If you’re an adult in the U.S., odds are you know at least one couple whose
bundle of joy was a "surprise." For some people, an unwanted pregnancy simply
becomes a new, pleasant direction in life as parents. For others, it’s a
devastating nightmare. Modern medicine has given us a lot of options when it
comes to preventing this life-changing event. But like any tool, these methods
only work when they are used correctly.
Whether you’re new to the game or an
old hat looking for new tricks, read on to learn about the 15 most popular ways
to avoid meeting Junior too soon.
15) Withdrawal
This is undoubtedly one of the oldest forms of birth control. Officially
called coitus interruptus, this is when the penis is withdrawn during
intercourse before ejaculating. It’s definitely an inexpensive method, and in
theory, easy to employ. Stereotypically, it’s thought of as being used by
teenagers with limited access to birth control, but is a sworn method among even
some experienced adult partners. Most experts, however, reject it as an
effective means of contraception, citing a perfect use of only four percent.
With an actual failure rate of nearly 30 percent,
it should be the last method employed by couples.
Courtesy of snorgtees.com
The trouble with "pulling out" is that it’s inaccurate and sometimes
stressful. A male partner has to have a strong bodily awareness to withdraw in
time, and a female partner must rely on both his awareness and commitment to the
method. This can lead to a lot of uncertainty that dampens the thrill of sex for
at least the woman, if not both partners. Moreover, even if a couple’s use of
the method is perfect, pre-ejaculate can sometimes contain viable sperm if the
man’s plumbing is ‘leaky,’ leading to the possibility of getting pregnant even
with interrupted intercourse. The mechanics, therefore, are deceptively simple,
making this one of the least effective popular strategies for holding off on
having that baby shower.
14) Fertility Awareness
Those with that kind of equipment know that ovulation isn’t just a one or
three day a month thing, with a menstruation period stretching up to one week
out of every month. All roughly 28 days of the cycle are accounted for and alter
physiology ever so slightly, including amount and quality of cervical mucus and
body temperature in addition to a unique number of days between periods. Modern
fertility awareness takes all of these things into account, with women who
choose to use this method measuring at least one of these facets, if not all
three.
If you do choose to use a calendar method to track ovulation days, there are
devices you can buy to help you, such as a specialized set of colored calendar
beads that mark your "safe" and fertile days. This method maintains a four percent fail rate for couples who actively use a
marker method. Also called the symptothermal method, if you track your days
using temperature and cervical mucus your failure rate drops to roughly one
percent. The price of using the method itself is free, obviously, but the tools
and classes or books on using it to your best advantage start at $20 to $40 and
go up from there.
Women and couples often choose this method to avoid hormonal methods of birth
control in cases of their incompatibility for medical or lifestyle reasons. It
also avoids the physical hassles of some of the other methods on this list,
though while other forms of sex play can be enjoyed during fertile days. It does
make intercourse less spontaneous unless a back-up method is employed.
13) Emergency Contraceptive
This is on the list because it is a popular contraceptive, not an
abortificant as its opponents suggest, but unlike the other ways of preventing
pregnancy. However, this one isn’t designed to be a regular birth control method. If
you’re an adult, you can buy this over the counter in most states, where on
average, it costs between $30 and $70; sometimes it can be found for
significantly less at health clinics. If you’re 16 or younger, you’ll have to go
through your family doctor to obtain the one-step pill.
"Plan B" Pill - Emergency Contraception
By Anka Grzywacz (Own work) [CC-BY-2.5-pl],
via Wikimedia Commons
Taken up to five days after unprotected sex or failure of a primary birth
control method, the "morning after pill" as it is popularly called, prevents
implantation of a fertilized egg in the lining of the uterus. This means that
you are never pregnant, because if for the fertilized egg to become an embryo,
called a zygote, it would have to be attached to the uterine wall to send and
receive hormonal signals. The pill blocks this process, sometimes even inducing
the menstrual cycle in some patients. It’s an effective drug, and it’s only real
drawback is the time constraint, particularly if you’re young enough to need a
doctor’s permission for it.
12) Sponge
Among other things, this contraceptive method can lay claim to being a famous
plot device on the hit sitcom Seinfeld. A vaginal sponge is a circle of plastic
foam material soaked in spermicide that is inserted at the top of the vagina to
prevent sperm from moving past the cervix. It must be in place before
intercourse, and must be left in for six hours afterwards, when it is then
removed with a nylon loop. Some women like this method because it does not
require insertion of any device into the uterus, and avoids hormonal birth
control all together. As long as it is positioned correctly, you can insert it up to 24 hours
before sex to prevent disrupting the move from foreplay to intercourse, and it
can also be prepared and used on the spot.
