnancy outcomes.
Have a preconception check-up.
At this visit, the provider will do a general wellness check, screen for chronic illnesses like diabetes or hypertension, and make sure that any pre-existing conditions are under control. They may also do a blood test to check hormones and other levels that can impact getting pregnant, pregnancy, or overall health. The provider will want to review your client’s family history, any previous pregnancies, and might want to talk about their reproductive life goals.
This is also a good time for your clients to ask questions about their cycle, tracking ovulation, and when to have sex to increase the chances of getting pregnant.
Start taking a prenatal vitamin.
Prenatal vitamins have a lot of the nutrients needed to support a healthy pregnancy. The American College of Obstetrics and Gynecology (ACOG) recommends beginning prenatal vitamins before pregnancy. That means that if your client is trying to become pregnant, or if they aren’t preventing pregnancy and are having sex regularly, it’s a good idea for them to take prenatal vitamins.
Eat well and exercise
This is really a recommendation for everyone but is often given as a reminder before and during pregnancy. Realistically, it can be challenging to access affordable, healthy food and the time and freedom for formal exercise. If this is a concern for your client, work with them to consider the ways they already get exercise (walking, taking the stairs, playing with their children, dancing) and if they can do more of those things. You can also remind them that healthy eating can be about choosing the best option available and doesn’t require an all-or-nothing approach.
Further Information & Resources
Learn more about trying to get pregnant and preconception care from these helpful resources.
Sexual & Reproductive Health
Sexual & Reproductive Health (SRH)
Sexual and reproductive health is a lot more than just preventing pregnancy or trying to get pregnant. It impacts all areas of our lives and is part of overall health. We think of SRH as made up of the following components (outside of pregnancy and prevention):
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Sexual and Reproductive Health Education
Understanding our bodies allows us to make informed choices regarding our sexual and reproductive health. The sexual and reproductive health education offered in schools throughout the U.S. is rarely comprehensive and often biased towards abstinence and white, straight people. This leaves most adolescents (and adults!) with a lot of questions and at risk of negative SRH outcomes.
There are countless important SRH topics and every individual has different needs. For people assigned female at birth, learning to understand the phases of their individual menstrual cycle, what is typical vs something that requires medical attention, and how it impacts fertility and overall health, is the first step towards taking control of their sexual and reproductive health.
While we keep working towards improving SRH education in schools, there are many incredible, comprehensive, and diverse SRH educational resources available to fill the gap that you can share with your clients. We’ve linked a few of our favorites below.
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Counseling and Care Related to Sexuality, Sexual Identity, and Sexual Relationships
Exploring sexual identity and sexuality is something everyone experiences regardless of their gender assigned at birth. We believe that access to unbiased support is a sexual and reproductive right. This could look like providers not making assumptions and using preferred pronouns and terms, acceptance from family and friends, equitable policies and access, and more.
The following organizations provide information and support for clients and providers.
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Sexual Pleasure
Enjoying sex, knowing what you like, and how to communicate your preferences is an integral part of sexual health. Historically, the sexual pleasure of women, and other marginalized groups has been ignored in favor of the sexual pleasure of straight white men. Painful sex isn’t normal and can and should be treated. Sex should be fun, safe, and consensual.
We’ve linked some resources below that provide education and support around sexual pleasure specifically geared toward historically marginalized populations.
- Sex, Pleasure & Sexual Dysfunction, Planned Parenthood (English)
- Sexo, placer y disfunción sexual, Planned Parenthood
- Kimbritive, Sexual Wellness for Black Women
- Feminist Sex-Ed
- A Guide to Sexual Concerns and Pleasure, the National Coalition for Sexual Health
- Promotional Materials, the National Coalition for Sexual Health
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Disease and Illness Prevention and Treatment
There are illnesses and diseases of the reproductive health system just like there are for all aspects of health. Most sexually transmitted infections are preventable, easily testable, and treatable. If left untreated they may cause serious illness, though sometimes a person can have an STI without any symptoms. We believe people have the right to prevention and treatment of all diseases and illnesses, including those related to sexual and reproductive health.
The Planned Parenthood resources linked below provide information on STIs and cancers of the reproductive system. We suggest becoming familiar with them so you can speak about how to get tested for and prevent STIs with your clients when appropriate. You can also share the links with clients directly.
- Sexually Transmitted Infections (STDs), Planned Parenthood (English)
- Enfermedades de Transmisión Sexual, Planned Parenthood
- STI Fact Sheets, CDC
- Cancer, Planned Parenthood
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Access to Safe Abortion
Access to safe, legal abortion is a critical component of sexual and reproductive healthcare. Every Body Texas does not provide or fund abortion care, however, we believe that abortion is important medical care that must be available to any person who can become pregnant.
We’ve put together a resource that you can share with clients for more information on abortions and how to access them, even if they live in Texas or another state that has made abortion illegal.
The content on this page was written and reviewed in June 2023.