About one half of all pregnancies are unplanned. Birth control helps a woman plan her pregnancies. Today, there are many birth control methods. Most women will use different methods of birth control over the course of her lifetime. The choice is very personal. Remember that all methods have a chance of failure. Choose a method you will be able to use consistently in order to lower the failure rate. When choosing a birth control method you should also think about preventing sexually transmitted infections; condoms are the best way to protect yourself and they can be used with any of the other methods listed below.
Permanent Methods (over 99% effective)
The thing to remember here is “permanent.” These methods of birth control are not meant to be reversed, so if you think you may want more children in the future, these methods are not for you. Attempts at reversal may not work. Reversals require major surgery, are expensive, and are usually not covered by insurance companies.
- FOR WOMEN: Tubal sterilization
- Tubal sterilization can be done either with surgery in the hospital or local surgery center. The goal of surgery is to close the fallopian tubes or remove them entirely. With the tubes closed or removed, an egg and a sperm cannot meet and pregnancy can’t happen.
- FOR MEN: Vasectomy
- Vasectomy involves cutting a man’s vas deferens so that sperm cannot mix with semen. The vas deferens are cut or clamped so that the ends do not join. This procedure is done with a local anesthetic and is performed in the doctor’s office or clinic.
Long-Acting Reversible Contraceptive (LARC) Methods (over 99% effective)
LARC methods are by far one of the most popular methods of contraception. This is because they do their job without women having to think about them or remember to do anything special. While these methods can be used between 3-10 years, it’s important to remember they can be removed at any time.
- The IUD is a T-shaped device that is inserted into the uterus and can be left in place for several years. There are three types of IUD currently available:
- The ParaGard IUD contains no hormones. It can be used for up to 10 years.
- The Liletta IUD contains the hormone progestin can be used for up to 8 years. Because of the hormone in this IUD, many women experience lighter and less frequent periods. Some women don’t have any periods at all.
- The Kyleena IUD contains an even lower dose of the hormone progestin and can be used for up to 5 years. It is very similar to the Liletta, slightly smaller in size, and is meant for use in younger women and teenagers who have never been pregnant.
- Birth control implants are another option. Implants are placed beneath the skin of the upper, inner arm.
- The Nexplanon Implant is a small, flexible plastic rod which contains the hormone progesterone. It can be used for up to 3 years.
Hormonal Contraception (between 85-94% effective, depending on the method)
With this type of birth control a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. As long as there is no egg to fertilize, pregnancy cannot occur. The hormones can also cause changes in the cervical mucus and the uterus. Hormonal birth control pills, injections, patches, and rings are all very effective when used correctly, however if doses are missed or taken late an unplanned pregnancy could occur. There are some risks involved, though typically those risks are small. However, for women over the age of 35 who smoke there is an increased risk of heart attack and stroke.
- Birth control pills must be taken every day, and close to the same time every day. Most birth control pills contain a combination of the hormones estrogen and progestin. There are many different types of pills containing differing levels of hormones. Talk to your doctor to determine which pill will be best for you.
- The contraceptive patch is a small adhesive patch worn on the body. A new patch is worn each week for 3 weeks, then on the fourth week no patch is worn and menstruation occurs. If a patch falls off or is applied late an unplanned pregnancy could occur. The risks and benefits of this method are similar to birth control pills.
- The vaginal ring is a flexible, plastic ring that is placed inside the vagina. The ring releases estrogen and progestin to prevent pregnancy. It is worn for 21 days (3 weeks) and is then removed for 7 days. During the week without the ring in place a woman has her period. After the 7 days, a new ring is inserted. The risks and benefits of the contraception ring are similar as those of birth control pills.
- Birth control can also be done as an injection or shot. One type of injectable hormone is called Depo-Provera and it provides birth control for three months with each injection. That’s only four shots each year. There is usually a slight weight gain for women on this type of birth control method and most women have some spotting when starting.
Barrier Methods (between 76-88% effective)
Barrier methods are meant to stop sperm from reaching an egg. In order for these methods to work best they need to be used every single time you have sex.
- Spermicides are chemicals that kill sperm. They are placed in the vagina close to the cervix. They include tablets, foam, cream, and jelly. There is a 26% failure rate resulting in pregnancy with this method. Spermicides can be used with many of the other barrier methods below, increasing their effectiveness.
- The male condom is a thin sheath made of latex (rubber), polyurethane (plastic), or animal membrane. It is worn by the man over his erect penis. Only water-based lubricants should be used with a condom. It is unsafe to use oils, lotions, petroleum jelly, olive oil, or cold cream. The pregnancy rate with this form of birth control is 14%.
- The female condom is a thin plastic pouch that lines the vagina. It is held in place by a closed inner ring at the cervix and an outer ring at the opening of the vagina. The failure rate with this form of birth control is 21%.
- The diaphragm or FemCap is a small, round rubber dome that fits inside the woman’s vagina and covers her cervix. The failure rate with this form of birth control is 20%. The diaphragm must be prescribed by a doctor and fitted to your body.
If a woman has intercourse without any type of birth control or if she thinks her birth control method has failed (i.e. the condom broke), she may be interested in Emergency Contraception.
Talk to your doctor right away if you think you may need this option. If used within 3-5 days of unprotected sex, your chance of getting pregnant is greatly reduced. Emergency Contraception is not a replacement for regular birth control.
Natural Family Planning
Natural Family Planning may be referred to as “the rhythm method” or “fertility awareness.” It isn’t just one method, but a variety of methods. It does not require drugs or devices, but the success of this method depends on you knowing when you ovulate and that you do not engage in intercourse during that fertile period, or that you use another method during that time.
- Basal body temperature monitoring requires that you take and chart your temperature every morning in order to detect the slight increase in temperature that indicates ovulation has occurred.
- The ovulation/cervical mucus method is just as it sounds. A woman notes the changes in her cervical mucus that indicates ovulation.
- Keep a menstrual calendar in order to chart your menstruation and fertile periods.
The withdrawal method is not a reliable birth control method. The idea is that the man takes is penis out of the woman prior to ejaculation and not allowing sperm to be released into the woman’s vagina. The reason this method isn’t reliable is that millions of sperm can be present in the fluid produced by the penis before ejaculation, and because some men fail to withdraw completely or in time.