Placement is key, though, and inaccuracies in insertion and removal give it
high use rates for failure. The sponge is more effective if you have never given
birth. In this case, if you use the sponge correctly every time, your failure
rate will only be around nine percent. If you have previously had a baby, that
rate jumps to 20 percent, because of the changes in your cervix and upper
vaginal walls. Forgetting to use the
sponges sometimes, the rate for women who haven’t given birth is 12 percent,
with that doubling for those who have. Some complaints about this form of birth
control are that it can be messy, and some women dry out using it. Still, those
women who love it swear by it, and if Elaine is willing to go on a 25 block hunt
for them, you might find them spiffy, too.
11) VCF (Vaginal Contraceptive Film)
VCF is probably the most unusual method on this list, but it’s been gaining
in popularity since the early 2000s. The film is a small, clear square that
looks almost like a dental dam. In this case, however, it’s not meant to be a
physical barrier, but when inserted into the vagina, turns into a spermicide
coating over the cervix. While basically just another type of spermicide method,
film doesn’t have the mess of jellies or foams, and is easy to carry concealed
on dates. In fact, those who love it cite the fact it is good for spontaneous
sex as it can be carried and used anywhere, at any time. You may also appreciate
that it is available over the counter, and is inexpensive - usually around $13
for a box of 12 films.
Courtesy of teenhealthsource.com
VCF is also fairly effective in theoretical use rate, sitting around six
percent failure. In
use, though, the number jumps to 28 percent on average. What you need to
remember is that the film’s effects only last for one hour after insertion, at
which time another film must be used. Not adhering to the effective time period
is the most common mistake
associated with the failure of this birth control method.
10) Diaphragm/Cervical Cap
Technically two different devices, these are listed together as the same
method because they perform similar functions. Diaphragms and cervical caps are
both placed at the top, or back, of the vagina as a physical barrier to sperm.
All cervical caps and some diaphragms are coated with spermicide before
insertion to add to their contraceptive power, and you can set both in place up
to six hours before sex. Cervical caps have a slight advantage over diaphragms
because they can be left in for longer - 48 hours as opposed to a diaphragm’s 24
- and you don’t need to reapply spermicide with each round of intercourse.
Cervical caps have a higher perfect use fail rate, at nine percent to the diaphragm’s six percent, but in
typical use, only around 14 percent of women will likely become pregnant, as
opposed to 16 percent with the diaphragm.
Diaphragm
Both devices require an exam to
obtain, and the diaphragm requires a fitting process. You’ll pay anywhere from
$15 to $75 for the device itself, then the exam fee and spermicide.
9) Male Condoms
Condoms are also a lot older than most people give them credit for, but the
difference is, the modern ones you buy today have material that is actually
effective at blocking sperm. Thank the microscope for teaching us cloth is
porous enough to let motile gametes swim through. Granted, lambskin condoms
still exist for the choosy few, but most of the ones you'll find now are latex
and latex rubber substitutes. These have superior elasticity and durability
under stress, which is increased with proper lubrication used in production.
Not to say one won’t ever break on you, though. Improper oil-based lubricants
can cause them to split, as well as the condom itself being out of date, being
the wrong size, or being put on and taken off incorrectly. Often used with
spermicide, condoms carry a two percent failure rate under perfect conditions,
and a 15 percent failure rate under typical use. Female condoms also exist, and are used in much the same
ways as a male condom, only going up inside the vagina instead of over the
penis. These have slightly lower failure rates under perfect use, but are more
difficult to contend with and those using them often fear they will come out
easily if not properly inserted. You may also find them a hassle, or you may
disagree entirely. Either way, condoms are most popular as a back-up or
accessory form of birth control, as they are cheap and relatively simple to use,
becoming easier with practice. Additionally, condoms are one of the few
effective, available forms of birth control that puts the primary responsibility
on men to prevent pregnancy. If you want to be known for your sensitivity and
consideration in the bedroom, this is a good place to start, guys.
8) Mini-Pill
These are listed separately because their purpose is a little different from
regular birth control pills. Mini-pills are low doses of progestin only. While
systemic like the more common combination pill, mini-pills don’t last as long in
your system, meaning the effect is gone after 24 hours. This makes your
fertility more reversible than with other hormonal birth control methods, which
may be a good or bad thing depending on what your future family planning
strategy may be. As long as you take it at exactly the same time every day, the
mini-pill has the same less than one percent fail rate of regular birth control
pills. However, with typical use, the failure rate is between 9 and 11 percent.
