BIRTH CONTROL & PREVENTING PREGNANCY

Since many sexual activities (not just intercourse) can result in a pregnancy, persons desiring to avoid pregnancy often turn to Birth Control methods and devices (also called Contraceptives = against conception).

We provide the following as information, not as an endorsement of inappropriate or ill-advised sexual activity.

BARRIER METHODS (keep male’s semen from entering female vagina)

Diaphragm⁶

• a rubber cup that holds spermicide and is inserted by a woman before sexual activity into her vagina to cover the cervix and prevent sperm from entering the uterus;
• it is fitted by a doctor
• possible side effects are vaginal infections and if the woman is hypersensitive (allergic) to the rubber, she could experience irritation or itchiness
• used with spermicide, prevents pregnancy about 80-90%

Cervical Cap¹⁰

• a cup-shaped sponge impregnated with spermicidal that fits against the cervix and prevents sperm from entering the vagina
• possible side effects are vaginal discharge, vaginal odour, cervical sores
• can cause vaginal irritation and therefore may increase the risks of acquiring STD.s (sexualityandu.ca newsletter October, 2003)
• effectiveness rate same as diaphragm

Male Condom^8,9

• a rubber sheath placed over the man's erect penis to catch sperm released during intercourse and keep it away from the woman
• can become ineffective if kept for awhile, especially in a warm place (e.g. wallet, back pocket) or a cold place (e.g. a car during winter)
• can slip or break or not get put on before ejaculation
• some semen may be released before the condom is placed
• some condoms are coated with spermicide (see below) for added protection; however, women whose partners use these face greater risk of urinary tract infections
• can be effective 84-98% if in perfect condition, used at the correct time, with no slippage or breaks

Spermicides

• chemicals inserted into the woman's vagina which kill sperm before they have the chance to make a woman pregnant
• available as foams, jellies, creams, suppositories; are usually used with a condom, diaphragm or cervical cap
• possible side effects are vaginal and penile discomfort, irritation, soreness or  itching
• other risks are birth defects and miscarriages if the spermicide is used close to conception
• prevent pregnancy from 70-90% of the time

Contraceptive Sponge

• a cup-shaped sponge which a woman inserts into her vagina before intercourse to absorb semen (containing sperm)
• toxic shock syndrome is a risk of longer duration sponges
• prevents pregnancy from 75-90% of the time
   

NON BARRIER METHODS

Birth Control Pill

• used by 32% of Canadian women surveyed in 2002^2,3
• taken orally on a monthly schedule
• it changes a woman's hormone levels to prevent ovulation
• it changes the uterine environment to make it unfriendly to sperm
• it makes the uterus uninhabitable to a fertilized egg (prevents implantation)
• possible side effects are yeast infections, headaches, weight gain, sore breasts, spotting, nausea, bloating, high blood pressure, liver tumours, depression, decreased sex drive
• sun tanning while on the pill can cause brown skin splotches on cheeks or forehead or a thin, brown line on the upper lip
• possible long-term risks are increased possibility of breast cancer AND cervical cancer, blood clots, birth defects, infertility, and strokes (especially for women who smoke)
• 84-99% of the time if taken exactly on schedule and not nullified by other medications (such as certain antibiotics and herbal medications)

Depo-Provera

• a hormone injected into a woman's upper arm or buttock by a doctor
• over a 90 day period, the hormone is released into her bloodstream, changing the woman's hormone levels to prevent ovulation
• like the BC pills, this injection changes the uterine environment to make it unfriendly to sperm
• it also makes the uterus uninhabitable to a fertilized egg (prevents implantation)
• it ceases menstruation
• possible side effects (which can last longer than the 90 days) are weight gain, depression, irregular bleeding, allergic reaction
• once it's in the body, it can't be removed, so if a woman doesn't like the side effects, she's committed to this method for 90 days unlike other methods which she can stop at short notice
• possible long-term risks are increased susceptibility to breast cancer, increased susceptibility to osteoporosis,
• effective 99% of the time

Intrauterine Device (IUD)

• up to 10% of women expel the device during first year of use¹
• a small plastic "T" or "Y" either wound with coppers coil or filled with slow-release progesterone⁴
• it changes the chemistry in the uterus, killing sperm⁴
• it makes the uterus uninhabitable to a fertilized egg (prevents implantation⁴
• increases the risk of ectopic pregnancy⁴
• possible side effects are vaginal discharge, heavy periods, pelvic pain, menstrual cramping⁴
• other risks are perforation of the cervix or uterus as well as embedding of the IUD in the uterine wall (would need to be removed surgically and could cause future miscarriages, infertility)⁴
• prevents pregnancy 95% of the time
• inserted into a woman's uterus by a doctor

Contraceptive Ring

• a vaginal soft, flexible plastic ring that a woman inserts into her vagina once every 4 weeks. It is removed after 3 weeks for her menstrual cycle
• it releases estrogen and a progestin like birth control pills
• same side effects as oral contraceptives
• better statistical protection since patient error (forgetting pills) is not an issue (sexualityandu.ca newsletter January, 2005)

Contraceptive Patch: EVRA®²

• a woman places a patch on her abdomen for three weeks, then removes it for a week
• the patch releases hormones like the birth control pill does, changing a woman's hormone levels to prevent ovulation
• it changes the uterine environment to make it unfriendly to sperm
• it makes the uterus uninhabitable to a fertilized egg (prevents implantation)
• side effects are similar to the pill

Any of the methods which act as an abortifacient (Birth Control Pill, Contraceptive Ring, Contraceptive Patch and IUD) may lead to a moral dilemma for those women who believe that life begins at conception and feel it is wrong to destroy a human being, no matter how tiny.

