Family planning is the means and methods that allow individuals and couples to decide if and when to have children. Family planning includes contraceptives such as pills and implants that limit fertility, barrier methods such as condoms, and non-invasive methods like fertility awareness. In addition, this service provides information about how to become pregnant as well as resources for infertility.
Understanding the best method for family planning requires an understanding of our options to limit fertility and a meeting with our care provider to create a customized plan. Increasing access to modern contraceptives helps remove barriers that rural populations have faced. When we’re empowered to plan when we want to have children we enable autonomy to complete our education and improve our economic security.
Examining how to limit fertility through intrauterine contraception (IUD), hormonal methods, barrier methods, fertility awareness-based methods, lactational amenorrhea method, emergency contraception, and permanent methods of birth control helps enable our decision making and prevents unwanted pregnancies. Learn what’s right for you by exploring reversible, barrier, fertility awareness, and lactational amenorrhea birth control methods.
Levonorgestrel intrauterine system (LNG IUD) - This small T-shaped device is placed inside the uterus by a doctor. It releases small amounts of progestin daily. This helps regulate hormones and prevent pregnancy. Depending on the device, the IUD stays in our uterus for up from 3 to 6 years. According to the CDC, the typical use failure rate is 0.1-0.4%.
Copper T Intrauterine Device - Sometimes referred to as the non hormonal IUD option, the copper wire coiled IUD produces an inflammatory reaction that is toxic to both the sperm and eggs thus preventing pregnancy. This device may stay in our uterus for up to 10 years. According to the CDC, the typical use failure rate is 0.8%.
Implant - The size of a matchstick, this flexible plastic rod is placed under the skin of the upper arm. Similar to the LNG IUD, it releases doses of progesterone into our body for over three years. According to the CDC, the typical use failure rate is 0.1%.
Injection or ‘Shot’ - Referred to as the birth control shot, the Depo-Provera shot contains medroxyprogesterone (a man-made female hormone, similar to progesterone), and is considered 99% effective if received once every 3 months. With that said, due to the frequency of missed shots, the CDC reports that the typical use failure rate is 4%.
Combined Oral Contraceptives - Frequently called “the pill”, combined oral contraceptives contain both estrogen and progestin and are taken daily. Our doctor can help prescribe them. The CDC recommends that if you are over the age of 35, smoke, and have a history of blood clots or breast cancer to speak to your doctor about the potential risk. They also report that the typical use failure rate is 7%.
Progestin Only Pill - Sometimes called the “minipill”, the progestin-only pill contains the single hormone, progestin and is taken daily. Also prescribed by our doctors, it may be a better option for women who cannot take estrogen. The CDC reports that the use failure rate is 7%.
Patch - The birth control patch releases both estrogen and progestin into your bloodstream. The patch is often worn on the lower abdomen, buttocks, or upper body. We replace the patch weekly for three weeks. During the fourth week, the patch is removed to allow menstrual bleeding. The CDC reports that the typical use failure rate is 7%.
Hormonal Vaginal Contraceptive Ring - The vaginal ring is a flexible, latex-free plastic ring that’s inserted into the vagina. Over a three week period, both estrogen and progesterone are released. The ring is taken out during the week of our period and after, a new ring is inserted. The CDC reports that the use failure rate is 7%.
Diaphragm or Cervical Cap - The diaphragm and cervical cap covers the cervix by inserting them into our vagina with spermicide to block or kill sperm. The cervical cap is a thimble-shaped cup and the diaphragm is a shallow shaped cup. Schedule an appointment with your doctor to establish the best fit for you. The CDC reports the typical use failure rate for the diaphragm is 17%.
Sponge - This soft polyurethane disk-shaped foam contains spermicide and is inserted deep inside the vagina to cover the cervix before having sex. The sponge works for up to 24 hours and must be left in the vagina for at least 6 hours after intercourse. After, it may be removed and discarded. According to the CDC, the typical use failure rate for women who have never had a baby is 14% and 27% for those who have had a baby.
Male Condoms - Condoms are a thin latex, rubber, polyurethane or lambskin sheath that is placed over the erect penis prior to intercourse. Latex condoms help prevent HIV and other STDs, while synthetic condoms also help prevent pregnancy, but may not provide as much protection against STDs and HIV. Condoms can only be used once and the CDC reports they have a failure rate of 13%.
Female Condom - This method of birth control protects against pregnancy and sexually transmitted diseases. The female condom is a soft, loose-fitting pouch with a ring on each end and is packaged with a lubricant. The rings are used to hold the condom in place inside the vagina and the open end remains outside the vagina. The CDC reports the typical failure rate is up to 21%.
Spermicide - This product comes in foam, cream, gel, suppository, film, or tablets and is placed in the vagina one hour before intercourse to help kill sperm. Spermicide is recommended to leave in place for six to eight hours after intercourse. It may be used in addition to a condom, diaphragm, or cervical cap. The CDC reports that the failure use rate is 21%.
Fertility Awareness-Based Methods
The fertility awareness method tracks your ovulation so we can prevent or plan our pregnancies. By understanding our monthly fertility pattern we can track which days we are infertile and which days fertility is likely. With a regular menstrual cycle, we have about nine or more fertile days each month. If you’re looking to not get pregnant, it is recommended to not have intercourse on days you are fertile or to use barrier methods. According to the CDC, failure rates vary across these methods, reporting a 2-23% failure rate.
Emergency contraception can be used after no birth control was used during sex or if the control method failed.
Copper IUD - The copper T IUD may be inserted within 5 days of unprotected sex.
Emergency Contraception - There are three different types of emergency contraceptive pills in the United States. Women can take one up to 5 days after unprotect sex. The sooner the pills are taken, the better they work.
Lactational Amenorrhea Method
For recent mothers who are breastfeeding, the lactational amenorrhea method (LAM) may be used when there are no menstrual periods after delivery, fully or nearly fully breastfeeding, and is less than 6 months after delivery. LAM is a temporary method of birth control and mothers should consult with their doctors to ensure they meet the criteria to practice.
Permanent Methods of Birth Control
Female Sterilization - By having her fallopian tubes tied or closed, a woman can undergo permanent surgery to prevent the sperm from fertilizing the egg. Most women go home the same day of the surgery and resume normal activities within a few days. The CDC reports that this method is effective immediately and the typical use failure rate is 0.5%.
Male Sterilization - A vasectomy blocks sperm from entering our semen during ejaculation. This small operation allows for men to go home the same day with a recovery time of less than a week. Over the course of 12 weeks, the man will regularly visit his doctor to count their sperm until it drops to zero. Until then, it is recommended to use another form of birth control. The CDC reports that the typical use failure rate is 0.15%.
Plan the Method that Works Best For You
As we consider our options for family planning, it is essential to remember that abstinence is the best way of preventing an unplanned pregnancy. If we are looking to engage in safe sexual activities then using a barrier method such as a male or female condom is the most effective way in preventing an STD.
Regardless of how you choose to practice, always remember to do research and choose the method that feels right for you. Consulting with your partner and doctor will help put you on the path to your very own family planning.
If you have any questions about how Orchid Health can help with your family planning, please contact your local clinic by visiting www.orchidhealth.org.