Sub-links: Birth Control / Vaginal Infections / STD's / Gardasil

In 1969, two physicians, Edward C. Allred M.D. and Kenneth L. Wright M.D., founded the Family Planning Associates Medical Group (FPA) for the purpose of making family planning techniques available to all California women. Their principle service was the termination of problem pregnancies.

As FPA expanded, it became clear that additional family planning services were needed. FPA now has numerous office locations in Southern California that provide a variety of women's medical services such as birth control (including the IUD), sterilization, pap smears as well as pregnancy termination.

We are here for you! FPA is a nationally recognized leader in family planning. We are the largest and most experienced family planning network in the country and we provide the finest medical care you can get. Our job is to let you know about the available family planning alternatives and help you make your own informed decision about the alternative that best suits your needs.

URINE PREGNANCY TESTS
Pregnancy tests detect human chorionic gonadotropin (HCG) in the urine or serum of a pregnant woman. HCG is produced when the pregnancy is implanted in the endometrium (ectopic pregnancies are implantations in other sites). Pregnancy tests are designed to detect this hormone.

Two types of urine pregnancy tests used by Family Planning Associates are the urine chorionic gonadotrophin (UCG) and the Early Pregnancy Test (EPT). Blood tests are not performed to determine pregnancy at Family Planning Associates.

1. The UCG is a presumptive urine test offered to patients whose menstrual cycle is at least two weeks late. This test is not as sensitive as the EPT and results are available within the hour. There is a no charge for the UCG test.
2. The EPT is a presumptive urine test offered to patients who have not yet missed their menstrual cycle but wish to determine if they are pregnant. There is a $15.00 fee for this highly sensitive test capable of detecting the pregnancy hormone within 7 days of conception. Results are available within the hour.

A first morning urine specimen is preferred for pregnancy testing because the pregnancy hormone is more concentrated.

Results: Pregnancy tests cannot be used alone as a diagnosis of pregnancy because false positive and false negative results can occur. False readings can be caused if the urine is too diluted, the pregnancy is very early, or in ectopic pregnancy.

In order to confirm a diagnosis of pregnancy, Family Planning Associates recommends that a pelvic exam be done by a clinician. Appointments can be made for this service.

PAP SMEAR
This important exam and cancer screening test should be performed on an annual basis as recommended by the American College of Obstetrics and Gynecology (ACOG).

IUD/MIRENA BIRTH CONTROL
A simple, office-based procedure where a small contraceptive device, called Mirena, is inserted in the uterus.  This method provides exceptional birth control for 5 years, or until the patient decides to have the device removed.

ULTRASONOGRAPHY
Ultrasonography is the transmission of intermittent high-frequency sound waves through body tissue which are reflected back from this tissue to a transducer. From the transducer an image of the body tissue is displayed on the monitor screen.

Uses: Family Planning Associates Medical Group uses ultrasound technology to assist in gestational age dating. Nurse Practitioners or Physician Assistants who have received training in measuring specific fetal structures for age dating perform the ultrasound. Our physicians also use the ultrasound for evaluating patients. While it is common to feel pressure in the abdomen or the vagina, there is little discomfort associated with the use of ultrasounds.

Risks: Numerous studies have been performed to determine the risks of ultrasound use in pregnancy. The studies have determined that there are no known risks and no confirmed biological hazards.

Types of Exams using Ultrasound

1. Pelvic - The abdominal/pelvic exam involves placement of the transducer on the abdomen. A conducting gel is placed on the abdomen through which sounds waves are transmitted and received. A "real time" image is displayed on the monitor screen.
2. Vaginal - The vaginal ultrasound consists of placing a specially designed probe (with latex cover) into the vaginal canal (these probes are sanitized after each use). The vaginal ultrasound usually produces a more distinct picture of the uterine contents and allows for dating (in most cases) of an earlier gestational age.

Costs: The usual/customary fee is $130.00. When FPA provides abortion services the ultrasound is included in your service fee.

