Birth Control FAQs

If you are of childbearing age, you may consider using a form of birth control to prevent becoming pregnant. The practice of preventing pregnancy is as old as human existence. For centuries, humans have attempted to avoid pregnancy at certain times of their lives to accommodate their careers, marital situations, and preferences.

Today, the voluntary control of fertility is of paramount importance to modern society. From a global perspective, countries currently face the crisis of rapid growth of the human population that has begun to threaten human survival.

According to the Population Reference Bureau's 2003 World Population Data Sheet, the world's current growth rate is 1.3%. Based on this growth rate, the population would double in 53.8 years. The less developed world's natural increase rate (births minus deaths, without migration) is 1.6%; therefore, population in these countries would double in 43.8 years. See the Population Reference Bureau's 2003 World Population Data Sheet for more information. The United Nations lists a growth rate of 2.41% for the least developed countries, which would imply that at the current rate, populations in these nations would double in 29 years. This information can be viewed at the United Nations Population Database.

Keep in mind that doubling time cannot be used to project future population size because it assumes a constant growth rate over decades when growth rates are constantly changing. Nevertheless, these figures do provide a picture of how fast the population is growing at present.

The ability to control whether and when you become pregnant can affect your ability to achieve your own goals and can contribute to your sense of well-being.

Your choice of birth control method involves factors such as how easy it is to use, safety, risks, cost, and personal considerations. Each form of birth control has its own advantages and disadvantages.

If you are a woman and would have trouble remembering to take a pill each day, daily birth control pills may not be your best choice. Talk with your health care provider about the method that is right for you.

Sexually transmitted diseases are easily spread and can have serious consequences for your health and the health of a child if you become pregnant.

The male condom is the best way to protect yourself against getting or spreading a sexually transmitted disease such as genital herpes or chlamydia or more serious HIV (which leads to AIDS). Talk with your health care provider and your sexual partner about your concerns. Risks exist, even with condom use. Condoms can break during sexual intercourse. Using condoms correctly can minimize these risks.

See Birth Control Barrier Methods for more information about condoms.

Tubal sterilization is a surgical procedure for women. Vasectomy is a form of permanent sterilization for men. Both are intended to be permanent and are not easy, and sometimes not possible, to reverse. The decision to have a permanent form of birth control must be taken seriously and should involve you and your spouse or partner. See Birth Control Permanent Methods for more information.

Each birth control method has a failure rate. Even the permanent forms of sterilization, tubal ligation and vasectomy, are not 100% effective. Understand your risks for pregnancy before you have sexual relations. Combine methods to further lower your risk.

Check out the birth control methods and failure rates at this link from the Food and Drug Administration: Birth Control Guide.

Some insurance plans pay for birth control pills and other birth control methods that are available by prescription only. Some insurance plans do not pay for prescription birth control methods. 

Before you begin a hormonal birth control method, such as the birth control pill, check into the cost by asking at your pharmacy (doctors generally do not know the costs) and asking your insurance company if they cover it. If you don’t think you will be able to afford a hormonal method, you may want to consider other forms of birth control that are available without a doctor’s prescription (such as condoms) before you begin a program you cannot afford.

You may wish to contact your local Planned Parenthood organization as well, to see if discounted birth control is available to you through them.

Condoms (also called rubbers) are available in most supermarkets, drug stores, and in vending machines in some public restrooms. They are available without a doctor’s prescription.

Most condoms are made from latex rubber. A man puts the condom on his erect penis before having sex. A condom is used only once. Some men and women are allergic to the latex in condoms. If you aren’t allergic, you should use condoms made from latex because they are best at preventing pregnancy and protect against transmitting sexual diseases such as AIDS and herpes. Do not use condoms with lubricants such as Vaseline or other brands of petroleum jelly or oils. They make the latex less effective and may damage the condom. You may use a lubricant, such as K-Y Jelly, which does not contain oil.

A form of female condom (brand name Reality) is also available at stores without a doctor’s prescription. These are made of polyurethane. A woman inserts the condom into her vagina right before sex and uses it only once.

