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Family Planning
&
Birth Control
Kids? How many?
When?
 All
women and men should have control over if and when they become parents. Making
decisions about birth control, or contraception, is not easy--there are many
things to think about. Learning about birth control methods you or your partner
can use to prevent pregnancy and talking with your health care provider are two
good ways to get started. North Basin Medical Clinics has Board Certified Family
Practitioners, all well-versed in the latest birth control methods. If you have
questions or concerns about Family Planning and Birth Control, click on the
“Physicians/Providers” navigation bar on our Home Page to find out more about
them and their practices.
Want the best birth
control method?
 There
is no "best" method of birth control. Each method has its own pros and cons.
Some methods work better at preventing pregnancy. Researchers are always working
to develop or improve birth control methods. Bear in mind that NO method of
birth control prevents pregnancy all of the time. Birth control methods can
fail. But you can greatly increase a method's success rate by using it correctly
all of the time.
Don’t be embarrassed to talk with your healthcare provider about correct usage.
Learning how to use some birth control methods can take time and practice.
Sometimes health care providers do not explain how to use a method because they
may think you already know how. For example, some people do not know that you
can put on a male condom "inside out." Also, a common mistake with condoms is
not leaving a "reservoir" or space at the tip of the condom for the sperm and
fluid when a man ejaculates, or has an orgasm. Without this extra space, the
condom can break.
The more you know about the correct way to use birth control, the more control
you will have over deciding if and when you want to become pregnant.
Where to
start…
The birth control method you choose should take into account the following…
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Your overall health
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How often you have sex
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The number of sexual partners you have
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If you want to have children
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How well each method works (or is effective) in preventing
pregnancy
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Any potential side effects
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Your comfort level with using the method
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Your ability to commit to usage (daily pill, weekly patch or
use of condom every time you have sex)
Birth
Control and Sexually Transmitted Diseases
 Keep
in mind that most birth control does NOT protect you from HIV or other
sexually transmitted diseases (STDs) like gonorrhea, herpes, and chlamydia.
Other than not having sex, the best protection against STDs and HIV is the male
latex condom. The female condom may give some STD protection. Other birth
control methods that involve using a spermicide (a cream or jelly that kills
sperm) also may give some protection against chlamydia and gonorrhea.
Current
Birth Control Methods…
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Here is a list of current birth control methods with estimates of effectiveness,
or how well they work in preventing pregnancy when used correctly, for each
method.
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Continuous Abstinence---This
means not having sexual intercourse at any time. This method is 100%
effective at preventing pregnancy.
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Periodic Abstinence or Fertility Awareness Methods---A
woman who has a regular menstrual cycle has about nine
or
more fertile days, or days when she is able to get pregnant, each month.
Periodic abstinence means you do not have sex on the days that you may be
fertile. Fertility awareness means that you can be abstinent or have sex but use
a "barrier" method of birth control to keep sperm from getting to the egg.
Barrier methods include condoms, diaphragms, or cervical caps, used together
with spermicides, which kill sperm. These methods are 75-99% effective at
preventing pregnancy. Keep in mind that to practice these methods, you need to
learn about your menstrual cycle (or how often you get your period). You keep a
written record of when you get your period, what it is like (heavy or light
blood flow), and how you feel (sore breasts, cramps). You also check your
cervical mucus and take your basal body temperature daily, and record these in a
chart. This is how you learn to predict, or tell, which days you are fertile or
"unsafe." You can ask your health care provider for more information on how to
record and understand this information.
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The Male Condom---Condoms
are called barrier methods of birth control because they put up a block, or
barrier, which keeps the sperm from reaching the egg. Only latex or
polyurethane (because some people are allergic to latex) condoms are proven
to help protect against STDs, including HIV. "Natural" or "lambskin" condoms
made from animal products are also available. But lambskin condoms are not
recommended for STD prevention because they have tiny pores that may allow
for the passage of viruses like HIV, hepatitis B and herpes. Male condoms
are 86-98% effective at preventing pregnancy. Condoms can only be used
once. You can buy them at a drug store. Condoms come lubricated (which can
make sexual intercourse more comfortable and pleasurable) and non-lubricated
(which can also be used for oral sex). It is best to use lubrication with
non-lubricated condoms if you use them for vaginal or anal sex. You can use
KY Jelly or water-based lubricants, which you can buy at a drug store.
