As beautiful as pregnancy is, not every couple is up for it. Some may choose to remain childless while others may want to plan their pregnancy and have children at a certain time. This is where contraceptives come to play and these may include the use of hormones, devices, or surgery to avoid a pregnancy.
Did you know?
Other than the male condom, most types of contraception don’t protect against sexually transmitted infections (STIs). So, if you happen to be using another type of contraception, such as a diaphragm, a condom will be necessary if you’re concerned about contracting any kind of STI.
Types of contraception
There are different types of contraceptives available and they all function to prevent pregnancy.
Condoms (male and female)
Condoms are designed to work as a barrier by preventing sperm from reaching and fertilising an egg, hence avoiding a pregnancy. Condoms for males are also effective as protection against STIs, including HIV, preventing them from being passed from one sexual partner to another. They come in different sizes, colours, etc and are used during penetrative sex as well as oral sex to protect against STIs.
Diaphragms and caps
Diaphragms and caps are barrier methods of contraception used by women. They fit inside the vagina and prevent sperm from passing through the entrance of the womb (cervix). These forms of contraception do not prevent STIs.
Combined contraceptive pill
The combined contraceptive pill, usually just referred to as the ‘pill’, is made up of synthetic versions of the female hormones oestrogen and progesterone, which women produce naturally in their ovaries. It is quoted as being over 99% effective if taken as instructed. The pill is usually taken to prevent pregnancy but it can also be used to treat painful periods; heavy periods; premenstrual syndrome and even endometriosis.
The combined contraceptive pill should be taken only under a doctor’s advice. Women who have had blood clots, or have health conditions including severe liver problems or are on certain medications should not use this method of contraception. There are also risks of serious side effects for smokers who used combined contraceptives. To be safe, always ask your doctor which is the best contraceptive method for you.
Progestogen-only contraceptive pill
This is also known as the mini pill, and it does not contain oestrogen. It is not as effective as the combined pill and it must be taken at the same time every day. It is an option for women who have side effects when they take oestrogen, or who cannot have the combined pill for health reasons. This contraceptive is commonly used just after childbirth especially when a mother is breastfeeding, to avoid pregnancy during that time.
Contraceptive implants and injections
Contraceptive implants and injections are long-acting, effective, reversible compared to progestogen-only methods of contraception. They are over 99% reliable in preventing pregnancy but they do not protect against STIs. The injection is given every 12 to 14 weeks and the implant lasts for three years.
Emergency contraception
In cases of emergency, a woman can use what’s called the ‘morning-after pill’ to prevent pregnancy after having unprotected sex, or if a method of contraception has failed. There are two types of emergency contraception:
- The emergency contraceptive pill: This is a single pill containing progesterone. You can get it from a doctor or most pharmacies without a prescription. You need to take it as soon as possible, preferably within 24 hours of having sex, but it will still work for up to five days. It prevents up to 85 percent of pregnancies.
- Intrauterine devices (IUD): The IUD is a small, T-shaped contraceptive device made from plastic and copper that fits inside the womb (uterus). The IUD used to be called a ‘coil’ or a ‘loop’. It’s a long-acting and reversible method of contraception, which can stay in the womb for five to ten years depending on the type. It can also be effective emergency contraception if fitted by a healthcare professional within five days (120 hours) of having unprotected sex. Some IUDs contain hormones that are gradually released to prevent pregnancy. These IUDs can also be used to manage heavy periods. IUDs are 99% effective in preventing pregnancies.
Vasectomy
This is a ‘male sterilisation’ surgical procedure which is a simple and reliable method of preventing pregnancies. In most cases, a vasectomy is permanent and so, it’s a very big step, and the decision to have one should not be made too hastily. A vasectomy is usually done under local anaesthetic. It is a quick and painless procedure.
Female sterilisation
Similar to a vasectomy, the female sterilisation method is an effective form of contraception that permanently prevents a woman from being able to get pregnant. It involves cutting or blocking the fallopian tubes, which carry eggs from the ovaries to the womb (uterus). This prevents the eggs from reaching the sperm and being fertilised. It’s a fairly minor operation and many women can return home the same day. Like a vasectomy too, female sterilisation is a big decision that should be fully discussed with your doctor.
Vaginal ring
The vaginal ring is a small, soft plastic ring that’s placed inside the vagina on the first day of a woman’s period and is removed after 21 days. Seven days later a new ring is used. A vaginal ring is about 4mm thick and 5.5cm in diameter. It contains oestrogen and progestogen, so it’s not suitable for women who can’t take contraception that contains oestrogen.
Using contraceptives after birth
It’s possible to become pregnant again very soon after the birth of a baby, even if you’re breastfeeding and even if your periods haven’t returned. You ovulate (release an egg) about two weeks before your period arrives, so you may be fertile enough to conceive after unprotected sex.
Plan your contraceptive methods early. If you have given birth in a hospital, you should discuss contraception with your doctor or midwife before going home. In any case, you’ll be asked about contraception at your six-week postnatal check.
If you’re not breastfeeding, you can choose any type of contraception. You can start using the Pill or vaginal ring six weeks after you have had your baby.
If you’re breastfeeding, you can use condoms or a contraceptive implant right away. You can start using an IUD after four weeks, or the mini-pill, a diaphragm or vaginal ring after six weeks.
Effectiveness of contraception
Most types of contraception are over 99% effective if used correctly. This means that fewer than 1 in 100 women who use contraception will become pregnant each year. The male condom is 98% effective if it’s used correctly and consistently. The effectiveness of contraception may, however, depend on factors such as age; how frequent sex takes place, and also whether you are using the contraceptive the right way.
Where you can get contraceptives
- Your doctor’s office
- A family planning clinic
- Pharmacies
When to stop using contraception
Fertility usually starts to decline from around age 37, although you will still need to use contraception after this time to prevent unplanned pregnancy. Most women will have reached menopause by the time they’re 55 years old, in which case they can stop using contraception.
