Family - Pregnancy
By: - at September 14, 2013

Top 15 Ways to Prevent Pregnancy

If youíre an adult in the U.S., odds are you know at least one couple whose bundle of joy was a "surprise." For some people, an unwanted pregnancy simply becomes a new, pleasant direction in life as parents. For others, itís a devastating nightmare. Modern medicine has given us a lot of options when it comes to preventing this life-changing event. But like any tool, these methods only work when they are used correctly.

unwanted pregnancy

Whether youíre new to the game or an old hat looking for new tricks, read on to learn about the 15 most popular ways to avoid meeting Junior too soon.

15)  Withdrawal
This is undoubtedly one of the oldest forms of birth control. Officially called coitus interruptus, this is when the penis is withdrawn during intercourse before ejaculating. Itís definitely an inexpensive method, and in theory, easy to employ. Stereotypically, itís thought of as being used by teenagers with limited access to birth control, but is a sworn method among even some experienced adult partners. Most experts, however, reject it as an effective means of contraception, citing a perfect use of only four percent. With an actual failure rate of nearly 30 percent, it should be the last method employed by couples.

pulling out
Courtesy of

The trouble with "pulling out" is that itís inaccurate and sometimes stressful. A male partner has to have a strong bodily awareness to withdraw in time, and a female partner must rely on both his awareness and commitment to the method. This can lead to a lot of uncertainty that dampens the thrill of sex for at least the woman, if not both partners. Moreover, even if a coupleís use of the method is perfect, pre-ejaculate can sometimes contain viable sperm if the manís plumbing is Ďleaky,í leading to the possibility of getting pregnant even with interrupted intercourse. The mechanics, therefore, are deceptively simple, making this one of the least effective popular strategies for holding off on having that baby shower.

14)  Fertility Awareness
Those with that kind of equipment know that ovulation isnít just a one or three day a month thing, with a menstruation period stretching up to one week out of every month. All roughly 28 days of the cycle are accounted for and alter physiology ever so slightly, including amount and quality of cervical mucus and body temperature in addition to a unique number of days between periods. Modern fertility awareness takes all of these things into account, with women who choose to use this method measuring at least one of these facets, if not all three.

Fertility Awareness

If you do choose to use a calendar method to track ovulation days, there are devices you can buy to help you, such as a specialized set of colored calendar beads that mark your "safe" and fertile days. This method maintains a four percent fail rate for couples who actively use a marker method. Also called the symptothermal method, if you track your days using temperature and cervical mucus your failure rate drops to roughly one percent. The price of using the method itself is free, obviously, but the tools and classes or books on using it to your best advantage start at $20 to $40 and go up from there.

Women and couples often choose this method to avoid hormonal methods of birth control in cases of their incompatibility for medical or lifestyle reasons. It also avoids the physical hassles of some of the other methods on this list, though while other forms of sex play can be enjoyed during fertile days. It does make intercourse less spontaneous unless a back-up method is employed.

13)  Emergency Contraceptive
This is on the list because it is a popular contraceptive, not an abortificant as its opponents suggest, but unlike the other ways of preventing pregnancy. However, this one isnít designed to be a regular birth control method. If youíre an adult, you can buy this over the counter in most states, where on average, it costs between $30 and $70; sometimes it can be found for significantly less at health clinics. If youíre 16 or younger, youíll have to go through your family doctor to obtain the one-step pill.

"Plan B" Pill - Emergency Contraception
"Plan B" Pill - Emergency Contraception
By Anka Grzywacz (Own work) [CC-BY-2.5-pl], via Wikimedia Commons

Taken up to five days after unprotected sex or failure of a primary birth control method, the "morning after pill" as it is popularly called, prevents implantation of a fertilized egg in the lining of the uterus. This means that you are never pregnant, because if for the fertilized egg to become an embryo, called a zygote, it would have to be attached to the uterine wall to send and receive hormonal signals. The pill blocks this process, sometimes even inducing the menstrual cycle in some patients. Itís an effective drug, and itís only real drawback is the time constraint, particularly if youíre young enough to need a doctorís permission for it.

