Birth Control

Birth control discussion might feel awkward, yet it’s a crucial conversation to have before getting intimate with your partner. It not only shares the responsibility of protection but also lays the foundation for a healthy relationship.

Robin Watkins, a certified nurse midwife and women’s health nurse practitioner emphasizes that initiating discussions about sex and birth control may not be easy initially and might require some practice. Depending on your relationship, you may need protection from pregnancy, sexually transmitted diseases (STDs), or both. Before diving into the birth control discussion, do some soul-searching. Consider if you want children and, if so, when. These answers will shape your conversations and decisions as a couple.

When you’re ready, here are some tips from Watkins:

1. Say it out loud: Put your thoughts into words. Practicing in front of a mirror ensures smoother communication when nerves kick in.
2. Turn to someone you trust: Rehearse the birth control discussion with a friend to gain confidence and clarity.
3. Choose the right time: Avoid discussing it in the heat of the moment. Find a stress-free, private place and schedule dedicated time for the conversation.

In heterosexual relationships, Watkins advises ensuring that both partners have aligned desires regarding pregnancy. If not, take a step back and have that conversation before discussing specific birth control methods.

Discussing STDs, especially HIV, can be uncomfortable, but Watkins suggests a low-stress approach:

• Share your most recent test results.
• Ask your partner about their STD test history, emphasizing a non-judgmental stance.
• Discuss past partners openly.
• Express care about your partner’s health, emphasizing the importance of knowing and managing it.
• Highlight that knowledge about each other’s health contributes to a safer and more enjoyable sexual experience.

Watkins even suggests starting the conversation via text or a phone call if an in-person discussion feels challenging.

If you or your partner hasn’t received the HPV vaccine, consider it, as it’s available until age 26, and in some cases, up to age 45. The HPV vaccine is crucial in preventing genital warts and certain cancers. Always consult with your doctor to determine the suitability of the vaccine for your situation.

Condom Use: A Vital Conversation

Addressing the importance of birth control, particularly condoms, is essential in any relationship, serving not only as a contraceptive but also as a shield against HIV and STDs. This becomes especially crucial if you or your partner is not in a monogamous relationship, emphasizing the need to use condoms consistently.

Approaching the Condom Conversation:

While the most effective condoms for preventing STDs are made of latex and fit over the penis, initiating the discussion can sometimes be challenging. Here are some ideas for bringing up the topic:

1. “My other birth control method isn’t 100%; let’s use a condom, too.”
2. “Honey, I got us a present!” (while presenting a package of condoms)
3. “I’d feel more comfortable and relaxed if we used these from now on.”
4. “We (or I) haven’t been tested in a while; let’s use these.”

An alternative to external condoms is the internal condom, suitable for various couples, including straight, gay, or bisexual. Made of nitrile, it’s a latex-free option for those with allergies.

One Size Doesn’t Fit All: Understanding Birth Control Options

Choosing the right birth control method involves considering various factors, such as lifestyle and personal beliefs. Engaging in a conversation about these options is crucial. Here are some key birth control methods:

1. IUDs (Intrauterine Devices): A highly effective, long-term contraception method, IUDs are inserted into the uterus by a healthcare provider, preventing pregnancy for years. They come in hormonal and copper varieties, offering a “set it and forget it” approach.
2. Hormonal Methods: Prescribed by a doctor, hormonal methods, including pills, patches, rings, shots, and implants, work by preventing the release of eggs. Their varied durations cater to different preferences.
3. Barrier Methods: Beyond condoms, other barrier methods include diaphragms, sponges, and cervical caps. These require preparation before sex and work best when combined with spermicide to enhance effectiveness.
4. Fertility Awareness: Also known as natural family planning, this method involves understanding the female’s fertile days during the month. It requires disciplined tracking and may have varying success rates based on adherence.

Navigating Changes and Seeking Advice:

Birth control needs to evolve throughout life, and consulting a doctor is vital, especially during specific times such as:

• Right after childbirth and while breastfeeding
• For smokers over 35
• For those with heart disease, blood clots, or cancer
• Entering perimenopause or menopause when periods become unpredictable or stop

Transgender men, assigned female at birth, taking testosterone but not undergoing gender-affirming surgeries, may still require contraception. Using protection is crucial in preventing pregnancy, even without menstruation.

Robin Watkins emphasizes that it’s acceptable to ask your partner to use protection, whether for preventing STDs or pregnancy. Open communication about needs and preferences is key, to ensuring a healthy and consensual sexual experience. If your needs are not met, it’s okay to say no, she adds.

When considering birth control methods beyond condoms, a visit to your doctor is essential, as most options require a prescription. Here’s a guide on how to start the birth control conversation with your OB/GYN or healthcare provider actively and straightforwardly.

Initiating the birth control conversation

Talking about birth control and intimate topics may feel uneasy, but choosing a trusted doctor, whether it’s your primary care physician, OB/GYN, or a local health clinic doctor, can make the discussion more comfortable. For those under 18, some states may require parental permission to obtain birth control.

