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What if the Pill is Not for You? Reversible Contraceptive Choices

  • Barrier Methods: These are methods that physically prevent the sperm from reaching the egg. The most common barrier contraceptive is the condom. The only contraceptive methods which confer protection against HIV/AIDS and other STDs are abstinence and barrier methods, particularly condoms. If you are not in a long-term, monogamous relationship with a partner who is also monogamous, and if you have chosen a contraceptive method other than condoms, you may choose to use condoms in addition in order to confer STD protection.

  • Spermicides: These contraceptive jellies, creams, foams, sponges, or vaginal suppositories are most effective when used in combination with another form of contraceptive, particularly barrier contraceptives such as condoms or diaphragms.

  • Hormonal Methods: This category includes three ways to give contraceptive hormones by injection: Norplant implants ("the rods"), Depo-Provera ("the shot") and Lunelle ("the new shot"). It also includes NuvaRing, a vaginal ring that releases hormones daily and is changed once a month as well as Ortho Evra, the contraceptive hormone patch that is changed weekly.

  • Intrauterine Devices (IUDs): These are devices that are placed inside the uterus (womb) to prevent pregnancy by preventing implantation.

  • Emergency contraception (The "Morning After" pill): While this is not recommended as a contraceptive choice, it is a good back-up option for women who do not want to get pregnant, but whose primary contraceptive has failed or failed to be used.

  • Natural Family Planning (Rhythm, Fertility Awareness, and Periodic Abstinence): This method involves scheduling intercourse to avoid the time during a woman's cycle when she is likely to ovulate. While this method works well for some couples, it is the most unreliable method of contraceptive.

  • Withdrawal: This method should not be considered a contraceptive option, but as a means of last resort if other precautions weren't taken.

Choosing a birth control method depends on several factors including one or both partner's health; frequency of sexual activity; desire to conceive future children; and number of partners. Contraceptive effectiveness rates, based on both statistical and actual usage estimates, are one of the most important considerations. No contraceptive method is 100% effective, nor are all choices equally desirable for all couples. Many couples rely on one of several methods of male or female sterilization for the most reliable form of contraception; while there are circumstances in which sterilization may be surgically reversed, this should be viewed as irreversible. Sterilization also provides no protection from STDs.

When used consistently and correctly, most birth control methods prevent pregnancy safely and effectively. . .but not completely. More than three million American couples conceive unintentionally each year, leading to high rates of abortion and unwanted pregnancies. How can this be? In about half of these pregnancies, the contraceptive method the couple used simply did not work as it should have, or, more likely, they used it inconsistently or incorrectly. . .or left it in the drawer, even "just once". The other half of unintended pregnancies, however, result from failure to use any contraceptive method at all.

Abstinence, complete avoidance of heterosexual intercourse, is the only method of birth control that is 100 percent effective. Even sterilization procedures can fail. Under typical usage circumstances (as opposed to effectiveness in clinical trials), reversible contraceptives have a significant failure rate. The failure rate for the pill can be as high as 6 percent; for latex condoms, the failure rate is nearly 12 percent; and for diaphragms, the failure rate is approximately 18 percent. Although failure rates are generally lower with increasing age, the rate of unintended pregnancies among women in their 40's is nearly as high as that for teenagers.

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 According to the 2000 Gallup Survey of Women's Health and Contraception Methods, nearly 4 out of 10 women ages 18-49 now use some form of long-acting birth control, including sterilization, injections, implants, and IUD's. 

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