Birth control is the use of various devices, drugs, agents, sexual practices, or surgical procedures to prevent conception or pregnancy.
It enables people to choose when they want to have a baby.
A range of devices and treatments are available for both men and women that can help prevent pregnancy.
Some methods are more reliable than others. How well a method work often depends on how carefully it is used.
The contraceptive pill, for example, used correctly, is over 99 percent effective. However, because people make mistakes, as many as 9 women each year will become pregnant while using it.
This article will look at a range of methods of preventing pregnancy. It gives the actual rates of effectiveness, which take into account the possibility of human error.
Fast facts about birth control
- Birth control can help people decide when they want to have children.
- There are many types to choose from, including different types of barrier, medications, and traditional methods that need no additional resources.
- Effectiveness varies and often depends on how carefully the method is applied.
- Only a male condom offers any protection against sexually transmitted infections (STIs).
Traditional birth control does not involve any type of device or medication.
Abstinence: Celibacy or sexual abstinence means avoiding sexual intercourse.
Withdrawal: Also known as coitus interruptus, this is when the man removes the penis from the vagina so that ejaculation occurs outside of the vagina. In theory, this prevents the sperm from being deposited in the vagina.
According to the United States Health and Human Services (HHS) Office for Population Affairs, each year, for every 100 women who use this method, 20 may become pregnant.
In other words, withdrawal is about 80 percent effective, but this depends on how carefully and how consistently it is used.
The penis does not need to enter the vagina for pregnancy to occur. It can happen if sperm enters the vagina during foreplay, for example.
Barrier devices prevent the sperm from meeting the egg. They may be combined with spermicide, which kills the sperm.
The male condom forms a barrier and prevents pregnancy by stopping sperm from entering the vagina. It is placed over the penis before sexual intercourse begins. A condom is made of polyurethane or latex.
It can also help to prevent the spread of sexually transmitted infections (STIs).
It is around 82 percent effective. Some 18 women in every 100 may conceive if their partner uses a condom.
Condoms are available from drugstores, supermarkets, and many other outlets. Health providers also supply them, sometimes for free.
The female condom, or femidom, is made of polyurethane. It has a flexible ring at each end. One fixes behind the pubic bone to hold the condom in place, while the other ring stays outside the vagina.
Spermicides may be placed in the vagina before intercourse. A spermicide kills sperm chemically. The product may be used alone or in combination with a physical barrier.
The female condom is 79 percent effective. Around 21 women will become pregnant each year with this method.
The femidom is less easy to find than the male condom. Only the FDA-approved FC2 is available in the United States. Health providers may supply them, or you can get them from a drugstore on prescription.
A contraceptive sponge is inserted into the vagina. It has a depression to hold it in place over the cervix. Foam is placed into the vagina using an applicator. The foam is a spermicide that destroys the male sperm, and the sponge acts as a barrier to stop the sperm from reaching the egg.
Between 12 and 24 women out of every 100 who use the sponge may become pregnant.
It is less likely to work if a woman has already had a baby.
A diaphragm is a rubber, dome-shaped device that is inserted into the vagina and placed over the cervix.
It fits into place behind the woman’s pubic bone and has a firm but flexible ring that helps it press against the vaginal walls.
Used with spermicide, it is 88 percent effective. Used alone, it is between 77 and 83 percent effective.
A cervical cap is a thimble-shaped, latex rubber barrier device that fits over the cervix and blocks sperm from entering the uterus. The cap should be about one-third filled with spermicide before inserting. It stays in place by suction.
It is around 88 percent effective if used with spermicide, and 77 to 83 percent effective without.
The contraceptive injection, or “the shot,” is a progestin-only, long-acting, reversible, birth-control drug. The name of the drug is Depo-Provera, also known as the Depo shot or DMPA.
The shot is injected every 3 months at a doctor’s office. It prevents pregnancy by stopping the woman from releasing an egg.
It is 94 percent effective, and the chance of pregnancy increases as the shot wears off. It is important to remember to book another shot after 3 months to ensure its effectiveness.
It does not protect against STIs.
These range from pills you can take to devices that are inserted by a doctor. You need to see a health provider to obtain most of these types of birth control.
The intrauterine device (IUD)
The intrauterine device (IUD), or coil, is a small, flexible T-shaped device that is placed in the uterus by a physician.
There are two types:
A copper IUD releases copper, and this acts as a spermicide. It can last up to 10 years.