Mayoclinic.com gives good reasons to choose the mini-pill over a traditional
birth control pill, including if you are breastfeeding, have a history of blood
clots or heart disease, or have sensitivity to estrogen. Women who are planning
on having children soon but not at the moment often utilize this method to help
bring back fertility after using stronger, longer-term methods of birth control.
Mini-pills cost around the same as traditional birth control pills, and are
available by prescription in the same way. They have many of the same side
effects, so determining if they are a good alternative for you is something to
take up with your doctor.
7) The Pill
Another very famous contraceptive, birth control pills have a controversial
history as a symbol of feminine independence, progress in women’s healthcare,
and modern control of family planning by couples looking to be good stewards of
their fertility. The darker side of "the Pill’s" reputation is painted as an
increased in promiscuity among women, and encouragement of sexual activity by
teens, and of course, the breakdown of societal values, like nearly every other
human advancement. Today, birth control pills are used for a variety of
applications by those with female bodies, and may lessen symptoms of some
reproductive system linked disorders like PMDD. On a more surface level, they
allow you to better regulate your period and control PMS symptoms, and are one
remedy for teen and young adult acne.
On the family planning front, birth control pills are just over 99 percent
effective in perfect use. Accidentally skipping a day or not taking pills at the
same time every day drops this rate to 9 percent failure - 81 percent effective
- in typical usage as a contraceptive. Pills vary in cost, being slightly cheaper in generic
form and at health clinics, but as they also vary in dosage, source of hormones,
and inclusion of inactive ingredients. You may have to try a few and find one
that suits your body best over simply picking the cheapest option. Women have
complained of weight gain, break outs, and bloating on the pill, but these are
symptoms that can be treated on their own or by trying a new type of pill. Pills
are often used in conjunction with condoms, allowing both partners in a
relationship to take an equal share of the responsibility of avoiding
procreation.
6) Patch
The patch woks in a similar principle to the pill, providing the user with a
systemic hormone infusion through the body to suppress ovulation. Unlike the
pill, however, the patch is replaced only weekly, lending users more freedom in
their activities and making missed doses less likely. Patches are waterproof and
while they can fall off, they rarely do. Many place the patch on their arm where
it is easily accessible or on their lower belly where it can be hidden by
clothing. Patches carry the same failure rates as the pill overall, and the
patch is usually slightly more expensive, topping out at $80 for a one month
supply.
The Mayo Clinic also counter-indicates patches for those prone to blood
clots. Also, women who weigh over 198 pounds may find this method to be less
effective, since the dose of hormones may not be enough for their bodies. Like the Pill, the patch is often used not just for
pregnancy, but therapeutically, to treat disorders that include propensity for
ectopic pregnancy and certain types of iron deficiency anemia.
5) Ring
The ring is another device in the family of hormonal birth control methods. It’s
inserted vaginally once a month where it sits comfortably at the top near the
cervix, and left in for three week intervals. It can be found for as low as $15
at some health clinics. Unlike the pill
and the patch, it is not truly systemic. While some hormones will be found in
the blood stream, most will stay close to the uterine area to block ovulation,
as many of the signals used by this cycle are local conductors.
Close-up of the NuvaRing
The ring also carries the use failure rate of nine percent, along with the
pill and the patch, though on an individual basis, many suggest you may find it
easier to remember and fit into your schedule since it only has to be taken care
of once a month; if you forget and leave it in the fourth week, you simply don’t
have the same protection as the other three weeks. The off week is only meant to
allow you your period. Like the pill and patch, as well as some other forms of
birth control, it doesn’t prevent against STDs, meaning if you’re with a new
partner, you might want to combine this method with a physical barrier method
such as a condom.
4) Hormone Shot
Also known by the drug it contains – DMPA - the shot is a dose of progestin
that last in the body for three months. This is a common method used by military
personnel because it is a quick, certain process that requires no daily or
weekly upkeep. Under perfect use, it is equivalent to the pill, the patch, and
other such methods. In typical use - when shots are not given on schedule - the
failure rate is lower than the pill, though: Planned Parenthood puts it at
six percent.
An exam is needed to obtain the prescription to get the shot, and it can be
more expensive. Even after you have your initial visit, you will pay at least
$55 dollars every 12 weeks. This is significantly more than a month’s supply of
most birth control pills, but keep in mind, you’re purchasing it quite a bit
less. The shot is ideal if you have a busy life or value spontaneity in sex.
