An Overview of Birth Control

What Is Birth Control?

The term “birth control” refers to a broad spectrum of methods that partners engaging in sexual activity use to prevent pregnancy. The most common types of birth control are hormonal methods, barrier methods, surgical procedures, withdrawal, and abstinence. In the United States, over 40% of women are using some form of birth control, and 33% of men report that they use condoms.1 However, only 24% of men report that they use condoms every time they have sex.2 The primary reason to use birth control is that it prevents unwanted pregnancies. Couples who are engaging in sex have the option to be intimate without the risk of an unwanted pregnancy. However, there are several distinct advantages of using birth control on a regular basis for both men and women. The two most common non-pregnancy-related advantages of using birth control are protection from sexually transmitted infections (STIs) for both partners and more manageable periods for women.

 

A Brief History of Birth Control

Modern birth control is still a relatively new concept in the United States and around the world. New forms of birth control, as well as legislation regarding what is deemed appropriate, are constantly evolving. Depending on the area of the United States that somebody lives in, a person who is under the age of 40 may have never experienced any opposition to their desire to use birth control, while many others may have been met with great resistance.

Margaret Sanger is generally considered the pioneer of modern birth control.3 Sanger was a nurse who felt that unintended pregnancies were a hindrance on women’s freedom because raising children kept them from being able to pursue other goals. She became an outspoken activist for birth control in the early 1900s and opened up a birth control clinic in 1916. Sanger was arrested for being a public nuisance and given a short jail sentence. However, this resistance did not stop her, and she continued her work into her elderly years. In the 1950s when Sanger was in her 80s, she helped raise a large amount of money and did the research to get the first birth control pill on the market. In 1960, the Food and Drug Administration (FDA) finally approved the first birth control pill.3 Throughout the decades, birth control methods have evolved and been heavily debated. During the 1960s through the 1970s, the first intrauterine device (IUD) and hormone pills for women were introduced in mass quantities.3 In the 1990s, the first implant for women as well as emergency contraceptives were introduced.3 Every decade, there have been tremendous steps forward in making safer and more effective birth control available.

 


Margarat Sanger being arrested circa 1916 in Brooklyn, NY

 

While primitive types of condoms and spermicides have existed for hundreds of years, modern and effective birth control has only been accessible and legal for about 60 years.3 When considering the various alternative options people now have with birth control in the United States, including legalized abortions and more advanced and effective methods, the time of legal and accessible birth control drops from 60 years to around 20 to 30 years.

Effectiveness of Birth Control

The effectiveness of birth control is measured by two separate criteria. The two specific ways that a method of birth control is judged is by its “perfect-use failure rate” and “typical-use failure rate.”4

The perfect-use failure rate is the percentage of how often a method of birth control will fail when it is used every time partners engage in sexual activity, and if it is used exactly as the manufacturer has intended. For example, when male condoms are used properly every single time the male has sexual intercourse, the failure rate is only 2%. This means that if 100 men have sex by the manufacturer’s standards and wear condoms every time, only 2 of those condoms will malfunction.5

The typical-use failure rate is a more accurate percentage to judge a birth control method by. This percentage is found by observing the number of unintended pregnancies among people who actively use birth control. When we look at the typical-use failure rate for condoms, the percent jumps up to a much higher 18% failure rate.5 There are several reasons for this drastic change in the failure rate. Many males wear condoms on a consistent basis but still sometimes choose to refrain from condom use or may even forget to use protection. Other times they are used incorrectly, or the wrong type is used. Some people believe that it is efficient to use more than one condom at a time. However, this will only create friction that can tear or break them. A male should never use two male condoms with the belief that there will be twice the protection, and the same is also true for using a male condom with a female condom. There are many reasons why a condom may fail if used incorrectly.  

Because the typical-use failure rate is taken from a large sample of men and women, it is more accurate to judge birth control by this standard. The typical-use failure rate is highly fluid and different for each person based on that person’s habits. For example, if the average perfect-use failure rate for male condoms is 2% and the average typical-use failure rate is 18%, one male might be more careful than most people and have an individual failure rate of 5%, while a male who rarely wears condoms (or uses them improperly) may have a 50% failure rate.