A hormonal IUD contains progestin. It prevents the sperm from reaching and fertilizing the egg by thickening the cervical mucus and thinning the wall of the uterus.
It stays in place as long as pregnancy is not desired.
Depending on the type, it will last for 3, 5 or 10 years. It is over 99 percent effective.
The combined contraceptive pill is taken daily. It contains two hormones, estrogen and progestin. The hormones stop the release of the egg, or ovulation. They also make the lining of the uterus thinner.
It is effective for between 91 and 95 percent of women on average.
This is a transdermal patch that is applied to the skin. It releases synthetic estrogen and progestin hormones.
The patch is worn each week for 3 consecutive weeks, generally on the lower abdomen or buttocks. No patch is worn in the fourth week, to allow for the menstrual period. The patches are readily available.
It is estimated to be 91 percent effective.
The contraceptive vaginal ring is a flexible, plastic ring that releases a low dose of progestin and estrogen over 3 weeks. It prevents ovulation and thickens the cervical mucus, so that sperm cannot move easily.
The woman inserts the ring into the vagina for 3 weeks, and then she removes it for one week, during which she will experience a menstrual period.
It is also known as NuvaRing, the trade name for a combined hormonal contraceptive vaginal ring manufactured by Organon.
It is 99 percent effective, but the chance of human error reduces this to 91 percent.
An implant (often known by its brand name, Nexplanon) is a rod with a core of progestin, which it releases slowly. It is inserted under the skin of a woman’s upper arm.
The implant is effective for up to 4 years, but it can be removed at any time, and then pregnancy is possible.
It is 99 percent effective in preventing conception, but it will not protect against an STI.
Emergency “morning after” contraception
Emergency contraceptive pills, or the “morning-after pill,” may prevent pregnancy after intercourse. It prevents ovulation, fertilization, or implantation of an embryo.
It is different from medical methods of termination, because these act after the egg is already implanted in the womb.
Emergency contraception can be used up to 72 hours after unprotected sex. It is 95 percent effective during the first 24 hours, falling to 60 percent by 72 hours.
Emergency contraception should only be used when primary methods fail.
Some people see it as a kind of abortion, because the egg may have already been fertilized.
Sterilization is a permanent method of sterilization.
Tubal ligation: This is a form of female sterilization. The surgeon will cut, block, or burn the fallopian tubes, or a combination of these methods, to seal them and prevent future fertilization.
Tubal implant: A coil is placed in the female’s fallopian tubes. Tissue grows around it, blocking the tubes. It can take 3 months to work.
Female sterilization is over 99 percent effective.
Vasectomy: This is surgery to make a man sterile. The tubes through which sperm pass into the ejaculate are cut or blocked. It is over 99 percent effective.
It is sometimes reversible, but with a higher abundance of abnormal sperm, possibly resulting in lower fertility or birth defects.
Myths about birth control
Myths about birth control have proliferated throughout history, but science has put right some common misconceptions.
You cannot get pregnant while you are on your period: It is not true that a woman cannot get pregnant during her menstrual period. She may be less fertile for the first few days of menstruation, but pregnancy is possible, as sperm can live inside the female body for several days.
You cannot get pregnant if you have sex in a hot tub: Sexual intercourse in a hot tub or swimming pool does not prevent pregnancy. There is also no sexual position that prevents pregnancy.
Urinating or douching after sex prevents pregnancy: Douching with any substance after sexual intercourse does not prevent pregnancy.
Non-medical spermicide: Putting toothpaste or seeds in the vagina does not prevent pregnancy and should never be used as a contraceptive.
Sex without penetration, ejaculation, or orgasm is safe: Even if the man does not ejaculate, the woman can become pregnant. Pregnancy is possible any time the penis—or even sperm during foreplay—enters the vagina. A woman can become pregnant whether or not she has an orgasm or is in love with the man.
Breastfeeding protects against pregnancy: A woman can become pregnant while breastfeeding, although the chance is lower.
Using two condoms offers extra protection: Using two condoms or using a tight condom does not offer better protection than one. Using a male and female condom together may increase the risk of pregnancy, as they can shear and tear.
Contraception is a powerful tool both for preventing unwanted pregnancy. Some methods, such as the male condom, can also reduce the risk of an STI. However, it must be used correctly to do so.
No method of birth control is 100 percent effective. Combining two methods, for example, the pill with a condom, offers extra protection as well as some protection against STIs.
It is important to be informed and to use birth control wisely.
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