12)  Sponge
Among other things, this contraceptive method can lay claim to being a famous plot device on the hit sitcom Seinfeld. A vaginal sponge is a circle of plastic foam material soaked in spermicide that is inserted at the top of the vagina to prevent sperm from moving past the cervix. It must be in place before intercourse, and must be left in for six hours afterwards, when it is then removed with a nylon loop. Some women like this method because it does not require insertion of any device into the uterus, and avoids hormonal birth control all together. As long as it is positioned correctly, you can insert it up to 24 hours before sex to prevent disrupting the move from foreplay to intercourse, and it can also be prepared and used on the spot.

Contraceptive Sponge
Contraceptive Sponge
By Ceridwen, via Wikimedia Commons

Placement is key, though, and inaccuracies in insertion and removal give it high use rates for failure. The sponge is more effective if you have never given birth. In this case, if you use the sponge correctly every time, your failure rate will only be around nine percent. If you have previously had a baby, that rate jumps to 20 percent, because of the changes in your cervix and upper vaginal walls. Forgetting to use the sponges sometimes, the rate for women who havenít given birth is 12 percent, with that doubling for those who have. Some complaints about this form of birth control are that it can be messy, and some women dry out using it. Still, those women who love it swear by it, and if Elaine is willing to go on a 25 block hunt for them, you might find them spiffy, too.

11)  VCF (Vaginal Contraceptive Film)
VCF is probably the most unusual method on this list, but itís been gaining in popularity since the early 2000s. The film is a small, clear square that looks almost like a dental dam. In this case, however, itís not meant to be a physical barrier, but when inserted into the vagina, turns into a spermicide coating over the cervix. While basically just another type of spermicide method, film doesnít have the mess of jellies or foams, and is easy to carry concealed on dates. In fact, those who love it cite the fact it is good for spontaneous sex as it can be carried and used anywhere, at any time. You may also appreciate that it is available over the counter, and is inexpensive - usually around $13 for a box of 12 films.

VCF (Vaginal Contraceptive Film)
Courtesy of

VCF is also fairly effective in theoretical use rate, sitting around six percent failure. In use, though, the number jumps to 28 percent on average. What you need to remember is that the filmís effects only last for one hour after insertion, at which time another film must be used. Not adhering to the effective time period is the most common mistake associated with the failure of this birth control method.

10)  Diaphragm/Cervical Cap
Technically two different devices, these are listed together as the same method because they perform similar functions. Diaphragms and cervical caps are both placed at the top, or back, of the vagina as a physical barrier to sperm. All cervical caps and some diaphragms are coated with spermicide before insertion to add to their contraceptive power, and you can set both in place up to six hours before sex. Cervical caps have a slight advantage over diaphragms because they can be left in for longer - 48 hours as opposed to a diaphragmís 24 - and you donít need to reapply spermicide with each round of intercourse.

Cervical Cap
Cervical Cap
By Ceridwen, via Wikimedia Commons

Cervical caps have a higher perfect use fail rate, at nine percent to the diaphragmís six percent, but in typical use, only around 14 percent of women will likely become pregnant, as opposed to 16 percent with the diaphragm.


Both devices require an exam to obtain, and the diaphragm requires a fitting process. Youíll pay anywhere from $15 to $75 for the device itself, then the exam fee and spermicide.

9)  Male Condoms
Condoms are also a lot older than most people give them credit for, but the difference is, the modern ones you buy today have material that is actually effective at blocking sperm. Thank the microscope for teaching us cloth is porous enough to let motile gametes swim through. Granted, lambskin condoms still exist for the choosy few, but most of the ones you'll find now are latex and latex rubber substitutes. These have superior elasticity and durability under stress, which is increased with proper lubrication used in production.