Types of Birth Control

This section will discuss the different types of birth control and how effective each one is so that you can make an informed decision about which type might be best for you personally. This article will review five primary types of birth control. These will include the advantages and disadvantages of barrier methods (condoms), hormonal methods (the pill, the implant, the shot, IUD, etc.), surgical methods (abortion, vasectomies, tubal ligation), withdrawal, and abstinence.

Barrier Methods

Barrier methods of birth control provide a physical barrier between the male’s ejaculate and the female’s reproductive system. Some of these methods also create a barrier between partners’ genitals. The advantage of using barrier methods in terms of pregnancy is that the sperm is prevented from travelling to the female’s egg, which is the process that begins a pregnancy. Another advantage of some barrier methods is that they allow people who can potentially transfer sexually transmitted infections (STIs) to their partners to instead have safe sex. Some barrier methods not only block and contain ejaculate, but also contain chemicals called spermicides that kill sperm, adding an extra layer of protection against pregnancy. Male condoms, female condoms, cervical caps, and diaphragms will be discussed.

Male Condom

Perfect-Use Failure Rate: 2%
Typical-Use Failure Rate: 18%

Male condoms are one of the easiest methods of birth control to acquire without access to insurance or consulting with a doctor. The condom is a lining that is placed over the entire penis before intercourse. They are generally made out of latex, although people allergic to latex can use a polyurethane alternative. Most condoms come pre-lubricated, although some do not. If you decide to add lubricant to the condom, make sure that the lubricant is water-based to prevent the condom from ripping. Many condoms also come with a spermicidal lubricant applied to it. When using a condom, the first step is to find out which way the condom rolls down. Once this has been figured out, insert your finger into the center of the condom with the rolled-up part in a position where it can roll down the rest of your finger. Pinch the end of the condom, place it at the tip of your penis, and roll it down to the base. The reason to pinch before rolling the condom down the penis is to create an empty space, referred to as the “reservoir,” for sperm to collect once you have ejaculated.7

There are many varieties of condoms in size, material, and thickness. The most important aspect of using condoms is to choose the correct type for your penis. Because condoms can take away from the physical sensation of sex, many manufacturers create thinner condoms to increase sensation. However, these condoms often break and men should be careful when using them. Some men also buy condoms that are too big (such as Magnum condoms). These are ineffective, as they can slip off during intercourse, or sperm can leak out of the bottom if used by someone with a penis size not intended for the size of that condom. Below is a short list of the pros and cons of male condoms:

Advantages
- Easily accessible
- Affordable
- 98% effective against pregnancy when used correctly
- Protects against sexually transmitted infections

Disadvantages
- Decreases sensation during sex
- Sometimes reduces spontaneity or creates awkward moments when putting on right before sex
- Need to be kept in cool places and expire at different rates
- Males must maintain erection for duration of condom use

 

Female Condom

Perfect-Use Failure Rate: 5%
Typical-Use Failure Rate: 21%

The female condom performs almost identically to the more commonly used male condom. It is made from a latex material and has one hardened ring on each end to help maintain its shape and form. The female condom is inserted into the vagina with the closed end being placed near the cervix and the open end resting outside of the vagina. Similar to the lubrication found on the outside of male condoms, female condoms contain lubrication on the inside. The female condom is also the only form of female birth control that protects against both pregnancy and sexually transmitted infections. Never use a female and a male condom together, as the friction between the two of the is likely to cause tears in one or both of the condoms and reduce its efficacy.

Advantages
- Protects against both pregnancy and sexually transmitted infections
- Can be inserted prior to sex to increase spontaneity
- Male does not need to maintain an erection for it to work

Disadvantages:
- May reduce erotic sensitivity or produce distracting noise
- Male may accidentally insert his penis into the vagina outside of the condom
- Entire condom may be pushed into the vagina during coitus

 

The Diaphragm and Cervical Cap

Perfect-Use Failure Rate: 6%
Typical-Use Failure Rate: 12%

 

 

 

 

 

The diaphragm was one of the first types of birth control for women and was incredibly popular before the far more effective and easy-to-use oral contraceptives came to the market. With newer and more convenient birth control methods available now, the diaphragm has lost its popularity, with only 1 in 50 American women still using it.8 The diaphragm is a dome-shaped piece of latex or silicone with a stiff-but-flexible strip around the perimeter. This barrier device sits in the vagina in front of the cervix, blocking the passage of sperm. Because sperm can migrate around the edges of the diaphragm, it must be used in conjunction with either a spermicidal jelly or foam. The diaphragm must also be fitted by a medical professional and left in for at least six hours after sex to remain effective, causing it to be a less popular option in present day.8 The cervical cap is a smaller type of diaphragm that actually holds on to the cervix, similar to a suction cup.        

