The thought of adding another child to the mix is enough to cause a panic attack. But for many women in the U.S., even having a house full of kids isn’t enough to prevent unplanned pregnancies.
According to the Centers for Disease Control, almost half of all pregnancies in the U.S. are unintended.
With so many babies coming unannounced, choosing the right birth control is crucial in meeting your family planning goals.
“The days are gone when you had no control over the number of children you had,” said Russell Fothergill, MD, vice chair of OB/GYN. “Birth control has really revolutionized that.”
Not only do contraception methods help you control the number of children you bear, but they also help to prevent pregnancy-related complications.
“There is some health risks associated with pregnancy,” Dr. Fothergill said. “Contraception limits those risks.”
What birth control options are available for moms?
The gynecologist said there are several types of contraception and they can be broken up into different categories.
Traditionally, barrier methods like condoms, diaphragms and spermicidal lubricants were the only contraceptives available without a prescription, but recently emergency contraception has also become available over-the-counter.
“That’s typically what people refer to as the ‘morning-after pill,’” Dr. Fothergill said. “That’s been pretty revolutionary to be able to get that pill without a prescription.”
Emergency contraception is only available in pill form without a doctor’s consent. And Plan B One-Step, Next Choice and Ella contraceptive methods are the only over-the-counter emergency birth control options approved by the Food and Drug Administration.
The most common type of hormonal contraceptive is the birth control pill. The pill and other types of hormonal contraceptives use female hormones—estrogen and progestin—to stop ovulation.
Other forms of hormonal contraception:
- Vaginal ring
- Hormonal patch
- Injectable progesterone
- Implantable contraceptive– implanted under the skin of the arm.
Intrauterine Device (IUD)
This type of contraceptive is a T-shaped piece of plastic that is inserted into the uterus to prevent sperm from ever getting to the egg.
“There are currently two IUDs that are commercially available,” Dr. Fothergill said. “The most popular one is the Mirena, which is a progesterone-containing IUD. The second one, that’s been around for a long time, is the copper IUD—ParaGard. They both work in similar ways and use different medicines to achieve that.”
And the gynecologist said that despite fears that IUDs might be an abortifacient—that they induce abortion—it is simply not true. IUDs prevent conception from happening. They don’t terminate existing pregnancies.
If you aren’t planning on having any more children, sterilizing yourself or your partner might be a good option. That includes tubal ligation for women and vasectomies for men. Both have their advantages and disadvantages, the doctor said.
“The vasectomy is typically a safer procedure to perform,” Dr. Fothergill said. “It can be done in a clinic as an outpatient. Whereas tubal sterilization for women is much deeper inside anatomically and is usually a surgical procedure.”
But despite the risks, tubal sterilization is one of the most common surgical procedures, the most popular form of birth control and the most effective at preventing pregnancy.
Are some birth control options more effective than others?
As cliché as it may sound, the best way to prevent pregnancy with no failure rate is by practicing abstinence.
“We do mention that to people because virtually every form of birth control has a failure rate, even tubal ligation.”
But even though there is a slight risk of the procedure failing to prevent pregnancy (about a .05 percent risk over a ten-year period), tubal sterilization is the most effective form of contraception.
Not far behind it is the IUD.
“Statistically, the failure rate of an IUD is almost the same as the failure rate of a tubal ligation. That’s how effective it is.”
The biggest reason that these methods are so effective is that they eliminate one important part of contraception – user failure rate.
“In another words, you don’t have to remember to do anything or take anything,” he said. “That’s the reason why a lot of contraceptives fail.”
Are there side effects associated with birth control?
Every contraceptive method has some associated side effects. It’s important to discuss these with your doctor because there are some conditions, like migraine headaches, that can be exacerbated by the kind of contraceptive you choose.
Side effects can be mild or serious, with most people experiencing what is called nuisance side effects.
“A nuisance side effect of the birth control pill could be that it makes you nauseous or that it briefly gives you headaches or bleeding.”
Even though most people don’t develop serious side effects, they can happen.
“The most serious would be developing a blood clot,” Dr. Fothergill said. “The risk for developing a blood clot from taking birth control pills is about 1 in 10,000 risk. Bt when you compare that to the risk of developing a blood clot during pregnancy, which is about 10 to 20 per 10,000, then you realize you have a significantly higher risk of developing a blood clot during pregnancy.”
What should a woman do if she is interested in birth control?
“If somebody comes to see me, the first thing we’ll do is review any history of medical problems that might limit them to certain kinds of contraception,” he said. “The second step is talking to them about their family planning and their long-term goals.”
The last step is to see if the patient has any other gynecologic problems that could benefit from a certain type of contraceptive.
“If the patient had a history of endometriosis, a better choice for them might be getting on the birth control pill or the injectable progesterone because those methods will suppress that issue.”
Dr. Fothergill also warns patients to be leery of direct-to-consumer marketing for contraceptives.
“The best thing you can do is talk to your doctor and stay informed,” he said. “And when you do go in to talk to your doctor about birth control, have an idea about your plans and what your history is because those are all going to be important in making a decision about contraception.”