FEMALE STERILIZATION
No method of birth control is without its drawbacks. After you've struggled with various birth control methods for a while, and after you've had all the children you want, you may want to consider permanent birth control, or sterilization. Female sterilization is a surgical procedure that works by blocking the Fallopian tubes, thus preventing the eggs released by the ovaries from reaching the uterus and being fertilized by sperm.

How does it work? The Fallopian tubes can be blocked in several ways. Until recently, the most common methods were laparotomy and colpotomy. In a laparotomy, an incision is made in the abdominal wall through which the tubes are cut and tied. In a colpotomy, the tubes are approached through the vagina. Both of these procedures require a hospital stay. Today's most popular method of female sterilization is the one used at FPA, tubal cauterization by laparoscopy. It's a long word for a short procedure; in fact, it's so simple and leaves such small scars that it's sometimes called "band-aid surgery."

In a laparoscopy, a tiny incision is made just below the navel. The incision is only about one quarter of an inch long. Through this incision, the abdominal cavity is filled with carbon dioxide gas.

The gas lifts the abdominal wall and adjoining organs away from the fallopian tubes, allowing clear visibility. Another tiny incision is made just below the pubic hairline. A laparoscope, an instrument like a telescope with its own lighting, is then inserted through the first incision. The doctor looks through the laparoscope to get a clear view of the Fallopian tubes. A cauterizing instrument is inserted through the second incision. Looking through the laparoscope, the doctor uses the cauterizing instrument to grasp and seal a small section of the tube on each side of the uterus.

Effectiveness: Tubal sterilization by the cauterization procedure is considered 99% effective in preventing pregnancy. Once in a while, the sealed ends of the tubes grow back together or an egg is fertilized outside of the uterus. However, the incidence of pregnancy after tubal cauterization is less than 3-4 in 1000.

Permanence: Tubal cauterization is considered permanent. It is theoretically possible to reconnect the tubes, but the operation is expensive and complex, requiring a major incision and hospital stay, and is not always successful. You should choose this form of birth control only if you are certain that you don't want any more children.

Counseling: If you are interested in a tubal cauterization, you can make an appointment with one of FPA's skilled counselors who will answer your questions and help you make sure this procedure is right for you. You must be at least 18 years old. Because of the procedure's permanence, we recommend a one or tow week waiting period, during which you can withdraw your consent if you change your mind.

How long does it take? Tubal cauterization, as performed by one of FPA's fully trained and licensed gynecologists, takes only 20 to 30 minutes. However, with the preparation and post-operative observation, your stay in the clinic is about five hours.

Recovery: You will probably be discharged from the clinic a few hours after your surgery. We advise you to rest for a day. You may feel tired, and you may feel some soreness in the chest and shoulders. This soreness results from the position of your body during surgery and from the small amount of carbon dioxide gas that is still putting some pressure on your internal organs. Most of the gas is pumped out immediately after tubal cauterization, and the remaining gas gradually goes away during the 24-48 hours after surgery.

Your throat may be a little sore from the administration of the anesthesia, and you may have a small amount of vaginal spotting. Every woman is different, so the time needed to recover from surgery will vary, but we recommend that you avoid heavy lifting and wait until after your two weeks post-operative check-up to have intercourse.

Complications: No surgery is risk-free. Complications are rare; however, they do exist. Your counselor will explain them to you. Surgeons who are experienced with laparoscopy consider this procedure to be safer than a tonsillectomy, an appendectomy, or childbirth.

After Effects: After the Fallopian tubes have been blocked, the ovaries continue to function normally. Sterilization has no effect on the production of hormones, nor does it interfere with menstruation or menopause. It causes no physical changes.

The only after-effect is a beneficial one; without the fear of an unwanted pregnancy, you will probably feel a new sense of freedom and an increase in sexual response.

Cost: In keeping with FPA's commitment to provide quality care at moderate cost, the fee for sterilization includes counseling, surgery, and follow-up care. During your first appointment, we will review the charges with you and help you decide what form of payment is best suited to your financial position. We accept private insurance, Medi-Cal, Champus, and several credit cards and major health agencies. Ask your counselor for further information.

Sub-links: Birth Control / Vaginal Infections / STD's / Gardasil

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