Advantages
- Can be inserted before sexual activity
- Relatively cheap
- Does not typically affect sensation during intercourse
- Long-term use has been shown to reduce instances of cervical cancer
- Cervical cap can be used if women have difficulty inserting diaphragm

Disadvantages
- Inconvenient for women to have it fitted, clean it, to insert and remove it.
- Occasional urinary tract infections occur, and spermicides may cause other irritations.
- Can become dislodged during intercourse
- Failure rate for pregnancy and sexually transmitted infections is higher than alternatives
 

A Final Note on Barrier Methods

For those who are sexually active, barrier methods are the only method of birth control that will provide protection from both unwanted pregnancies and sexually transmitted infections. While other forms of birth control (primarily hormonal) may prevent against pregnancy, they do not prevent the possible bacteria and/or viruses that are transmitted through bodily fluids, such as semen. As with any type of birth control, barrier methods are most effective when combined with another form of birth control. However, using some barrier methods simultaneously (two condoms at once) will significantly reduce the efficacy and increase the risk of failure. Spermicidal jelly or foam is often a good idea to incorporate during intercourse. Some women find that the chemicals in these foams or jellies irritate the lining of the vagina, but for those who do not have this issue, they are strongly recommended. For example, if a condom breaks during intercourse, the spermicide will provide extra protection against an unwanted pregnancy. These chemicals are not ideal for every female, as they often cause irritation. However, if they do not cause an irritation, they are a great addition to the protection that barrier methods provide.

Hormonal Methods

Hormones are chemicals found in our bodies that control how our bodies regulate themselves.9 Appetite, sleep, mood, stress, excitement, and essentially everything that is felt on a biological level is the result of hormonal balance or imbalance.9 Two hormones that are incredibly relevant with regard to sex and females are estrogen and progesterone.10 Estrogen is a hormone that is produced in the female’s ovaries and her adrenal glands. This hormone is responsible for the growth of pubic hair and breasts, and helps to strengthen the lining of the uterus to hold an egg once one has been implanted. Similar to estrogen, progesterone is a hormone that helps prepare the body for pregnancy and maintains the menstrual cycle.11

 

The purpose of these hormones is to regulate the menstrual cycle and create a safe and strong environment in the uterus for a potential pregnancy. So, the goal of the several types of hormonal birth controls are to disrupt the ability for these hormones to do what they are designed to accomplish. This is why hormonal birth control methods are extremely effective at creating an environment in the female body that will not maintain a pregnancy. While these methods are highly effective, they are also known to have negative side effects for many women. There is always the possibility for an adverse reaction to a hormonal method of birth control. However, as technology has improved and new forms of this birth control have been tested and used, the negative effects of modern-day hormonal birth control are more limited and manageable.

Birth Control Pills

Perfect-Use Failure Rate: 0.3%
Typical-Use Failure Rate: 9%

There is a wide variety among types of birth control pills. However, when taken as directed, they are one of the most effective forms of birth control on the market.12 The two main types of birth control pills are combination pills (those containing estrogen and progestin) or a pill containing progestin only. Choosing the right type of birth control pill to take is a decision that is something that should be discussed with your doctor. Because these pills come in different strengths, have different chemical/hormonal balances, require ingestion in different cycles, and have different side effects, it would be best to come up with a plan with your doctor.13 Many females find that the combination pills help reduce cramps, shorten periods, and sometimes reduce acne.14

However, the estrogen in these pills can often cause headaches, nausea, and increase the chances of heart disease and strokes in women over age 35.14 For these reasons, the progestin-only pill is ideal for many females, as they do not have as many side effects as the combination pill. Generally, with the combination-pill packs, there are four to seven pills that contain only a small percentage of hormones and are intended to keep you in the habit of taking the pill every single day. The start of these “placebo” pills is when a woman will begin her period, which will ideally be shorter and less intense than if she were not on the pill. However, because the progestin-only pills do not contain these placebo pills, they must be taken every single day and at the same time to remain effective.14 