Oil-based lubricants like massage oils, baby oil, lotions, or petroleum
jelly will weaken the condom, causing it to tear or break. Always keep
condoms in a cool, dry place. If you keep them in a hot place (like a
billfold, wallet, or glove compartment), the latex breaks down, causing the
condom to tear or break.
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Oral Contraceptives---Also
called "the pill," it contains the hormones estrogen and progestin. A pill
is taken daily to block the release of eggs from the ovaries. It also
lightens the flow of your period and protects against pelvic inflammatory
disease (PID), ovarian cancer, and endometrial cancer. It does not protect
against STDs or HIV. The pill may add to your risk of heart disease,
including high blood pressure, blood clots, and blockage of the arteries. If
you are over age 35 and smoke, or have a history of blood clots or breast or
endometrial cancer, you health care provider may advise you not to take the
pill. The pill is 95-99.9% effective at preventing pregnancy if used
correctly. You will need a prescription and visits with your provider to
make sure you are not having problems.
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The
Mini-Pill---Unlike
the pill, the mini-pill only has one hormone, progestin, instead of both
estrogen and progestin. Taken daily, the mini-pill reduces and thickens cervical
mucus to prevent sperm from reaching the egg. It also prevents a fertilized egg
from implanting in the uterus
(womb). The mini-pill also can decrease the flow
of your period and protect against PID and ovarian and endometrial cancer.
Mothers who breastfeed can use it because it will not affect their milk supply.
The mini-pill is a good option for women who can't take estrogen or for women
who have a risk of blood clots. The mini-pill does not protect against STDs or
HIV. Mini-pills are 95-99.9% effective at preventing pregnancy if used
correctly. You will need a prescription and visits with your health care
provider to make sure you are not having problems.
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Copper T IUD (Intrauterine Device)---
An IUD is a small device that is shaped in the form of a "T." Your health
care provider places it inside the uterus. The arms of the Copper T IUD
contain some copper, which stops fertilization by preventing sperm from
making their way up through the uterus into the fallopian tubes. If
fertilization does occur, the IUD would prevent the fertilized egg from
implanting in the lining of the uterus. The Copper T IUD can stay in your
uterus for up to 10 years. It does not protect against STDs or HIV. This IUD
is 99% effective at preventing pregnancy. Requires visits with your
health care provider to have it inserted, to make sure you are not having
any problems, and then to have it removed.
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Progestasert IUD (Intrauterine Device)---This
IUD is a small plastic T-shaped device that is placed inside the uterus by a
health care provider. It contains the hormone progesterone, the same hormone
produced by a woman's ovaries during the monthly menstrual cycle. The
progesterone causes the cervical mucus to thicken so sperm cannot reach the
egg, and so that a fertilized egg cannot successfully implant into the
lining of the uterus. The Progestasert IUD can stay in your uterus for one
year. This IUD is 98% effective at preventing pregnancy. Requires
visits with your health care provider to have it inserted, to make sure you
are not having any problems, and then to have it removed. Not all health
care providers insert IUDs.
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Intrauterine System or IUS (Mirena)---This
IUS is a small T-shaped device like the IUD and is placed inside the uterus
by a health are provider. It releases a small amount of a hormone each day
to keep you from getting pregnant. The IUS stays in your uterus for up to
five years. It does not protect against STDs or HIV. The IUS is 99%
effective. The Food and Drug Administration approved this method in
December 2000. Requires visits with your health care provider to make sure
you are not having any problems. Not all health care providers insert the
IUS.
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The Female Condom---Worn
by the woman, this barrier method keeps sperm from getting into her body. It
is made of polyurethane, is packaged with a lubricant, and may protect
against STDs, including HIV. It can be inserted up to 24 hours prior to
sexual intercourse. Female condoms are 79-95% effective at preventing
pregnancy. There is only one kind of female condom and its brand name is
Reality. Purchase at a drug store.