NATURAL CONTRACEPTION

There are several methods of avoiding pregnancy without the use of devices or medications. In all of these methods, a woman learns to recognize her fertile periods and she abstains from sexual activity during those days.

Sympto-thermal Method: www.serena.ca
also know as Natural Family Planning

• a woman measures her body temperature, the thickness of the discharge from the vagina and other body signs
• costs are for a basal thermometer, a modest instruction fee and a manual to learn the method (instruction is in Vancouver)

Billings Ovulation Method: www.billingsmethod.com, www.woomb.org

• a woman learns to recognise a particular type of mucus secreted from her cervix without which sperm are unable to live
• the only cost is the purchase an instruction book
• instruction and follow-up are available in the Victoria area

Salivary Ovulation Prediction Method:

• a woman tracks differences in saliva patterns through a microscope, thus noting her fertile phase
• cost is about $100 for the kit; however it is usable for years and can be passed on to other people

Withdrawal

The 4th most common method used in a 2002 Canadian contraception study³

• the male withdraws his penis from the woman before ejaculation occurs
• this requires good self-control on the part of the male
• consequences may include decreased pleasure for the male
• some males may be unable to predict ejaculation and unable to withdraw before semen is released
• since some semen is usually released early, pregnancy is possible between 4-24% of the time⁴
• does not protect for STIs
   

PERMANENT BIRTH CONTROL

The 3rd most common type of contraception in Canada^2,7

• these methods prevent the sperm from travelling up the fallopian tubes and reaching eggs
• neither method is possible to reverse

Tubal Ligation

• aka "getting your tubes tied"
• a surgical procedure where the physician enters the abdomen (by incision, by laparoscope or vaginally, up through the uterus) to reach the fallopian tubes
• the tubes are either cut and tied off, cauterized (burned together) or shut with clips
• depending on the method, may require general anesthetic

Coils (e.g. "Essure")

• little coils of metal are inserted where the fallopian tubes enter the uterus
• a surgical procedure done vaginally through the uterus
• does not require general anesthetic
   

ABSTINENCE - choosing not to have sexual activity

• in a 2004 Canadian study of 3345 women aged 15-44, 13% were practicing abstinence⁵
• has no negative side effects
• prevents pregnancy all the time

Remember that a woman can become pregnant only certain days of the month but can get a Sexually Transmitted Disease every day of the month. For more information about STDs., See FactStack: Body Talk. The Pregnancy Reliability Rates of these Prevention methods would be cut in half to obtain Disease Reliability Rates.

At Options Pregnancy Centre we frequently see the traumatic results of people who have trusted their health and their future to Birth Control devices or methods. An unintended pregnancy or unexpected disease/infection can change your whole life. We recommend that people choose to delay sexual activity until they are in a committed monogamous (only one partner) relationship like marriage where a pregnancy would be welcomed and the chance of a Sexually Transmitted Infection or Disease is minimal.

Citations:

1. Hatcher,R., Trussel, J.,et al.(1998). Contraceptive Technology, Seventeenth Revised Edition, New York, NY: Irvington Publishers
2. Society of Obstetricians and Gynaecologists of Canada
   http://sexualityandu.ca/eng/news/e-newsletter_1104.cfm
3. Wilks, J. (1996). A Consumer's Guide to the Pill and Other Drugs. Stafford, VA: ALL Inc.
4. Grey, J., editor (1995). Therapeutic Choices. Canadian Pharmaceutical Association.
5. Journal of Obstetrics and Gynecology in Canada, 2004: 580-90 and 646-56
6. Women’s College Hospital
   www.womenshealthmatters.ca/centres/sex/birthcontrol/diaphragm.html
7. Society of Obstetricians and Gynaecologists of Canada
   http://sexualityandu.ca/eng/news/e-newsletter_0406.cfm
8. Vessey, M.,  Villard-Mackintosh,L., McPherson, K., Yeates,D. "Factors influencing  use-effectiveness of the condom", British Journal of Family Planning. 1988, 4:40-43.
9. Sonenstein, F, Lindberg, L., Turner,C., Pleck, J. "Changes in sexual behaviour and condom use among teenaged males: 1988 to 1995", American Journal of Public Health, 1998;88: 956-959
10. Women’s College Hospital
    www.womenshealthmatters.ca/centres/sex/birthcontrol/cervical.html

107-1505 Admirals Road
Victoria, British Columbia
V9A 2P8

e-mail:  info@optionspregnancy.org
phone:   250-380-6883

Copyright © 2005 Options Pregnancy Centre
All Rights Reserved
Disclaimer

Web hosting provided by MyUniserve

OPTIONS PREGNANCY CENTRE