- family planning
Birth control refers to a conscious decision that sexually active couples make to prevent unwanted pregnancy. The decision may result from personal situations, medical conditions, or both.
What is the information for this topic?
Some forms of birth control keep the sperm from fertilizing an egg. Other forms keep the fertilized egg from being implanted. The couple may consider these factors when choosing birth control:
- failure rates
- health risks
- partner involvement
- side effects
Natural family planning methods Many couples choose a natural method because of religious or personal beliefs. Some natural family planning methods are as follows:
- Withdrawal, also known as "coitus interruptus". The penis is withdrawn from the vagina before the male ejaculates. This method has a high failure rate because sperm may enter the vagina before the penis is removed.
- Douching after sex. This involves flushing the vagina with a liquid. This method is not very effective. Many sperm continue up to the ovary and can fertilize the egg.
- The rhythm method. This means a woman avoids intercourse during the middle of her menstrual cycle. This method has a high failure rate. It should only be used by women who have regular, predictable cycles.
- Modern natural family planning. In this method, rather than relying on counting calendar days, a woman determines where she is in her fertility cycle by assessing the position of her cervix, the character of her cervical discharge, and her basal body temperature. In experienced hands, this method has achieved up to 96% effectiveness in preventing pregnancy - not as high as some artificial birth control methods, but considerably higher than other natural methods or, in general, than barrier methods.
- Breastfeeding. This method is not entirely reliable in preventing pregnancy. A backup method of birth control, such as a condom, should be used.
Traditional barrier methods Barrier methods use physical or chemical blocks to keep sperm from fertilizing the woman's egg. Under ideal conditions, these methods have about a 3 to 10 percent failure rate in a year of use, but failure under "typical use" conditions is closer to 20 percent.
These methods include the following:
- Condoms, or synthetic sheaths. Male condoms cover the penis and keep semen from going into the vagina. Female condoms cover the external genitals and the walls of the vagina.
- Spermicides. These are chemicals that kill the sperm in the vagina. They come in the form of jellies, foams, creams, films, or suppositories.
- A diaphragm. This is a flexible rubber cap that is placed inside the vagina.
- A cervical cap. This is smaller than a diaphragm and covers the cervix
HormonesCombinations of female hormones can be used to prevent pregnancy. These methods have well under a 1 percent failure rate when taken correctly. These combinations include:
- oral contraceptives, or birth control pills, which prevent ovulation
- progestin-only birth control pills, or minipills, which do not have estrogen
- progestin implants, which are small plastic rods that are placed beneath the skin to supply small daily doses of hormones
- injections of synthetic progestins, which are hormones given every 3 months
Because the injectable and implantable versions do not depend on having to remember to take a pill, "actual use" effectiveness is much closer to the ideal effectiveness rate, than with the pill.
Intrauterine devices Intrauterine devices, or IUDs, are placed in the uterus. They keep the fertilized egg from being implanted. IUDs have been linked with an increased risk of sexually transmitted disease. They can also increase the risk for pregnancy outside the uterus, or ectopic pregnancy. The Food and Drug Administration cites about a 1-2 percent failure rate for the IUD.
Sterilization Surgery can be performed on a man or woman to prevent pregnancy. A vasectomy in a male involves cutting and tying off the tubes that carry sperm. A tubal ligation in a woman involves cutting and tying off the fallopian tubes. Surgical removal of the uterus, or hysterectomy, also causes sterilization.
This method of contraception has a very low failure rate (well under 1 percent) - but is intended to be permanent and should only be used by individuals or couples who are sure that they do not want any more children. Although it is possible to reverse male or female tubal sterilization, reversals are expensive and may not work.
Emergency contraception Emergency contraception means birth control that is given after unprotected intercourse has taken place. Hormones can be given over a 24-hour period, within 72 hours of the unprotected sex. Another method uses an intrauterine device (IUD). This is placed into the woman's uterus within 5 days after unprotected sex.
Individuals and couples should be aware that emergency contraception (EC), progestin-only hormonal methods, birth control pills and the IUD, may be effective, at least in part, because they prevent an embryo from being implanted in the uterus. Women who believe life begins at conception may not be comfortable using a method of birth control that can, whether by design or otherwise, cause an embryo to not implant in the uterus, and thus to be lost.
Experts debate whether post-fertilization effects occur and how frequently they occur. Nevertheless, since they are possible, it is recommended that each individual and couple should discuss these issues with their healthcare professional.
Abstinence Abstinence, or the avoidance of sexual intercourse, is the only absolutely effective way to prevent pregnancy.