Male Condoms

Not to say one wonít ever break on you, though. Improper oil-based lubricants can cause them to split, as well as the condom itself being out of date, being the wrong size, or being put on and taken off incorrectly. Often used with spermicide, condoms carry a two percent failure rate under perfect conditions, and a 15 percent failure rate under typical use. Female condoms also exist, and are used in much the same ways as a male condom, only going up inside the vagina instead of over the penis. These have slightly lower failure rates under perfect use, but are more difficult to contend with and those using them often fear they will come out easily if not properly inserted. You may also find them a hassle, or you may disagree entirely. Either way, condoms are most popular as a back-up or accessory form of birth control, as they are cheap and relatively simple to use, becoming easier with practice. Additionally, condoms are one of the few effective, available forms of birth control that puts the primary responsibility on men to prevent pregnancy. If you want to be known for your sensitivity and consideration in the bedroom, this is a good place to start, guys.

8)  Mini-Pill
These are listed separately because their purpose is a little different from regular birth control pills. Mini-pills are low doses of progestin only. While systemic like the more common combination pill, mini-pills donít last as long in your system, meaning the effect is gone after 24 hours. This makes your fertility more reversible than with other hormonal birth control methods, which may be a good or bad thing depending on what your future family planning strategy may be. As long as you take it at exactly the same time every day, the mini-pill has the same less than one percent fail rate of regular birth control pills. However, with typical use, the failure rate is between 9 and 11 percent.

Mini-Pill gives good reasons to choose the mini-pill over a traditional birth control pill, including if you are breastfeeding, have a history of blood clots or heart disease, or have sensitivity to estrogen. Women who are planning on having children soon but not at the moment often utilize this method to help bring back fertility after using stronger, longer-term methods of birth control. Mini-pills cost around the same as traditional birth control pills, and are available by prescription in the same way. They have many of the same side effects, so determining if they are a good alternative for you is something to take up with your doctor.

7)  The Pill
Another very famous contraceptive, birth control pills have a controversial history as a symbol of feminine independence, progress in womenís healthcare, and modern control of family planning by couples looking to be good stewards of their fertility. The darker side of "the Pillís" reputation is painted as an increased in promiscuity among women, and encouragement of sexual activity by teens, and of course, the breakdown of societal values, like nearly every other human advancement. Today, birth control pills are used for a variety of applications by those with female bodies, and may lessen symptoms of some reproductive system linked disorders like PMDD. On a more surface level, they allow you to better regulate your period and control PMS symptoms, and are one remedy for teen and young adult acne.

The Pill female sexual freedom

On the family planning front, birth control pills are just over 99 percent effective in perfect use. Accidentally skipping a day or not taking pills at the same time every day drops this rate to 9 percent failure - 81 percent effective - in typical usage as a contraceptive. Pills vary in cost, being slightly cheaper in generic form and at health clinics, but as they also vary in dosage, source of hormones, and inclusion of inactive ingredients. You may have to try a few and find one that suits your body best over simply picking the cheapest option. Women have complained of weight gain, break outs, and bloating on the pill, but these are symptoms that can be treated on their own or by trying a new type of pill. Pills are often used in conjunction with condoms, allowing both partners in a relationship to take an equal share of the responsibility of avoiding procreation.

6)  Patch
The patch woks in a similar principle to the pill, providing the user with a systemic hormone infusion through the body to suppress ovulation. Unlike the pill, however, the patch is replaced only weekly, lending users more freedom in their activities and making missed doses less likely. Patches are waterproof and while they can fall off, they rarely do. Many place the patch on their arm where it is easily accessible or on their lower belly where it can be hidden by clothing. Patches carry the same failure rates as the pill overall, and the patch is usually slightly more expensive, topping out at $80 for a one month supply.

the patch contraceptive

The Mayo Clinic also counter-indicates patches for those prone to blood clots. Also, women who weigh over 198 pounds may find this method to be less effective, since the dose of hormones may not be enough for their bodies. Like the Pill, the patch is often used not just for pregnancy, but therapeutically, to treat disorders that include propensity for ectopic pregnancy and certain types of iron deficiency anemia.

5)  Ring
The ring is another device in the family of hormonal birth control methods. Itís inserted vaginally once a month where it sits comfortably at the top near the cervix, and left in for three week intervals. It can be found for as low as $15 at some health clinics. Unlike the pill and the patch, it is not truly systemic. While some hormones will be found in the blood stream, most will stay close to the uterine area to block ovulation, as many of the signals used by this cycle are local conductors.