Remember, your discussion is confidential, ensuring that everything you share stays between you and your doctor alone. To make the conversation more productive, come prepared with information about available birth control methods and your personal goals.

Questions to Ask Your Doctor during the birth control conversation

To guide your discussion, consider asking your doctor the following questions:

1. What birth control options are available to me?
2. How effective is each method?
3. What are the potential risks or side effects?
4. Based on my situation, which method do you recommend?
5. Which methods also protect against sexually transmitted diseases (STDs)?

Choosing the Right Method:

Several birth control methods exist, each catering to different needs. These include:

1. Hormonal Methods: Such as the pill, implant, patch (Xulane), ring (NuvaRing), or shot (Depo-Provera).
2. Intrauterine Devices (IUDs): Both copper and hormonal options are available.
3. Barrier Methods: Including condoms, diaphragms, and contraceptive sponges.

Consider Your Needs:

To narrow down your choices, assess your specific needs by considering questions like:

1. Do you have multiple sexual partners? If so, options like female or male condoms can provide protection against both STDs and pregnancy.
2. Do you prefer a low-maintenance method? Long-acting options like IUDs or implants offer protection for 3–10 years with minimal effort, eliminating the need for daily pills or frequent replacements.

By initiating a candid and informed conversation with your OB/GYN, you can make an empowered decision about the birth control method that aligns with your lifestyle and preferences.

When it comes to preventing unplanned pregnancies, the array of birth control options can be overwhelming. It’s crucial to understand the effectiveness of each method, taking into account both perfect and typical use. Let’s delve deeper into the various birth control options, providing a comprehensive overview that considers personal preferences, lifestyle, and adherence levels.

Most Effective Birth control

1. Tubal Ligation (Tying Your Tubes ): This surgical procedure nearly guarantees pregnancy prevention, with a success rate exceeding 99%. It severs the fallopian tubes, blocking the sperm’s journey to the egg, leaving fertilization virtually impossible.
2. Vasectomy: Take control of your family planning with a quick and minimally invasive procedure! A vasectomy involves snipping a section of the tubes carrying sperm, effectively reducing your chances of fathering a child to less than 1%. Despite its simplicity, vasectomy is highly effective in preventing conception.
3. Implantable Rod (Nexplanon): For those seeking long-term protection, the Nexplanon rod, inserted under the skin, offers three years of coverage with a less than 1 in 100 chance of getting pregnant. Its set-it-and-forget-it nature makes it a convenient option.
4. Copper IUD (ParaGard): An intrauterine device that is immediately effective and boasts a 99% success rate. It changes little about the natural hormonal cycle, providing a less than 1 in 100 chance of pregnancy per year.
5. Hormonal IUDs (Kyleena, Liletta, Mirena, Skyla): Releasing hormones directly into the uterus. These IUDs provide effective contraception, with a less than 1 in 100 chance of getting pregnant in a given year. The flexibility of removal when pregnancy is desired adds to their appeal.

Effective Birth control

1. The Shot (Depo-Provera): Administered every three months, the shot offers a perfect use chance of less than 1 in 100. However, typical use, where some may delay getting the next dose, increases the risk to about 6 in 100.
2. The Pill: Combining estrogen and progesterone, the pill is a popular choice. With perfect use, it has a 1 in 100 chance of pregnancy, while typical use raises the risk to 9 in 100.
3. The Patch: Applied weekly, the patch provides a perfect use chance of 1 in 100. However, typical use increases the risk to about 9 in 100. Consistent application is key to its effectiveness.
4. Vaginal Ring (NuvaRing): Inserted into the vagina for three weeks, the ring has about a 9 in 100 chance of pregnancy with typical use. Its user-friendly design contributes to its popularity.

Partly Effective:

1. Barrier Methods (Condoms, Diaphragms, Sponges, Cervical Caps): The type of barrier method you choose and how you use it affect its effectiveness, which can range from 12 to 24 pregnancies prevented out of 100.. Adding spermicide further enhances their protective properties.
2. Withdrawal Method: Commonly known as “pulling out,” this method involves withdrawing the penis before ejaculation. Although it provides some level of protection, this method falls short compared to others. With a 22% pregnancy rate per year, roughly 22 out of every 100 users will conceive within that timeframe.
3. Natural Family Planning: Also known as the “rhythm method,” this approach involves tracking fertility based on menstrual cycles. About 24 in 100 people who practice this method will get pregnant in any given year. It requires diligent monitoring and understanding of one’s body.

Choosing the right birth control method involves a combination of personal preferences, lifestyle considerations, and the ability to adhere to the chosen method consistently. Consulting with a healthcare professional is essential to finding the best fit for individual needs. Remember, the effectiveness of each method is influenced by how diligently it is used, making informed decisions crucial for successful contraception.