Birth Control and Pregnancy

Choosing The Right Contraceptive Method

Choosing the right contraceptive method(s) for you and your partner depends on many factors.

Here are some things to consider when choosing a method of contraception:

  • Use: Will you remember to take a medication (at the same time every day)? Do you know how to use a barrier method? Will you be able to use this method (correctly) every time? Do you understand the instructions for this and other methods? Do you know what happens if you forget to use it? Are you willing to use a backup method?
  • Effectiveness: How well does it prevent pregnancy? What can impact the effectiveness of each method? Would using a backup method make you more comfortable with the effectiveness?
  • Side effects: What happens if you stop a medication? What should you expect when you start a new one? Are you willing to watch out for and deal with the side effects and risks (especially important for hormonal methods, with mood changes and weight gain)?
  • Cost: Does it require a prescription? Doctor visits? Will you have access to this method in the future? Can it be purchased by both partners?

Contraceptive options include:

  • Barrier methods: Condoms, diaphragms, the contraceptive sponge and cervical caps
  • Hormonal methods: Birth control pills (BCPs; also called oral contraceptives (OCs), Long-acting hormonal methods (shots, Mirena and implants), Hormonal contraceptive patch or vaginal ring
  • Behavioral methods: Abstinence, Natural family planning, Withdrawal
  • Other options: Intrauterine devices (IUDs), Emergency contraception, Sterilization/Vasectomy, Spermicides

Pregnancy options include:

  • Abortion
  • Adoption
  • Raising a child

Contraceptive Technology offers a side by side comparison of various forms of contraception.

Understanding Effectiveness

When looking at the effectiveness rating of a birth control option, it is important to remember how effectiveness is measured and what the effectiveness means.

Effectiveness is the average rate of success for sexually active couples using this method for one year. For example, with typical use, male condoms are about 85% effective. This means that for a large sample of couples using exclusively male condoms for one year, about 85% of them did not get pregnant (15% of the couples sampled did get pregnant).

So, the failure rate for each individual time using a condom is much lower, while the lifelong effectiveness rate compounds failure rates for every year.

Effectiveness is often divided into “perfect use” and “typical use”.

  • Perfect use is a measure of effectiveness when the method of birth control is used correctly every time (ie. Taking the pill at exactly the same time each morning, always leaving space at the tip of condoms applied with lube) and for every instance of intercourse.
  • Typical use is a measure of the effectiveness of the method as it is generally used, with some error in use and application. Typical use accounts for mistakes on the part of those providing instructions on how to use the method, mistakes on the part of the method’s users, conscious non-compliance, and impeded access to the method.