Considering Contraceptive Options
Taylor Thompson, family nurse practitioner
The recent shift in the landscape of reproductive health in the United States has increased awareness and concern regarding access to safe, effective, and affordable contraceptive options. In today’s world, women have more options than ever before when it comes to contraception. Understanding which methods of contraceptives are available and how to obtain them can empower women to make a well-informed decision regarding their reproductive well-being.
Nearly half of pregnancies in the United States are unintended. According to the Guttmacher Institute, non-Hispanic Black women, women with lower levels of income, and women with lower education levels are at higher risk of unintended pregnancy. Unmarried women and women living with partners are four times more likely to have unintended pregnancies than married women.
About 95% of unintended pregnancies occur among women who are not using contraception or are using it incorrectly or inconsistently. Abstinence, or not having sexual intercourse, is the only guaranteed method to prevent pregnancy and sexually transmitted infections; however, for those choosing to engage in a sexual relationship, contraceptive options can help prevent an unplanned pregnancy.
A wide variety of contraceptive options are available, and determining which option works best can be as easy as consulting with a health care provider. Aside from obtaining contraceptives, visits with health care providers are also beneficial for maintaining optimal reproductive health and screening for underlying diseases or infections. It is essential for individuals to choose a provider they can communicate openly with so there is no hesitation in discussing concerns. Having a regular provider for reproductive health services also allows open conversations regarding available contraceptive options and any potential risks or side effects. Contraception is very beneficial in preventing unplanned pregnancies, but it has many other uses, including managing several women’s health disorders.
Highly Effective Options
These contraceptive options are known as “get it and forget it,” making it easier and more effective for many women. It is estimated that less than 1 in 100 women will get pregnant using these options:
Birth Control Implant – A birth control implant is a tiny rod inserted into the arm and releases hormones to prevent ovulation. The implant can last up to three years and is 99.3% effective.
Intrauterine Device or IUD – A small plastic device is inserted into the uterus by a health care provider to prevent sperm from reaching the fallopian tubes to fertilize an egg. Depending on the type, IUDs can last between three and 12 years and are 92-99.8% effective.
Sterilization – For women not wanting to have children, an outpatient surgery called tubal ligation is completed, which prevents eggs from leaving the fallopian tubes for fertilization. Men can also be sterilized by having a vasectomy, which blocks or seals the tubes carrying sperm. Both are permanent methods of contraception. A vasectomy has lower risks of complications, lower cost, and is more convenient than tubal ligation.
Moderately Effective Options
These hormonal options prevent ovulation and require consistency to be effective in preventing pregnancy. It is estimated that six to nine out of 100 women will get pregnant using one of these methods:
Birth Control Pills – Birth control pills are small and must be taken every single day. The pill is 99% effective with perfect use but around 93% effective with typical use.
Birth Control Patch – A thin plastic patch is placed on the skin for three weeks, removed during week four, and then repeated with a new patch each month. The patch is more than 99% effective with perfect use but around 92% effective with typical use.
Vaginal Ring – A small flexible ring is inserted into the vagina every three weeks and removed during the fourth week. Some rings are reusable for a certain period of time, and other versions are changed every month. The vaginal ring is 91% effective.
Birth Control Shot – An in-office or self-administered shot must be taken every three months and is 94% effective.
Less Effective Options
For these methods to work, you or your partner must use one or more of these methods each time you have sex. It is estimated that 12-24 out of 100 women will get pregnant by using one or a combination of condoms, spermicide (a substance that makes it harder for sperm to reach the egg), withdrawal, and fertility awareness (tracking fertility signs).
Deciding between contraceptive options and working with your health care provider to find what works best for you can increase comfort, convenience, and confidence in this critical aspect of life.
HopeHealth provides women’s health services to women of all ages. Our board-certified gynecologists and nurse practitioners provide various services, including routine gynecological exams and counseling on contraceptive options. As a health care home, we also work alongside our primary care providers to coordinate services and can refer to specialists for surgical procedures or mammograms. As a community health center, we accept all patients regardless of ability to pay and offer a sliding scale for those needing income-based payment options.