Birth Control Methods


 

Trying to decide what is the best birth control method starts from knowing what options are available. Only you can decide what is best for you.  Please talk to your doctor for more details.

Non-Medication Options

  • Abstinence – of course 100% effective.

Breastfeeding as birth control (Lactation Amenorrhea Method)

  • Is an effective birth control for the first 6 months after delivery, but only if a woman:
    • Does not substitute food or formula for breast milk
    • Feeds at least every 4 hours during the day and every 6 hours at night
    • Has not had a period since she delivered her baby
  • Less than 1 in 100 women will become pregnant if she alwayspractices continuous breastfeeding.
  • About 2 out of 100 women will become pregnant in the first 6 months if they don’t alwayspractice it correctly.
  • Does NOT protect against sexually transmitted diseases or STD (should use latex or female condoms).

Condoms and spermicide

  • An effective method for birth control when used correctly: in real life, it is approximately 80% effective.
  • Can protect against STD.

Withdrawal (pull out method)

  • Not an effective method if done incorrectly – 27 out of 100 women will become pregnant each year if they don’t alwaysdo it correctly.
  • Does not protect against STD.

Medication Options – Greater efficacy and reliability

Birth control pills – progestin only pills

  • Progestin-only birth control pills are effective if taken at the SAME TIME every day.
  • Women who are breastfeeding should take progestin-only pills and not the combined oral contraceptive pills because this can decrease breast supply.
  • Less than 1 out of 100 women will get pregnant each year if they alwaystake a pill each day.
  • About 9 out of 100 women will get pregnant each year if they don’t alwaystake the pill each day.
  • Will not protect against STD.
  • Although it is a very rare to get pregnant while you are taking the pills, in the very rare cases where pregnancy does occur, the risk of ectopic pregnancy is increased, which can be life threatening.
  • You should not take any kind of birth control pills if you have had breast cancer.  Talk to your doctor about other options of birth control that is right for you.

Birth control shot (Depo-Provera)

  • Depo-Provera or DMPA is a hormone shot given every 3 months to prevent pregnancy.
  • Less than 1 out of 100 women will get pregnant each year if they alwaysuse the shot as directed.
  • About 6 out of 100 women will get pregnant each year if they don’t alwaysuse the shot as directed.
  • You need to use a back-up method for 1 week after getting the shot unless you are within three weeks from giving birth.
  • Most common side effects are: irregular menstrual periods, cessation of menstrual period, weight gain, and delayed return of fertility.
  • Although it is a very effective birth control method, in the very rare cases where pregnancy does occur, the risk of ectopic pregnancy is increased, which can be life threatening.
  • Temporary bone thinning occurs while you are on the birth control shot.  This risk increases with increasing length of use.  However, once you stop using the shot, your bone growth restarts again.  You can minimize these risks by exercising and supplementing with calcium and vitamin D.
  • You should not use the birth control shot if you have breast cancer or have had bone fractures from osteoporosis.

Intrauterine Device (IUD)

  • A small T-shaped device that is inserted by your doctor into the uterus to prevent pregnancy.
  • There are two types of IUD available in the US – copper (ParaGard) and hormonal (Mirena and Skyla)
    • ParaGard: is made of copper and can be effective for 12 years.
    • Mirena: is coated with progestin and can be effective for 6 years.
    • Skyla: is similar to but smaller than a Mirena and can be effective for 3 years.
  • Less than 1 in 100 women will become pregnant each year while using the IUD.
  • IUD does not protect against STD.
  • ParaGard IUD can be used as emergency birth control if inserted after unprotected intercourse.
  • Although it is a very effective birth control method, in the very rare cases where pregnancy does occur, the risk of ectopic pregnancy is increased, which can be life threatening.
  • Common issues encountered with IUDs:
    • Cramping pain after placement for a few days
    • Irregular spotting in the first 3-6 months with Mirena and Skyla
    • Heavier periods and increased cramping with ParaGard
  • Serious but rare problems encountered with IUDs:
    • Expulsion of IUD, either completely or partially.
    • Pelvic infection, which typically occurs within 3 weeks of insertion.  If occurs this can affect a women’s ability to become pregnant in the future.
    • IUD is imbedded into the wall of the uterus or, on rare occasions, a perforation of the uterus can happen and the IUD “travels” to areas outside the uterus, potentially causing harm to other parts of the body.  Surgery may be required to remove the IUD.

Morning-After pills (emergency contraception)

  • Birth control pills that can be purchased at health centers and drugstores to provide emergency contraception.
  • It may be taken up to 5 days after unprotected intercourse with good efficacy.
  • Ella and IUD are most effective but harder to obtain.
  • Plan B is less effective; especially if you take it more than 3 days after unprotected sex or have a higher BMI.  But, it is easiest to obtain since you don’t need a prescription.

Surgical Options

Female sterilization

  • It is a permanent form of birth control.
  • The Fallopian tubes can be tied and cut, sealed with instruments using electrical current, closed with clips or rings, or blocked off by placement of tiny inserts called Essure.
  • Risks of sterilization are not only surgical injury, but also increased chances of ectopic pregnancy if pregnancy were to happen, although this is very rare.
  • You should NOT consider sterilization if:
    • You may want to have more children in the future
    • You are being pressured by your partner or family
    • You are trying to solve other problems that may be temporary.

Male sterilization or vasectomy

  • It is a permanent form of birth control for men.
  • It is safe and effective, nearly 100%.
  • You need to wait approximately 3 months until it becomes fully effective as sperm remains beyond the blocked tubes.
  • You should NOT consider sterilization if:
    • You may want to have more children in the future
    • You are being pressured by your partner or family
    • You are trying to solve other problems that may be temporary.
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