There is an almost endless amount of advantages and disadvantages to birth control pills based on the wide variety of those available and the methods for taking them. Every female will react differently based on her own physiology. Here are some general advantages and disadvantages of the birth control pill:

Advantages
- Is extremely effective at preventing pregnancy when taken as directed
- Taking is easy and does not interfere with spontaneity during intercourse
- Reduces cramps, bleeding, and overall time of period
- Can be discontinued safely if/when a female decides to become pregnant
- Can clear acne and prevent bone thinning (combination pill)

Disadvantages
- Lowered sex drive, weight gain, mood changes, and nausea from the hormones
- Spotting in between periods
- Small chance of developing blood clots in the legs or lungs
- Do not prevent against sexually transmitted infections

 

The Implant

Perfect Use Failure Rate: 0.05%
Typical Use Failure Rate: 0.05%

A more recent method of hormonal birth control is the implant, sold under the name of either Implanon or Nexplanon.15 This form of birth control has become incredibly popular over recent years due to its ease of use and general lack of negative side effects. The implant is inserted into the arm of a female by a doctor and is effective for three years. It is a progestin-only method of birth control, meaning that the negative side effects that many women experience with combination pills do not take place. Also, because the progestin-only pill must be taken every day at the same time, there is a higher chance of that method failing, leading to pregnancy. With the implant, the possibility of forgetting to take a pill is no longer a potential risk. Because the implant does not begin to work immediately, the biggest reason for its failure rate is that females sometimes have unprotected sex directly after having it inserted.15

Advantages
- Most effective non-sterilization form of birth control
- Requires no thought or effort once inserted
- Can be removed at any time without consequence

Disadvantages
- Can cause spotting like other progestin hormone methods
- Must be inserted by a doctor
- Expensive
- Does not protect against sexually transmitted infections

 

The Intrauterine Device (IUD)

Perfect-Use Failure Rate: 0.5%
Typical-Use Failure Rate: 0.8%

The IUD was the first form of hormonal birth control that could be inserted. While this method was invented in the very early 1900s, it did not become popular until the 1950s-70s.16 Unfortunately, the IUD received a very bad reputation due to the early production and style. The first device that reached massive success was called the Dalkon Shield and was shaped similarly to a small beetle.17 Due to a great deal of misinformation about this type of birth control, IUDs were failing due to incorrect placement, females were developing infections with them, sometimes leading to infertility and miscarriages.17 While the IUD of today is very safe and doctors are highly educated about them, the public image of the IUD has never fully recovered from all of the serious problems they caused in the 1970s.

Today, the IUD comes in two basic forms: hormonal (progestin-only, similar to the implant) and copper. The structure of the IUD now resembles a small “T” which is placed in the uterus by a doctor. The hormonal IUD acts in an almost identical fashion to the implant by releasing progestin to prevent pregnancy. It is also effective for 3-5 years and the effects of it are immediately reversible once it is removed.
The other form of IUD on the market is made of copper and does not contain hormones. This IUD acts as a spermicide, rather than altering the lining of the uterus. Unlike the hormonal IUD, the copper IUD lasts for 10 years and can be used as an emergency contraceptive if inserted by a doctor five days after sexual intercourse.18

Advantages
- Highly effective
- Easily reversible
- Does not require the user to remember to do anything

Disadvantages
- Can cause irregular bleeding and cramping for up to 6 months
- Has the potential to cause ectopic pregnancy
- Expensive
- Does not protect against sexually transmitted infections

 

The Birth Control Shot

Perfect-Use Failure Rate: 0.2%
Typical-Use Failure Rate: 6%

The Depo-Provera shot is another popular hormonal birth control method for those who do not want to take a pill every day. However, this shot is only effective for an average of three months therefore, women must remember to go to their doctors about four times per year in order to maintain its efficacy.19 Similar to the IUD and the implant, Depo-Provera uses progestin to prevent ovulation and thicken the mucus on the inside of the uterus, in turn preventing pregnancy. While the IUD and implant provide consistent protection against pregnancy over a span of three to five years, the administration route of the progestin is through a doctor. This means less efficacy if a female forgets to go to the doctor or does not get the shot at the correct time.

