Written by Tánia Wilson
Family Planning: Different types of birth control & contraceptives – Part I
I actually had a different article in mind when I started writing this one, and had no idea how extensive this article would be! The piece I was going to write was about conception and fertility, and ways you can improve your chances of getting pregnant (which I will get to once I have finished this one), but just as my pen hit the sheet, I realised that the first question most people tend to ask is, “How soon after I stop using birth control can I get pregnant?”.
So that’s what has brought this article about. It is enormous, and since I will be covering at least nine different methods of birth control (applicable to women), I will publish it in four different parts.
The contraceptive options I will be covering are probably the most commonly used methods by women all over the globe. I have never used traditional birth control and have always applied natural family planning principles in the past, but I will try and answer the most common questions about each method.
We all choose to use contraceptives for different reasons. Some want to build a career and become financially stable enough to be able to cope with having a baby. Others are not sure of how they would want to give birth and the fear of that alone convinces them to postpone having a baby altogether. Maybe you’ve just had a baby and you want to space your subsequent babies sensibly.
For different women in different situations, there are different options. In fact, there is a multitude of different types of birth control you can choose from. In this article I will try to list all of the known options that I am able to find, as well as provide you with the pros and cons of each one.
Let’s get started!
1. Abstinence (not to be confused with the rhythm method)
This method is by far the most inexpensive, but when your commitment to it fails, could result in being your most expensive accident!
What is abstinence?
“Abstinence is the opposite of indulgence. People who practice abstinence deny themselves something, often something they really want. Regardless of whether people are abstaining from food, alcohol, or sex, they have to practice self-control. In fact, the word is derived from the Latin term for “to hold back.” The word abstinence is often used in reference to sex education courses that teach kids to hold themselves back from having sex.”
How does abstinence prevent pregnancy?
If there is no sperm entering the vagina, there can be no conception – therefore, no baby.
How effective is abstinence as a method of birth control?
If you are 100% committed to sticking to it, it is 100% effective.
What are the side effects?
Unless you are suffering withdrawal symptoms as a result of being a diagnosed sex addict, there are none.
What are the pros and cons?
- It’s free!
- It’s safe – there are no side effects
- It prevents unwanted sexually transmitted infections (STIs)
- You can get to know your partner in ways that do not involve intercourse, which could be a fun new experience!
- If you fail at being abstinent you may become pregnant
- Some relationships may suffer, but any partner that respects and supports your decision to abstain is worth having!
Who can stay abstinent?
On to the next one…
2. The Birth Control Implant (Implanon & Nexplanon)
This gives women up to 3 years contraception.
What is it?
“The contraceptive implant is a small flexible tube about 40mm long that’s inserted under the skin of your upper arm. It’s inserted by a trained professional, such as a doctor, and lasts for three years.” ~ NHS
How does it prevent pregnancy?
When the implant is put in place, it will release the hormone progestogen into your bloodstream. It acts very much like the hormone progesterone, which is produced during your period.
Using progestogen continuously will stop your ovaries from releasing an egg during ovulation, which happens every month. It will also cause your cervical mucus to be thicker, making it much more difficult for sperm to access the womb and fertilise an egg. It also thins the lining of the uterus so that it cannot support a pregnancy.
When does it start to work?
Once you and your doctor are certain that you are not pregnant, the implant will be fitted within the first five days of your menstrual cycle (your menstrual cycle begins at the start of your period, on the first day). If you wait until after your period, or after the first five days, you will not be protected for up to seven days, and the use of condoms is advised.
If you have just had a baby, you can have it fitted three weeks after you have given birth. It will be effective immediately if it is fitted on or before the 21st day of giving birth. If you wait until later than day 21, you will need additional contraception for seven days.
How effective is it?
If the procedure has been carried out properly, it is more than 99% effective. The chances of getting pregnant are smaller than 1 in 1000!
How is the procedure done?
You will receive a local anaesthetic to numb the area of the skin on your upper arm. A doctor or nurse can do the procedure and will close the tiny wound where the implant has broken the skin with a dressing, without the need for stitches.
What are the side effects?
Side effects that have been reported are:
- tender breasts
- lowered sex drive
The side effects usually don’t last longer than a few months. Some women also put on weight whilst having the implant, but there hasn’t been any evidence found that proves that it was caused by the implant.
What are the pros and cons?
- It can prevent pregnancy for up to 3 years
- It does not interfere with sexual activity
- It is another available option if oestrogen based contraception like the combined contraceptive pill, contraceptive patch or NuvaRing is unsuitable
- You don’t need a pelvic exam for it to be fitted (always a plus!)
- You won’t have to remember to take or insert your contraception for it to be effective. You can just forget about it (ish)!
- It is a safe option for breastfeeding women
- You could try for a baby as soon as it is removed
- It may protect against uterine cancer and pelvic inflammatory disease
- If you suffer from heavy or painful periods, you may find that the implant can reduce the symptoms after the first year of having it fitted
- It does not interfere with normal, everyday activities
- It is expensive in some countries like South Africa. The average cost is around R1 700 to R2 100, possibly higher, depending on where you go.
- Your periods may change a great deal. Around one in five women don’t have bleeding and about half of women experienced irregular bleeding or suffer from extended bleeding and longer periods.
- The side effects may be unpleasant (see above)
Who can use it?
It is suitable for most women, although it may not be suitable if the following applies to you:
- You think you may be pregnant
- You want your cycles to stay regular
- You have bleeding after sex or when you are not on your period
- You have a history of heart disease or stroke
- You suffer from deep vein thrombosis (blood clots)
- You have liver disease
- You have migraines
- You have or had breast cancer in the past
- You are a diabetic and suffer from complications
- You have cirrhosis or tumours on your liver
- You are at risk of osteoporosis
- If you are using any of these medicines, it may affect the efficiency of your implant: – HIV medication
– Epilepsy medication
– Antibiotics used to treat conditions such as Tuberculosis (Rifabutin)
– Antibiotics used to treat conditions such as Meningitis, TB and more or use enzyme- inducing medications such as Rifampicin.
Sources: NHS – http://www.nhs.uk/Conditions/contraception-guide/Pages/contraception.aspx
Planned Parenthood – https://www.plannedparenthood.org/learn/birth-control/abstinence
This concludes part I. I hope you have found it informative and I would appreciate any comments you may have on the subject.
Please keep an eye out for Part II – I will post it tomorrow with the next two contraceptive options!