Do not use a male and female condom at the same time. The male condom is more effective at preventing pregnancy and protecting against sexually transmitted diseases. See Birth Control Barrier Methods for more information about condoms.

Spermicides are available in drugstores without a prescription. They can be a foam, cream, film, or jelly. Spermicides contain a chemical that kills a man’s sperm. The woman should carefully follow the instructions on the package. Most spermicides must be inserted into the vagina 10-15 minutes before sexual intercourse. One dose usually works for an hour. Use another dose if you have sexual intercourse again, even if it has been less than an hour. Do not use douches or rinse your vagina for at least 6-8 hours after having sex. Spermicide alone is not completely effective at preventing pregnancy. See Birth Control Spermicides for more information.

Behavioral methods such as pulling out before ejaculation are not very effective. Douching (rinsing out the vagina) after sex is not effective and not recommended. Breastfeeding a newborn can be protective against pregnancy for up to 6 months, but most women don’t breastfeed often enough to keep hormone levels in check. See Birth Control Behavioral Methods for more information.

Discuss your birth control needs and preferences with your health care provider. Many methods are available from your doctor and can be arranged for during an office visit. Some options, such as a diaphragm (used with spermicide) or a cervical cap (also used with spermicide), require fitting, which can also be done during an office visit. See Birth Control Barrier Methods for more information about these methods. An intrauterine device (IUD) must be placed by a health care professional. See Birth Control Intrauterine Devices (IUDs) for more information.

• Your health care provider can fit you with a diaphragm. You insert this into your vagina before sex so it covers your cervix. Before you insert it, you put spermicide into the dome of the diaphragm. Diaphragms come in several sizes, so you must be fitted for it at a clinic.
  
  
• The cervical cap is a soft rubber cap that fits over the woman’s cervix. It is smaller than a diaphragm and sometimes more difficult to insert. It also works with spermicide.
  
  
• An IUD is placed into your uterus by a doctor. Currently in the United States, 2 types of IUDs are available: copper and hormonal.  Depending on the type, IUDs can be left in place for 1-10 years. Only your health care provider can insert and remove an IUD.

You need a doctor’s prescription for birth control pills. These contain hormones that keep your ovaries from releasing an egg. You must take a pill every day. Various types are available, each with different combinations of hormones. Your doctor can advise you on the best one for you. Birth control hormones can now be delivered through a patch you place on your skin. The hormones are absorbed through your skin. Hormone shots can be given to you every 3 months to prevent pregnancy. You must receive these at your doctor’s office. See Birth Control Hormonal Methods for more information on these options.

Both the male and female partner should consider this question before having sexual intercourse. Unintended pregnancy is not something to think about later.

Emergency contraception, in the form of prescription medication hormones such as birth control pills taken the “morning after,” can be used especially for rape victims and in the event other forms of birth control fail (such as a condom breaking). This method is used prior to a confirmed pregnancy. Emergency contraception is not a method to be used routinely or casually.

Other options for an unintended pregnancy include abortion and adoption.

|Web Links|

U.S. Food and Drug Administration, What Kind of Birth Control is Best for You?

U.S. Food and Drug Administration, Birth Control Guide

Planned Parenthood, Facts about Birth Control

4 Woman, Birth Control Methods

Planned Parenthood, Is Abstinence Right for You Now?

The Couple to Couple League for Natural Family Planning

4 Woman, Healthy Pregnancy, Fertility Awareness and Infertility

American College of Obstetricians and Gynecologists, Contraception While Breastfeeding

American College of Obstetricians and Gynecologists, Natural Family Planning

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Author: Omnia M Samra, MD, Clinical Instructor, Department of Obstetrics and Gynecology, Medical College of Pennsylvania/Hahnemann University.

Editors: Bryan D Cowan, MD, Director, Division of Reproductive Endocrinology, Professor, Department of Obstetrics and Gynecology, University of Mississippi College of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Lee P Shulman, MD, Professor of Obstetrics and Gynecology, Head, Section of Reproductive Genetics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.