Advantages

- Requires less diligence than the pill
- Highly effective when received regularly
- Not as invasive as the IUD or the implant

Disadvantages

- Does not protect against sexually transmitted infections
- Progestin causes irregular spotting
- Potential to forget to see the doctor reduces the efficacy

 

The Contraceptive Patch

Perfect-Use Failure Rate: 0.3%
Typical-Use Failure Rate: 9%

The contraceptive patch is another form of hormonal birth-control that contains both estrogen and progestin. This means that females who have had problems with the combination birth control pill may not benefit from the patch in the way it was intended. Similar to the other hormonal birth-control methods, the patch releases estrogen and progestin into the bloodstream for one week. This means that patches must be changed three times per month, allowing one week with no patch to start the menstrual cycle. Similar to the problems that arise from the birth control shot, the frequency of use is often the biggest reason why this method of birth control can be ineffective. A female may wear the patch longer than it was intended or simply forget to put a new one on at the end of the “off” week.

 

 

 

Advantages

- Highly effective when used properly
- Has the positive aspects of estrogen for young females
- Inexpensive compared to other methods of hormonal birth control
- Non-invasive

Disadvantages

- One of the easiest hormonal methods to misuse
- Can cause negative reactions in females sensitive to estrogen
- Does not protect against sexually transmitted infections.

 

The Vaginal Ring

Perfect-Use Failure Rate: 0.3%
Typical-Use Failure Rate: 9%

The vaginal ring, most commonly known as the NuvaRing, was approved as an effective birth control method in 2001.21 A major selling point to this method of birth control is how efficient it is, without the need for a doctor to insert it. A female keeps it inserted for three weeks and then will remove it for one week to allow for her period. This method is very similar to the birth-control patch in that it allows females to use it on their own time, does not require a doctor for insertion, has strong efficacy ratings, and contains a combination of estrogen and progestin.

Advantages

- Highly effective when used properly
- Has the positive aspects of estrogen for young females
- Inexpensive compared to other methods of hormonal birth control
- Non-invasive

Disadvantages

- One of the easiest hormonal methods to misuse
- Can cause negative reactions in females sensitive to estrogen
- Does not protect against sexually transmitted infections.

 

A Final Note on Hormonal Methods

When used correctly, hormonal forms of birth control are the most effective methods for preventing pregnancy. These are also generally considered the easiest method of birth control to use (other than no birth control or sterilization). However, there are three things to consider when using hormonal methods. The first consideration is the cost of these methods. With or without insurance, some of these methods can cost hundreds of dollars. The IUD will cost hundreds of dollars upon insertion because the cost goes to pay the doctor who inserts it and for the convenience of having 3, 5 or 10 years’ peace of mind knowing that you will not become pregnant. The most common type of hormonal birth control currently is the combination pill.22 These may not be as expensive up-front, but over the months and years they will add up in cost. Hormonal methods are expensive because, when used correctly, they are verifiably the most effective birth control methods on the market.

The second thing to consider is how the hormones will affect you. As mentioned earlier, hormones and neurotransmitters in the body control everything about how the body feels and performs. When you add or take away hormones, there is the possibility for either increased benefits or harmful disadvantages. For example, estrogen helps maintain bone density, can clear acne, and can make period cramps and bleeding much less severe, however, in others the estrogen can lead to heart disease and stroke (mostly among smokers and women over 35 years of age). These are issues to discuss with your doctor. Lastly, the final thing to consider with all of the hormonal birth control methods is that none of them protect against sexually transmitted infections. It is their purpose to disrupt your body’s ability to ovulate and sustain a fetus. However, they do nothing with regard to bacteria and viruses that may transmit during unprotected sex. This is why it is always recommended that a condom be used with any type of hormonal birth control to protect against both pregnancy and sexually transmitted infections. If the idea of using condoms is unappealing to a female who is very responsible with her birth control or who has a long-term method (IUD, Nexplanon Implant), she and her partner should both get tested for sexually transmitted infections before engaging in sexual activity without a barrier method. These hormonal methods are extremely efficient, but they are not 100% effective, so the additional use of a condom still provides added protection against pregnancy.  

