Q&A: Birth Control Effectiveness And Unprotected Sex

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QUESTION: I have been on the birth control pill for the past year. Is it safe to have unprotected sex without getting pregnant? Or could I still get pregnant? My boyfriend and I are both STI-free and we'd like to try sex without a condom.

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At some point in their lives, many women and men become interested in having sex without a condom either so that they can become pregnant or so that they can experience sex in a way that may feel closer, more natural or more sensitive than sex with a condom. However, having sex without a condom opens a couple to greater risks, and you are wise to consider these.

Birth Control Effectiveness

If you have been taking your birth control pills consistently and correctly (as prescribed), then there is little chance of becoming pregnant if you have sex without a condom. Birth control pills are about 99% effective at preventing pregnancy with perfect use, and about 92% effective with typical use.

You and your boyfriend are wise to consider pregnancy risk issues and to pay attention to your risk of sexually transmissible infections (STI), particularly since birth control pills don’t protect against STI.

Depending on when each of you was last tested for STIs, you may want to get tested again if needed. For example, HIV tests are often only considered absolutely accurate if a person gets tested 3-6 months after their last possible exposure.

Issues To Consider

Finally, before having sex without a condom, it may be worth thinking through a few other things in regard to your relationship.

For example, if you were to unintentionally become pregnant, how would each of you feel about raising a child, adoption, or abortion? What are your expectations about exclusivity or monogamy? In what way might having sex without a condom affect your feelings for each other, your sense of closeness, or your anxiety about becoming pregnant? If you stop using condoms, how will you feel about assuming primary responsibility for reducing pregnancy risk? And how will you two share the cost of contraception?

There are, of course, no “right” answers to these questions. Thinking about these issues, however, and talking to each other about these or other aspects of your relationship and sexual life together may help you to make decisions that you both feel comfortable with. And when couples feel comfortable with their sexual decisions, they also expand the possibilities for sexual pleasure and enjoyment.

Dr. Debby Herbenick (M.P.H., Ph.D.)

is a sexual health educator at The Kinsey Institute, Associate Director of the Center for Sexual Health Promotion at Indiana University and author of several books including Sex Made Easy and Because It Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction.
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