Close-up of the NuvaRing
Close-up of the NuvaRing

The ring also carries the use failure rate of nine percent, along with the pill and the patch, though on an individual basis, many suggest you may find it easier to remember and fit into your schedule since it only has to be taken care of once a month; if you forget and leave it in the fourth week, you simply donít have the same protection as the other three weeks. The off week is only meant to allow you your period. Like the pill and patch, as well as some other forms of birth control, it doesnít prevent against STDs, meaning if youíre with a new partner, you might want to combine this method with a physical barrier method such as a condom.

4)  Hormone Shot
Also known by the drug it contains Ė DMPA - the shot is a dose of progestin that last in the body for three months. This is a common method used by military personnel because it is a quick, certain process that requires no daily or weekly upkeep. Under perfect use, it is equivalent to the pill, the patch, and other such methods. In typical use - when shots are not given on schedule - the failure rate is lower than the pill, though: Planned Parenthood puts it at six percent.

depo provera Hormone Shot

An exam is needed to obtain the prescription to get the shot, and it can be more expensive. Even after you have your initial visit, you will pay at least $55 dollars every 12 weeks. This is significantly more than a monthís supply of most birth control pills, but keep in mind, youíre purchasing it quite a bit less. The shot is ideal if you have a busy life or value spontaneity in sex. Further, this can be a very private method, as you donít have to keep evidence of use around your house to be discovered.

3)  Implant
The implant is a small rod, usually inserted in the upper arm. While it might remind you of a strange cybernetic procedure designed to turn you into a member of a cyborgian race under radio control by alien overlords, the truth is, like the ring and patch, it diffuses progestin through your system to prevent pregnancy. Donít feel disappointed, though, because the effect can last up to three years, giving you a lot of freedom and long term family planning options.

Courtesy of

The upfront cost is significantly more than most methods, $400 to $800, and an exam is required, as well as a removal fee at the end of its term. However, breaking it down to monthly cost, if you can afford it or have the insurance, this method is a good value on a per diem basis. The only major side effect is that a poor insertion under the skin may become irritated and send you seeking a reinstallation, but other than that, it carries no more risk than any other hormonal form of birth control.

Interuterine devices developed a poor reputation at their first introduction, but these modern devices donít come with the same issues of infection and damage that their predecessors did. IUDs are similar to implants but are inserted into the uterus instead of some other part of the body, and so the lower dose of hormones they carry tends to be more localized and less systemic. They are even pricier than implants, costing between $500 and $1000, not including exam and removal fees. However, since some last up to 12 years, once again, upfront cost can be deceptive of long term value.

intrauterine system implant

Methods like IUDs are considered an investment by those looking for secure, long term family planning. Perfect use rates are zero percent failure, and even typical usage finds that IUDs tend to fail only one percent of the time. This easily makes them one of the most effective forms of birth control on the market.

1)  Abstinence
Regretfully, your high school health teacher was actually right. The only way to prevent pregnancy 100 percent of the time is just not have sex. This may not be the method that is used most consistently, but if youíre a sexually mature teen, a new parent, someone practicing celibacy, a long distance partner, or simply a lonely heart single, thereís a pretty good chance you have used or are using this method on a regular basis.

Abstinence - no sexual intercourse

Itís cheap, itís free, and while itís no fun, it gives you more time to explore new hobbies like raising earthworms or playing the ukulele.

Final Thoughts
Sex is a part of life, as are children. If you have your reasons for abstaining, more power to you. But a fear of pregnancy shouldnít be what stops you, especially with the variety of methods readily available to specifically prevent an unwanted pregnancy from occurring. Whatever you and your partner decide is the right method of family planning for you, whatís most important is that it fits your lifestyle and your long term goals, should that include parenthood all the way to a vow to remain ever childfree. Remember, what has worked for you in the past, and what works for you now, might not be what will work for you in the future. While a little awkward, this is something to continually revisit through your life, as circumstances change. Bring it up with your doctor or other healthcare provider, and know they are there to support you, not to judge. Choice and control are what drives both the popularity and development of contraceptives, and people look for new ways to enjoy one of the most primal and enjoyable components of being human.





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