Natural Methods of Birth Control

Fertility Awareness

Perfect-Use Failure Rate: 5%
Typical-Use Failure Rate: 24%

The fertility-awareness method of birth control is a natural way that females decrease the risk of pregnancy by timing their menstruation cycles, participating in abstinence through a part of the month, or using condoms for a small portion of the month. This method of birth control is the most involved for the female, as each type of fertility awareness method requires her to be aware of what her body temperature means and to do some basic calculations. There are a few different ways to accomplish this in a semi-efficient way. These two methods are based on bodily observations. When the body temperature rises slightly (by about 0.4°F), this generally means a female is ovulating.23 For three to four days after this change, the female must abstain from sex (abstinence) or use condoms with her partner. After this time has passed and her temperature is back down, she has completed her cycle and may go back to having unprotected sex. Another similar method is to observe the consistency of the cervical mucus. The mucus should be much more clear and slippery during ovulation. A female should practice abstinence or use condoms during this time. The last method of this kind of birth control is the calendar method, in which 6 to 12 months are spent recording the menstrual cycle, and an average is found over this period of time to figure out when ovulation is occurring and when to abstain from sex.

Advantages

- Free (other than a thermometer)
- Natural

Disadvantages

- Requires a significant amount of time and attention
- Is prone to human error and miscalculation
- Does not protect against sexually transmitted infections

 

Withdrawal

Perfect-Use Failure Rate: 4%
Typical-Use Failure Rate: 22%

Withdrawal, or “pulling out” is an incredibly common technique that males generally prefer to use. The perfect-use failure rate of 4% makes this seems like an effective method. However, this is only when withdrawal is used with a condom (however, this method is usually used instead of a condom).24 The purpose of withdrawal is to pull the penis out of the vagina right before orgasm in order to avoid ejaculating inside the female and causing pregnancy. However, this is very risky when considering that semen and sperm can be present during pre-ejaculation, which can cause pregnancy and other sexually transmitted infections.

Advantages

- Natural
- Allows both partners to enjoy natural sensation

Disadvantages

- Highly ineffective, even when considering for human error
- Does not protect against sexually transmitted infections.

 

Surgical Methods of Birth Control

Perfect-Use Failure Rate: 0.002%
Typical-Use Failure Rate: 0.01%

Sterilization

For Females:

Tubal Ligation, or having one’s “tubes tied,” is the most common form of female sterilization. This is done by interrupting the ability of the sperm and the egg to meet in the fallopian tubes. This is done surgically by making two incisions in the upper and lower areas of the fallopian tubes. Once this has been done, the surgeon then clamps these openings shut to prevent the passage and safe harbor of a sperm and an egg. There is also a method in which implants are inserted through the cervix, travel up the uterus, and stay in the fallopian tubes, where they create scar tissue that results in sterilization. Generally, the surgery takes thirty minutes, and the woman can return home on the same day. However, this is an invasive procedure.25

 

Sterilization

For Males:

Male sterilization, most commonly referred to as a “vasectomy,” is similar to the tubal ligation that women receive for sterilization. The vas deferens are the tubes that carry sperm from the testicles to the urethra and out of the penis during ejaculation. During a vasectomy, the vas deferens are tied, cut off, or blocked so that the sperm cannot leave the penis. Seminal fluid will still come out, as this fluid comes from the Cowper’s gland and the prostate gland (which are not affected), but the sperm itself will not come out. This procedure is less invasive than female sterilization, but they are both meant to be 100% permanent.

 

Neither male nor female sterilization will affect pleasure or sensation during sex, but neither will protect against sexually transmitted infections either. While both of these are meant to be permanent solutions with regard to pregnancy prevention, it is not impossible to reverse the procedure. It is easier for male sterilization to be reversed. However, the male is only going to be able to impregnate a female with a 30-70% chance of the possibility he had before the procedure.27 Both of these options should be considered seriously and in-depth before a decision is made, considering the intention of these procedures. This process is less invasive for the male and more easily reversible. In a permanent relationship, it is generally recommended that the male receive this surgery as a form of birth control. Other reasons people choose to sterilize themselves are based on certain factors in their lives, such as an inability to support another child financially or a high risk of passing down a congenital illness.

 

Other Methods of Birth Control

 

Abstinence

Abstaining from penile/vaginal sex entirely is the most guaranteed way to avoid becoming pregnant. Abstinence is oftentimes incredibly popular among those in the United States who are very religious. However, for the sake of this article, abstinence does not qualify as “birth control.” Abstinence prevents pregnancy, but this article is intended to discuss how to prevent pregnancy for those who engage in sexual activity. Abstinence can be used as a practice to prevent pregnancy or as a personal choice. If a person feels as though they are not ready to engage in sexual intercourse, then that should be respected by their partner. Coercion into sexual intercourse is sexual assault.

