Tuesday, October 4, 2011
I was asked to do a post on birth control and also highlight what I use (thanks for reading my blog). I will mention that my intention is not to promote any specific birth control method.
Though we commonly use the term "birth control" to mean oral contraceptives, it includes several other techniques and methods used to prevent fertilization or pregnancy interruption at its various stages.
Main point think about it before sexual intercourse, and if you are already pregnant talk to your partner about it at the end of your second trimester and discuss your decisions with your doctor.
Contraception methods that prevent fertilization includes barrier methods such as condoms or diaphragms, hormonal contraception (aka oral contraceptives), the patch, and injection contraceptives (such as depo provera). Contragestion methods include post sex birth control (i.e. preventing implantation of blastocyst) that includes IUD and emergency contraception aka morning after pill. Then there are behavioral methods, which is controlling when/if the sperm meets the egg and that includes fertility awareness, coitus interruptus aka withdrawal, to some extent Lactational Amenorrhea Method, and having sex but avoiding semen near the vagina since semen can travel along vaginal lubricating fluid. There is also total abstinence which is total sexual abstinence but some have revised this in some way or another that it works for them. Then there is surgical sterilization (i.e. tubal ligation for women and vasectomy for men) And finally, there is abortion and that is the removal or expulsion of fetus or embryo from the uterus.
Many people decide on birth control based on the effectiveness and its compatibility to their lifestyle. For example, oral contraceptives is a hormone pill that is taken at about the same time everyday (esp. to achieve success); the patch also releases hormone like oral contraceptives but it sticks on your skin and is placed once a week, another is nuva ring also the same mechanism but it is a transparent, flexible ring that goes in the vagina once a month.
Condoms- is placed correctly on the male penis ad used every time you have intercourse, this also helps protect against STIs but not genital wart. Depo- is an injection administered every 3 months; Implenon- is a small implant that goes under the skin and lasts for 3 years; Merena- intra-uterine device that lasts for 5 years and so on.
Birth Control effectiveness is measured usually by how many women achieved pregnancy while using any one of the above mentioned methods during the first year of use except for surgical sterilization, which I believe is usually measured in lifetime failure rate after a negative semen analysis. You really do have to do the research in order to decide what works best for you, and you have to give each birth control about 3 months to decide how it works for you. That been said, the overall consensus is that the best in terms of effectiveness does depend on regular user action (s). By that I mean that if there is less work for the user it has been shown to be more effective overall.
Although surgical sterilization is reversible, the goal should please be with the intent of never having to reverse. I understand however that things change but you should never jump into this decision if there is even the slightest doubt in your mind that you may change your mind, place a mirena instead to buy yourself some time to think. Usually the reversal procedure is not cheap, not guaranteed and it is done by reconnecting the fallopian tube in women and vasa deferentia in men. Its effectiveness totally depends on the original procedure, how much damage was done and the patient's age.
So here is the effectiveness summary: if you decide on surgical sterilization, Depo provera, implant, IUDs you have a failure rate of less than 1% (again since they require little to nothing from the user- well except for depo since you have to physically go get your shots every 3 months to the tee- can't skip days otherwise you've got to follow the essential waiting period).
Then hormonal contraception, oral, patch or ring, fertile awareness methods, lactational amenorrhea method if used perfectly also have less than 1% failure rate but can be as high as 5-25% if used incorrectly bu user. Condoms have a failure rate of 14% and if used perfectly 3% and cervical barriers have a failure rate of about 20%. Withdrawal if used consistently and correctly (that means men who claim to be pros) have a 4% failure rate. If you combine withdrawal with something else you can improve the failure rate to 2%.
One important thing to note is that the world worries so much about preventing pregnancy and many times forget about preventing Sexually Transmitted Infections (STIs). With pregnancy you have options but there are existing STIs that are not curable. Seriously, there is no harm in you and your partners getting tested for HIV, Hep C, syphilis and so on; there is also no harm in using condoms every time; keep in mind also that if condoms break you not only have to worry about achieving pregnancy but also all the many STIs you may have contracted. Sorry guys you also cannot screen by looking at people, or getting to know them or trusting they will tell you because many don't even know they are infected.
For me, I practiced total abstinence until I met my husband. Before our marriage I schooled myself on birth control options and decided that my best would be fertility awareness, specifically Billings Ovulation Method. In summary this involves monitoring and charting your cervical mucus and its consistency. God made us to always have a form of discharge and it has to be of a certain characteristics for the sperm to get to its destination. For example, when a female has a dry discharge it is difficult for a sperm to get to its destination. (Learn more about it) I chose this because I felt like I didn't know anything about my fertility partly because when I was 14 some doctor recommended to my mom that I go on birth control since my period was very minimal. Though I stopped it myself when I was 18 since I refused to pay for it myself, I was too busy to care enough about my fertility. However, my experience with oral contraceptive was that it helped my acne; I didn't notice a difference with weight gain- since I was trying to loose weight at the time and accomplished it; it helped a ton with period cramps-winner for me; I did see my period every month and at that age I wasn't really happy about it :(; for me it didn't matter whether I took it at the same time everyday or if I missed because my goal was not to prevent pregnancy and I didn't see why anyone cared if I had a period monthly.
Anyways, before my marriage I studied and learned my cycle using the Billings Ovulation Method http://www.woomb.org/bom/lit/teach/index.html it was a great option for hubby and I since it included him as well. He could look at the calender himself and know that we could do anything other than sexual intercourse on those marked fertile days. I really believe it can help in bringing couples together especially on days that you are forced to be creative (fertile periods) and also you don't feel rejected because you have previously discussed that you want or don't want to be pregnant. It was also a great tool for when I tried to achieve pregnancy (since hubby lived in another state and left on military assignments for at least half of the year. It helped though that I knew the exact day we got pregnant and matched the ultrasound to the day- it helped for later decisions when it came close to the birth of my daughter. It helped me learn a lot about my fertility and about fertility in general.
Now I don't have to chart because I know and understand my fertility very well. It is free but does require some back to school elementary knowledge of the female reproductive system. After the birth of our baby girl I still feel very confident in the Billings Ovulation Method and hence still use it, its failure rate is also less than 1% if used accurately. Also although not for the intention of birth control I solely breastfeed my daughter and hence I also use the Lactational Amenorrhea Method- I do not plan to substitute with anything else until she is 6 months old.
I hope this helped, good luck with your decision. Please feel free to add to what influenced your decisions on choosing a contraceptive that worked for you.