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Implant (Norplant and Norplant 2)---This
product was taken off the market in July 2002. If you are using the Norplant
system, you should contact your health care provider about what your
contraceptive options will be after the five year expiration date of your
Norplant system.
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Depo-Provera---With
this method, women get injections, or shots, of the hormone progestin in the
buttocks or arm every 3 months. It does not protect against STDs or HIV. It
is 99.7% effective at preventing pregnancy. Requires visits with your
health care provider to make sure you are not having any problems. Prolonged
use of the drug may result in significant loss of bone density. This bone
loss is greater the longer the drug is used. Women should only use
Depo-Provera Contraceptive Injection as a long-term birth control method
(longer than two years) if other birth control methods are inadequate.
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Diaphragm or Cervical Cap---These
are barrier methods of birth control, where the sperm are blocked from
reaching the egg. The diaphragm is shaped like a shallow latex cup. The
cervical cap is a thimble-shaped latex cup. Both come in different sizes and
you need a health care provider to "fit" you for one. Before sexual
intercourse, you use them with spermicide (to block or kill sperm) and place
them up inside your vagina to cover your cervix (the opening of your womb).
You can buy spermicide gel or foam at a drug store. Spermicide will also
help protect you from the STDs gonorrhea and chlamydia if they have
nonoxynol-9 in them. Some women can be sensitive to nonoxynol-9 and need to
use spermicides that do not contain it. The diaphragm is 80-94%
effective at preventing pregnancy. The cervical cap is 80-90%
effective at preventing pregnancy for women who have not had a child,
and 60-80% for women who have had a child. Requires a visit with your
health care provider for proper fitting.
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The Patch (Ortho Evra)---This
is a skin patch worn on the lower abdomen, buttocks, or upper body. It
releases the hormones progestin and estrogen into the bloodstream. You put
on a new patch once a week for three weeks, then do not wear a patch during
the fourth week in order to have a menstrual period. The patch is 99%
effective at preventing pregnancy, but appears to be less effective
in women who weigh more than 198 pounds. It does not protect you against
STDs or HIV. The Food and Drug Administration approved this method in 2001.
You will need to visit your health care provider for a prescription and to
make sure you are not having any problems.
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The
Hormonal Vaginal Contraceptive Ring (NuvaRing)---The
NuvaRing is a ring that releases the hormones progestin and estrogen. You
squeeze the ring between your thumb and index finger and insert it into your
vagina. You wear the ring for three weeks, take it out for the week that you
have your period, and then put in a new ring. The ring is 98-99% effective
at preventing pregnancy. The Food and Drug Administration approved this method
in 2001. You will need to visit your health care provider for a prescription and
to make sure you are not having any problems.
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Surgical Sterilization (Tubal Ligation or
Vasectomy)---These
surgical methods are meant for people who want a permanent method of birth
control. In other words, they never want to have a child or they do not want
more children. Tubal ligation or "tying tubes" is done on the woman to stop
eggs from going down to her uterus where they can be fertilized. The man has
a vasectomy to keep sperm from going to his penis, so his ejaculate never
has any sperm in it. They are 99-99.5% effective at preventing
pregnancy. Both procedures can be done by our general & gynecological
surgeon, Dr. Deanna Huntwork right here in Davenport.
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Nonsurgical Sterilization (Essure Permanent
Birth Control System)---This
is the first non-surgical method of sterilizing women and was approved by
the Food and Drug Administration in November 2002. A thin tube is used to
thread a tiny spring-like device through the vagina and uterus into each
fallopian tube. Flexible coils temporarily anchor it inside the fallopian
tube. A Dacron-like mesh material embedded in the coils irritates the
fallopian tubes' lining to cause scar tissue to grow and eventually
permanently plug the tubes. It can take about three months for the scar
tissue to grow, so it is important to use another form of birth control
during this time. Then you will have to return to your health care provider
for a test to see if scar tissue has fully blocked your tubes. In studies of
more than 600 women, followed for a year, there so far have been no
pregnancies in those whose Essure devices were implanted successfully.
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Emergency Contraception---This
is NOT a regular method of birth control and should never be used as one.
Emergency contraception, or emergency birth control, is used to keep a woman
from getting pregnant when she has had unprotected vaginal intercourse.