Generally, abstinence becomes a problem when society tries to teach it as a method of “birth control,” rather than treating it as a personal choice that should be respected.28 In the past when the United States has tried to teach abstinence as a method of birth control, it has led to incorrect sexual education that primarily teaches the fear and consequences of sex in an exaggerated proportion and leads to misinformation about how to have safe and protected sex once people are ready.28

 

Emergency Measures

It can be extremely stressful when a person or a significant other becomes pregnant, regardless of whether or not birth control was used properly and/or effectively. If an unintended pregnancy occurs, there are a few options for how to manage this situation.

 

Emergency Contraception

The most commonly used form of emergency contraception in the United States is the morning after or “plan B” pill. This medication releases high amounts of progestin and can be used up to five days after unprotected sex.29 It should be understood that the sooner this “Plan B” pill is taken, the more effective it will be. This medication works by creating an abundance of progestin, which prevents ovulation. This pill will not be effective and should never be used after five days because it will not prevent the formation of a fetus. This contraceptive needs to be purchased from a pharmacy but does not require a prescription. An alternative to the “Plan B” pill is an “anti-progestin” pill that works by altering how the female body uses progesterone. It is equally effective all five days following intercourse that it is taken, however it requires a prescription, making it more expensive and harder to obtain.29

 

Adoption

If a female becomes pregnant and cannot keep the child, adoption may be the option that she believes is best for her situation based on personal or religious beliefs.30 Putting a child up for adoption can be an extremely difficult and emotional process for many women. Before making the choice to carry the fetus to term, a female should consider whether she has any other options to take care for the child. There are several couples who cannot have their own children due to their own fertility complications, so adoption is a great way to provide a child with a loving household with the resources to provide the utmost care.  

 

Abortion

If a woman becomes pregnant and cannot carry the fetus to term, or does not have the financial ability to maintain her health during her pregnancy, abortion may be the best option. While this is a highly controversial and debated concept in the United States, roughly 650,000 abortions are performed yearly in the United States, according to the Center for Disease Control (CDC).31 There are two types of abortions: surgical and medical

 

Surgical Abortions
Most women that live in states that have laws allowing surgical abortions prefer to take this route. The procedure uses light suction and can be done up to 16 weeks after the last period.32

This procedure takes roughly 5-10 minutes in the clinic, and the physical after-effects are minimal. There is a slightly more invasive surgical abortion procedure that must be performed after the 14-16 week mark has passed, but the effectiveness and time of the procedure are virtually the same.

Advantages

- Only takes 5-10 minutes
- Is more effective
- Less physical side effects

Disadvantages

- Invasive
- Can cause cramping

 

Medical Abortion
The other type of abortion is known as a medical abortion. This involves a visit to the doctor’s office where the physician gives the female a pill up to 9-10 weeks after pregnancy, and then has her take the second pill 6-48 hours later when she’s at home.32 This medication is essentially forcing the body to have a miscarriage.

Advantages

- Can be done in private
- Feels more natural than the surgical method

Disadvantages

- Less effective
- Takes longer to accomplish
- Not as predictable
 

A Final Note On Emergency Measures

The emergency contraceptive pill should never be taken as a regular method of birth control. The only time it should be taken is if it is immediately apparent that another method has failed (i.e. the condom broke). If a woman chooses to keep the child or to have an abortion, it should be known that both of these options are extremely difficult for the woman to process, and one of the most life altering-decisions she can make. Regardless of the decision she makes, she should receive the utmost amount of respect and support. Abortions are highly controversial and heavily debated in the United States, with many clinics being out of reach for those who need their services, and with tight regulations being put on ones in certain states that oppose them. For example, in several states, a woman does not have the choice for a surgical abortion, and must go with the medical option. If a method of birth control has failed, and it comes down to making a very difficult decision, a person needs to surround themselves with support because no decision will be an easy one.

 

References:

1.     A Brief History of Birth Control in the U.S. (n.d.). Retrieved from ourbodiesourselves.

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32.  Planned Parenthood. (n.d.). Abortion Information | Information About Your Options.

 

Last Updated: 3 June 2018

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