Women use contraception for many reasons, but the primary reason is to prevent pregnancy. There are many options for contraception and some options are more effective than others. Choosing the right method for YOU can be confusing at first, but a conversation with your midwife or provider can help.
Natural Family Planning/Fertility Awareness:
1 in 4 women will be pregnant within a year using this method. The sad, tired, worn out joke goes: What do you call couples that practice Natural Family Planning? Answer: Parents.
Natural Family Planning involves a commitment to learning about your cycle, reading your body signals daily, and a commitment by both partners to practice abstinence during your fertile periods. This method can be highly successful for motivated partners.
Barrier Methods: 1 in 4 women will be pregnant within a year using this method, but you can purchase these over the counter without a prescription from a provider.
Diaphragm: The only diaphragm on the market currently is the Caya. It is a one-size fits all diaphragm that can be purchased over the counter at pharmacies. Coupled with a spermicide, it can be effective if used properly. This is a great option if you do not wish to become pregnant, do not want an implant inside your body, and are willing to use the Caya every time you have sex.
Condoms: This method has the benefit of protecting against sexually transmitted infections. Your partner must be willing to use the condom every time you have sex. The downside is that they can break, leak, slip, or just not be used.
Hormonal contraception options: About 1 in 15 women will become pregnant within a year using these methods. All of these methods require a prescription by a provider, but there is legislation in some states to make some of these methods available in the pharmacy without a provider visit.
Pills: The tradition birth control pills contain two hormones, estrogen and progesterone. The Mini Pill contains only progesterone. They do have a slight increased risk of blood clots, so your provider will investigate your medical history and ask questions related to migraines, heart disease, blood clotting disorders, seizures, and other medical complications. The pills are very effective if taken every day, but missing even one pill can cause you to ovulate and place you at risk of pregnancy.
Patch: If you choose the patch, you place a new patch on your skin every week for three weeks. The fourth week you do not wear a patch and you get your period. The hormones in the patch are both estrogen and progesterone. If you are overweight, the hormones might not work as effectively for you due to absorption issues through the skin.
Ring: The NuvaRing is a soft plastic ring that you can place in the vagina for three weeks. The hormones estrogen and progesterone slowly absorb into your body. The fourth week, you remove it and have your period. Some women love the convenience and some women report being able to feel the ring in the vagina.
Depo Shot: The hormonal method of birth control that has the greatest documented side effects is the Depo shot. It is an injection of high dose progesterone that you get every 3 months. For the first 3-6 months you can have very irregular spotting and bleeding, but usually after the 2nd or 3rd dose, your periods go away. It can take 18-24 months for your fertility to return after you stop the Depo shots. Major side effects include depression and weight gain.
Long Acting Reversible Contraception (LARC): <1 in 100 will get pregnant using these methods. They are as effective as tying your tubes but completely reversible.
Nexplanon: The Nexplanon is a small plastic rod that is inserted into your arm. It stays there for 3 years, slowly releasing progesterone every day to keep you from ovulating. The side effects can include unpredictable spotting, headaches, increase appetite, and depression. After about one year, many women report that their periods have stopped, but they will return when the Nexplanon is removed.
IUD: There are two forms of IntraUterine Devices: the Mirena and the Paragard. Both are inserted into the uterus and act primarily against sperm to prevent pregnancy. The Mirena lasts for 5 years, releases a small amount of progesterone to thin the lining of the uterus, and many women report lighter or no periods while using the Mirena. The Paragard lasts for 10 years, contains no hormone, but your periods might be heavier with heavier cramping. Both of these must be placed by a trained provider.