How Does Contraception Help Prevent Pregnancy?
Contraception, or otherwise known as birth control, is a blanket term for a number of methods used to prevent unplanned pregnancy. They differ in effectiveness, the technique used to prevent conception, and even in how long they will remain active. Contraception might consist of:
- Hormonal Treatments. Implants, injectables or medicines that alter the function of your ovaries, uterus, or your levels of oestrogen and progesterone (reproductive hormones). These can range from simple once-daily pills or temporary devices to regular injections, and even implants that remain potent for several years.
- Surgical Methods. These are more often than not permanent forms of contraception, requiring medical procedures to remove certain parts of the reproductive organs or otherwise ‘shut down’ their ability to produce ovum or sperm. Some options are reversible, and you may have to ask your healthcare professionals about this.
- Other Methods. This can consist of any method that involves preventing sperm from entering the vagina, or simply avoiding intercourse on your ‘risky’ days, when you are most fertile.
In general terms, these categories cover most of the individual methods of contraception. You might also choose to abstain from sex altogether, and while this is technically another method, it is primarily down to personal choice and requires little further explanation— you cannot get pregnant if you don’t have sex.
What Types of Contraception Are Available?
Within the three categories of contraceptives are a number of specific methods, some of which may be known to you already. If you are considering birth control for any extended period of time, or are unsure of the options available, consult your doctor or another healthcare professional, and they will help explain the different methods and what to expect. These could include:
- Long-Acting Reversible Methods (or LARCs). These are small implants inserted into the body, with a duration of several years. Implanon for instance, is a flexible stick of plastic around 4cm long, which slowly releases the hormone progestogen into your body, preventing your ovaries from releasing eggs over the next three years. Other options might include an intra-uterine device (or IUD), which is inserted into the uterus. A hormonal IUD works much in the same way as Implanon, steadily releasing hormones to prevent ovulation. A copper IUD ionises the fluids in the fallopian tubes and uterus, making them inhospitable to sperm. Both of these options are very effective, and can last anywhere between five and ten years.
- Tubal Ligation. You may know this as ‘tube tying’, where the fallopian tubes are snipped, blocked, or cauterised under local anaesthetic. This might be through a small incision in the abdomen, or laparoscopy, where a narrow telescope is used to examine your pelvic organs very closely. In most cases, this is a day operation, and you can go home right afterwards. Though this might be reversed by another operation in the future, only around half of women who have their fallopian tubes reattached are able to become pregnant once again; this operation is usually termed permanent birth control as a result.
- Salpingectomy. An even more permanent form of ‘tube tying’ where the fallopian tubes are removed entirely. This is typically used as a preventative measure for women at higher risk of developing ovarian cancer, or ectopic pregnancies.
- Vasectomy. The male equivalent of tubal ligation. Your partner’s vas deferens is cut and a small piece removed, with the resulting gap either blocked or cauterised shut. This prevents sperm from reaching the semen that is ejaculated from the penis. Like tube tying, this can be reversed later down the line, but the success rate of post-operative pregnancy diminishes the longer your partner waits to reverse the procedure— typically anywhere between 80% and 50%
- Injectables. This consists of a hormonal formulation of oestrogen and progestin, injected into your body with a syringe, which supresses ovulation. Depending on the type of medicine actually used, or the specific formulation, this might be a monthly injection, or one that happens every few months. If you consider this option, discuss this with your healthcare professional.
- The Pill. The common, colloquial name for a popular oral contraceptive containing oestrogen and progesterone. Taken at the same time every day, and typically during a 28-day cycle, it alters the menstrual cycle to eliminate ovulation. If done perfectly, without forgetting to take a pill, it is very effective, with a success rate somewhere around 99.7%.
- Vaginal Ring. A soft plastic ring that works in the same way as the pill, a vaginal ring is inserted high in the vagina, and this can be done yourself. It is left in place for three weeks, before being removed for your menstrual period, and can be replaced by a new ring afterwards. The advantage of the vaginal ring is in that you don’t have to constantly remember to use it; as long as you remove it after three weeks, it will remain effective.
- Condoms. Male contraceptive consisting of a flexible sheath that covers the penis. Typically, it is made of latex rubber, though other variants exist if allergies become an issue. Condoms are disposable, and often one of the most effective methods of ‘safe sex’— in addition to preventing sperm from entering the vagina, it also prevents sexually transmitted infections or diseases. Condoms can still be fallible, or become less effective past their expiration date, and many sexually active couples choose to use them in tandem with another method, such as an IUD or pill.
- Fertility Tracking. This refers to your ability to track which days of your menstrual cycle are ‘unsafe’ for sex, and abstain on those days. While abstinence at all is effective simply because it means you aren’t having sex at all, this is still subject to human error, or forgetfulness— if you are serious about birth control, this is not an advised long-term solution.
- Withdrawal. This method simply involves your partner ‘pulling out’ during intercourse and ejaculating elsewhere than the vagina. Again, this is subject to human error, and if this your only method of birth control, it is considered unsafe and usually ineffective.
Any of these methods above are more effective than simply having unprotected sex and hoping for the best. But, if you have had unprotected sex by mistake—such as forgetting to take the pill, using an expired or ruptured condom, or failing to withdraw—you still have methods of contraception as long as you act quickly:
- The Morning-After Pill. Also known as ‘Plan B’, this is considered an emergency contraceptive pill. Taken within 72 hours of unprotected sex, Plan B will work approximately 85% of the time. This can, however, be affected by factors such as bodyweight and antibiotics, so it is best to consult a health professional during this time as well.
- Copper IUD. If a copper IUD is inserted within roughly five days of having unprotected sex, it will be able to ionise the fluids within your uterus and make them inhospitable to whatever sperm is in your body.
What Contraception is Right for You?
Generally speaking, only you can decide what contraception is right for you—and this comes down to factors ranging from lifestyle choice, personal comfort, your desired permanency and your personal beliefs. All contraceptives come with some risks, side effects or drawbacks, and you should discuss with your partner and/or health professional to determine what might suit your situation the best. Approaching the topic of sexual activity and lifestyle with a doctor might be a little embarrassing at first, but it is in your best interests for both you and your healthcare professional to be well-informed about what to expect, and what your options are.
For more information on Contraception, view The Royal Australian and New Zealand College of Obstetricians and Gynecologists guidelines.