"Unprotected" can mean that no method of birth control was used. It can also
mean that a birth control method was used but did not work--like a condom
breaking. Or, a woman may have forgotten to take her birth control pills, or may
have been abused or forced to have sex when she did not want to. Emergency
contraception consists of taking two doses of hormonal pills taken 12 hours
apart and started within three days after having unprotected sex. These are
sometimes wrongly called the "morning after pill." The pills are 75-89%
effective at preventing pregnancy. Another type of emergency contraception
is having the Copper T IUD put into your uterus within seven days of unprotected
sex. This method is 99.9% effective at preventing pregnancy. Neither
method of emergency contraception protects against STDs or HIV. You will need to
visit your health care provider for either a prescription for the pills or for
the insertion of the IUD, and to make sure you are not having problems.
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Spermicide Foams & Gels---
You can purchase what are called spermicides in drug stores. They
work by killing sperm and come in several forms--foam, gel, cream, film,
suppository, or tablet. They are inserted or placed in the vagina no more
than one hour before intercourse and left in place at least six to eight
hours after. You may protect yourself more against getting pregnant if you
use a spermicide with a male condom, diaphragm, or cervical cap. There are
spermicidal products made specifically for use with the diaphragm and
cervical cap. Check the package to make sure you are buying what you want.
All spermicides have sperm-killing chemicals in them. Some spermicides also
have an ingredient called Nonoxynol-9, which can protect you from the STDs
gonorrhea and chlamydia. Nonoxynol-9 will not protect you from HIV. Some
women are sensitive to Nonoxynol-9 and need to use spermicides without it.
Spermicides alone are about 74% effective at preventing pregnancy.
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Withdrawal of the Penis---Withdrawal
is not an effective birth control method. It works much better when a
male condom is used. Withdrawal refers to when a man takes his penis out of
a woman's vagina (or "pulls out") before he ejaculates, or has an orgasm.
This stops the sperm from going to the egg. "Pulling out" can be hard for a
man to do and it takes a lot of self-control. When you use withdrawal, you
can also be at risk for getting pregnant BEFORE the man pulls out. When a
man's penis first becomes erect, there can be fluid (called pre-ejaculate
fluid) on the tip of the penis that has sperm in it. This sperm can get a
woman pregnant. Withdrawal also does not protect you from STDs or HIV.
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Frequently
asked questions about Birth Control Pills
Everyone
I know is on the pill. Is it safe?
Today's
pills have lower doses of hormones than earlier birth control pills. This
has greatly lowered the risk of side effects. However, there are both
benefits and risks with taking birth control pills. Benefits include having
more regular and lighter periods, fewer menstrual cramps, and a lower risk
for ovarian and endometrial cancer, and pelvic inflammatory disease (PID).
Serious side effects include an increased chance, for some women, of
developing heart disease and high blood pressure. Minor side effects include
nausea, headaches, sore breasts, weight gain, irregular bleeding and
depression. Many of these side effects go away after taking the pill for a
few months. Women who smoke, over age 35, or have a history of blood clots
or breast or endometrial cancer are more at risk for dangerous side effects
and may not be able to take the pill. Talk with your health care provider
about whether the pill is right for you.
Will
birth control pills protect me from HIV, the virus that causes AIDS, and
other STDs?
Some
people wrongly believe that if they take birth control pills they
are protecting themselves not only from getting pregnant, but also from
infection with HIV and other sexually transmitted diseases (STDs). Birth
control pills or other types of birth control, such as intrauterine devices
(IUDs), Norplant, or tubal ligation will NOT protect you from HIV and other
STDs.
Ready
to start?
For help with Family Planning issues and Birth Control methods, North Basin
Medical Clinics has nine Board Certified Family Practitioners. To see a list of
Physicians and other providers, go to our Home Page and click on
 “Physicians/Providers”
and read more about each provider and their practice. For appointments, call
Davenport Clinic (509) 725-7101
Reardan Clinic (509) 796-2737
Wilbur Clinic (509) 647-5321
Reproduced from: The National Women's Health
Information Center,
a project of the U.S. Department of Health and Human
Services, Office on Women's Health.
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