Further, this can be a very private method, as you don’t have to keep evidence
of use around your house to be discovered.
3) Implant
The implant is a small rod, usually inserted in the upper arm. While it might
remind you of a strange cybernetic procedure designed to turn you into a member
of a cyborgian race under radio control by alien overlords, the truth is, like
the ring and patch, it diffuses progestin through your system to prevent
pregnancy. Don’t feel disappointed, though, because the effect can last up to
three years, giving you a lot of freedom and long term family planning options.
Courtesy of birthcontrolnews.org
The upfront cost is significantly more than most methods, $400 to $800, and an exam is required, as well as a
removal fee at the end of its term. However, breaking it down to monthly cost,
if you can afford it or have the insurance, this method is a good value on a per
diem basis. The only major side effect is that a poor insertion under the skin
may become irritated and send you seeking a reinstallation, but other than that,
it carries no more risk than any other hormonal form of birth control.
2) IUD/IUC
Interuterine devices developed a poor reputation at their first introduction,
but these modern devices don’t come with the same issues of infection and damage
that their predecessors did. IUDs are similar to implants but are inserted into
the uterus instead of some other part of the body, and so the lower dose of
hormones they carry tends to be more localized and less systemic. They are even
pricier than implants, costing between
$500 and $1000, not including exam and removal fees. However, since some last up
to 12 years, once again, upfront cost can be deceptive of long term value.
Methods like IUDs are considered an investment by those looking for secure, long
term family planning. Perfect use rates are zero percent failure, and even
typical usage finds that IUDs tend to fail only one percent of the time. This
easily makes them one of the most effective forms of birth control on the
market.
1) Abstinence
Regretfully, your high school health teacher was actually right. The only way
to prevent pregnancy 100 percent of the time is just not have sex. This may not
be the method that is used most consistently, but if you’re a sexually mature
teen, a new parent, someone practicing celibacy, a long distance partner, or
simply a lonely heart single, there’s a pretty good chance you have used or are
using this method on a regular basis.
It’s cheap, it’s free, and while it’s no
fun, it gives you more time to explore new hobbies like raising earthworms or
playing the ukulele.
Final Thoughts
Sex is a part of life, as are children. If you have your reasons for
abstaining, more power to you. But a fear of pregnancy shouldn’t be what stops
you, especially with the variety of methods readily available to specifically
prevent an unwanted pregnancy from occurring.
Whatever you and your partner decide is the right method of family planning for
you, what’s most important is that it fits your lifestyle and your long term
goals, should that include parenthood all the way to a vow to remain ever
childfree. Remember, what has worked for you in the past, and what works for you
now, might not be what will work for you in the future. While a little awkward,
this is something to continually revisit through your life, as circumstances
change. Bring it up with your doctor or other healthcare provider, and know they
are there to support you, not to judge. Choice and control are what drives both
the popularity and development of contraceptives, and people look for new ways
to enjoy one of the most primal and enjoyable components of being human.
References:
15)
PlannedParenthood.org - (With an actual failure rate of nearly 30
percent)
14)
Planned Parenthood - (maintains a four percent fail rate for couples who
actively use a marker method)
12)
Plannedparenthood.org - (forgetting to use the sponges sometimes, the
rate for women who haven’t given birth is 12 percent, with that doubling
for those who have)
11)
teenhealthsource.com, run by United Way Toronto - (VCF is also fairly
effective in theoretical use rate, sitting around six percent failure)
10)
Plannedparenthood.org - (Cervical caps have a higher perfect use fail
rate..)
9)
Plannedparenthood.org - (condoms carry a two percent failure rate under
perfect conditions, and a 15 percent failure rate under typical use)
8)
Plannedparenthood.org and womenshealth.gov - (with typical use, the
failure rate is between nine and 11 percent)
7)
Plannedparenthood.org - (skipping a day or not taking pills at the same
time every day drops this rate to 9 percent failure - 81 percent
effective - in typical usage as a contraceptive)
6)
Plannedparenthood.org - (women who weigh over 198 pounds may find this
method to be less effective...)
5)
Plannedparenthood.org - (It can be found for as low as $15 at some
health clinics)
4)
Plannedparenthood.org
3)
Plannedparenthood.org - (upfront cost is significantly more than most
methods, $400 to $800)
2)
Plannedparenthood.org - (costing between $500 and $1000..)
