Birth Control

Overview

Is this topic for you?

Sometimes a woman may not use birth control, or her method may fail. If this happens to you, you may still be able to prevent pregnancy if you act quickly. For more information, see the topic Emergency Contraception.

What is birth control?

Birth control is any method used to prevent pregnancy. Another word for birth control is contraception (say “kon-truh-SEP-shun”).

If you have sex without birth control, there is a chance that you could get pregnant. This is true even if you have not started having periods yet or you are getting close to menopause. Each year, about 85 out of 100 women who don't use birth control have an unplanned pregnancy.¹

The only sure way to prevent pregnancy is to not have sex. But finding a good method of birth control you can use every time can help you avoid an unplanned pregnancy.

What are the types of birth control?

There are many different kinds of birth control. Each has pros and cons. Learning about all the methods will help you find one that is right for you.

• Hormonal methods include birth control pills, shots (Depo-Provera), the skin patch, the implant, and the vaginal ring. Birth control that uses hormones is very good at preventing pregnancy.
• Intrauterine devices (IUDs) are inserted into your uterus. IUDs work very well for 5 to 10 years at a time and are very safe. And the Mirena IUD contains a hormone that can help with heavy periods and cramping.
• Barrier methods include condoms, diaphragms, and sponges. In general, these do not prevent pregnancy as well as IUDs or hormonal methods do. To help a barrier work better, use it with a spermicide, a chemical that kills sperm.
• Natural family planning (also called fertility awareness) can work if you and your partner are very careful. You will need to keep good records so you know when you are fertile. And during times when you are fertile, you will need to skip sex or use a barrier method.
• Permanent birth control (sterilization) gives you lasting protection against pregnancy. A man can have a vasectomy, or a woman can have her tubes tied (tubal ligation). But this is only a good choice if you are sure that you don't want any (or any more) children.

For hormonal or barrier methods to work best, you have to use them exactly the way your doctor or the package instructions say. Even then, accidents can happen. So it is a good idea to keep emergency birth control on hand as backup protection. You can buy “morning-after pills” called Plan B in most drugstores if you are over 18.

How do you choose the best method?

The best method of birth control is one that protects you every time you have sex. And with many types of birth control, that depends on how well you use it. To find a method that will work for you every time, some things to think about include:

• How well it works. Think about how important it is to you to avoid pregnancy. Then look at how well each method works. For example, if you plan to have a child soon anyway, you may not need a very reliable method. If you don't want children but feel it is wrong to end a pregnancy, choose a type of birth control that works very well.
• How much effort it takes. For example, birth control pills may not be a good choice if you often forget to take medicine. If you are not sure you will stop and use a barrier method each time you have sex, pick another method.
• When you want to have children. For example, if you want to have children in the next year or two, hormone shots may not be a good choice. They can make it hard to get pregnant for several months after you stop them. If you never want to have children, natural family planning is not a good choice because it often fails.
• How much the method costs. For example, condoms are cheap or free in some clinics. Some insurance companies cover the cost of prescription birth control. But cost can sometimes be misleading. An IUD costs a lot up front. But it works for years, making it low-cost over time.
• Whether it protects you from infection. Latex condoms can help protect you from sexually transmitted diseases (STDs), such as HIV. But they are not the best way to prevent pregnancy. To avoid both STDs and pregnancy, use condoms along with another type of birth control.

If you are using a method now that you are not happy with, talk to your doctor about other choices.

What health issues might limit your choices?

Some birth control methods may not be safe for you, depending on your health. To make sure a method is right for you, your doctor will need to know if you:

• Smoke.
• Are or could be pregnant.
• Are breast-feeding.
• Have any serious health problems, such as heart disease, high blood pressure, migraine headaches, or diabetes.
• Have a family history of bone thinning (osteoporosis) or blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism).
• Have ever had breast cancer.
• Have a sexually transmitted disease.

How can you get birth control?

You can buy:

• Condoms, sponges, and spermicides in drugstores without a prescription.
• Plan B emergency birth control in most drugstores without a prescription. But you do need proof that you are 18 or older.

You need to see a doctor or other health professional to:

• Get a prescription for birth control pills and other methods that use hormones.
• Have an IUD inserted.
• Be fitted for a diaphragm or cervical cap.

Some pharmacists will not sell Plan B or fill prescriptions for birth control pills. If this happens to you, ask for the location of a pharmacist who will, or go to:

• The Emergency Contraception Web site at http://ec.princeton.edu, or call 1-888-NOT-2-LATE (1-888-668-2523).
• The Planned Parenthood clinic nearest you, or call 1-800-230-PLAN (1-800-230-7526).

For information about birth control laws in your state, see the Guttmacher Institute’s State Center at www.guttmacher.org/statecenter/contraception.html.

Frequently Asked Questions

Learning about birth control:	What is birth control? How does birth control prevent pregnancy? What are the different methods of birth control? How well do the different methods work? What methods help prevent sexually transmitted diseases (STDs)? What is emergency contraception?
For teens only:	How does pregnancy happen? How does birth control prevent pregnancy? What are common myths about sex and pregnancy? What should I do if I miss or skip a birth control pill?
Using birth control:	What should I know about: Condoms (male and female)? Female barriers (diaphragm, cap, Lea's Shield, or sponge)? Fertility awareness (natural family planning)? Combination estrogen plus progestin methods (pill, patch, or ring)? Progestin-only method (pill or shot)? Intrauterine device (IUD)? Tubal ligation and tubal implants for permanent birth control? Vasectomy for permanent birth control? Emergency contraception after unprotected sex?
Advantages and disadvantages:	What are the pros and cons of hormonal birth control? What are the pros and cons of hormone injections for birth control? What are the pros and cons of IUDs?
How-to questions:	How do I use a condom? How do I use a female condom? How do I use a hormonal skin patch? How do I use a hormonal vaginal ring?
Ongoing concerns:	Which birth control method should I use? Do birth control pills cause cancer? What should I do if I miss or skip a birth control pill? For a planned pregnancy, how long do I wait after stopping birth control to try to become pregnant?

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Author:	Merrill Hayden	Last Updated: May 23, 2006
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology
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