Method

Failure Rate*

Advantages

Possible Disadvantages

Patient Directions (Time to Start)

SURGICAL & HORMONAL METHODS:  Highly effective for contraception, but do not help protect against STIs

Sterilization

1) Female Tubal Sterilization

2) Male Vasectomy

1)0.50%

2)0.13%

• Permanent protection against pregnancy
• No lasting side effects
• No effect on sexual pleasure
• Protects women whose health would be seriously threatened by pregnancy

• Risks of minor surgery if incision is made
• Some people later regret not being able to have
• children
• Not usually reversible if you change your mind rarely, tubes reopen, allowing pregnancy to occur
  1) Tubal sterilization
• Bruising where the incision is made
• Very rare injury to blood vessels or bowel
• Pregnancies that rarely occur are more likely to be ectopic (in a fallopian tube) 2) Vasectomy
• Infection or blood clot in or near the testicles
• Temporary bruises, swelling, or tenderness of the scrotum
• Sperm leakage may form temporary small lumps near testicles

• Male or female sterilization may be performed at any time

IUD

1) Paraguard

2) Mirena

1) 0.8%

2) 0.1%

1) Paraguard

• May be left in place for up to 12 years
• Fertility returns immediately when IUD is removed

2) Mirena

• May be left in place for up to 7 years
• May reduce period cramps and bleeding

• May cause increase in cramps and heavier and longer periods
• Spotting between periods
• Rarely, wall of uterus is punctured during insertion

• Must be inserted by a clinician
• (start day of abortion or at follow-up visit)

The Shot

(Depo-Provera or Lunelle)

3.0%

• Each shot works for several weeks (Depo for 12 weeks and Lunelle for 4 weeks)
• No pill to take daily

• Loss of monthly period, spotting, weight gain, hair changes, depression, skin rash, change in sex drive

• May cause delay in getting pregnant after shots are stopped
• Side effects may not stop until medication wears off (up to 6 months for Depo-Provera)

• Must get shot every three months for Depo-Provera, every month for Lunelle
• (start day of abortion or at follow-up visit)

The Pill

(Combined and Minipill)

8.0%

• Nothing to do right before sex to protect against pregnancy
• More regular, shorter periods
• Less menstrual flow and cramping, acne, iron deficiency anemia, excess body hair, premenstrual symptoms, and related headaches and depression, and vaginal dryness and painful intercourse associated with menopauseReduces the risk of ovarian and endometrial cancers, pelvic inflammatory disease, noncancerous growths of the breasts, ovarian cysts, and osteoporosis
• Fewer occurrences of ectopic pregnancy
• Fertility returns quickly when use is stopped

• Must be taken daily
• Rare but serious health risks, including blood clots, heart attack, and stroke — women who are over 35 and smoke are at a greater risk
• Other side effects include temporary irregular bleeding, weight gain or loss, breast tenderness, nausea — rarely, vomiting, changes in mood, and other discomforts
• Persistent side effects may be relieved by having your clinician change your prescription

• Must be taken daily
• (start day of abortion or within 5 days)

Method

Failure Rate*

Advantages

Possible Disadvantages

Patient Directions (Time to Start)

SURGICAL & HORMONAL METHODS (cont’d)

The Ring

NuvaRing

8.0%

• Protects against pregnancy for one month no pill to take daily does not require a “fitting” by a clinician
• Does not require the use of spermicide
• Fertility returns quickly when use is stopped
• Nothing to do right before sex to protect against pregnancy
• Results of long-term studies won’t be available for some time, but researchers assume that the non-contraceptive advantages associated with using the Ring are similar to those known to be associated with the Pill

• Increased vaginal discharge, irritation
• Cannot use a diaphragm or cervical cap for a backup method of birth control
• Rare but serious health risks, including blood clots, heart attack, and stroke (women > 35 and who smoke are at a greater risk)
• Other side effects include temporary irregular bleeding (rarely), weight gain or loss, breast tenderness, nausea — rarely, vomiting, changes in mood, and other discomforts

• A small ring is inserted into the vagina
• Replace ring once per month
• (start day of abortion or within 5 days)

The Patch

Ortho Evra

8.0%

• Protects against pregnancy for one month
• No pill to take daily
• Ability to become pregnant returns quickly when use is stopped
• Nothing to do right before sex to protect against pregnancy
• Results of long-term studies won’t be available for some time, but researchers assume that the non-contraceptive advantages associated with using the Patch are similar to those known to be associated with the Pill

• Skin reaction at the site of application
• menstrual cramps
• For wearers of contact lenses, a change in vision or the inability to wear the lenses
• May not be as effective for women who weigh more than 198 pounds
• Rare but serious health risks, including blood clots, heart attack, and stroke — women who are over 35 and smoke are at a greater risk
• Other side effects include temporary irregular bleeding, weight gain or loss, breast tenderness, nausea - rarely, vomiting, changes in mood, and other discomforts

• A new patch is worn each week for three weeks per month
• (start day of abortion or within 5 days)

BARRIER METHODS:  Help protect against STIs (degree of protection varies by method) 

Male Latex Condom

15.0%

• Easy to buy (non-prescription)
• Helps protect against many infections, including HIV
• Can be put on as part of sex play
• Can help relieve early ejaculation

• Latex allergies
• Loss of feeling
• Can break or slip off

• Must be used every time
• (start when intercourse resumes)

Female Condom

(Reality)

21.0%

• Easy to buy (non-prescription)
• Helps protect against many infections, including HIV
• Can be put in as part of sex play
• Can help relieve early ejaculation

• May be noisy
• May be hard to insert
• May irritate vagina, penis
• May slip into vagina during sex

• Must be used every time
• (start when intercourse resumes) 

Diaphragm

16.0%

• Can last several years
• Costs very little to use

• May protect against some infections (NOT HIV)

• Allergies to latex or spermicide
• Should not be used during vaginal bleeding or infection
• Increased risk of bladder infection
• Can be left in place only 24 hours

• Must be used every time (start when intercourse resumes)
• Must be used with spermicide
• Must be fitted by a clinician

Cervical Cap

1) Parous women

2)Nulliparous women

1)32.0%

2)16.0%

• Can last several years
• Costs very little to use
• May protect against some infections (NOT HIV)

• Allergies to latex or spermicide
• Should not be used during vaginal bleeding or infection
• Can be left in place only 48 hours

• Must be used every time (start when intercourse resumes)

• Must be used with spermicide

• Must be fitted by a HC provider

* Percentage of women experiencing an unintended pregnancy within the first year of use with typical use.

Method

Failure Rate*

Advantages

Possible Disadvantages

Patient Directions (Time to Start)

OTHER FAMILY PLANNING METHODS

Emergency Contra-ception

(Plan B, Preven)

Lowers risk of pregnancy by at least 77%

• Can lower the risk of pregnancy if taken within 72 hours (up to 120 hours) of unprotected sex

• Nausea, vomiting, change in next period, breast pain

• Take 2 doses at same time (Plan B), otherwise 12 hours apart (start as soon as possible after unprotected sex)

Spermicide

(Cream, gel, foam, inserts)

29.0%

• Easy to buy without prescription
• Can be put in as part of sex play
• Comes in many forms: cream, gel, foam and inserts

• May irritate vagina, penis
• Can be messy
• Using nonoxynol-9 many times a day may increase risk of HIV infection

• Must be used every time (start when intercourse resumes)

Periodic Abstinence

25.0%

• No medical or hormonal side effects

• Many people find it difficult to abstain from sex for long periods of time

• Many people fail to use protection when abstinence ends

• Start abstaining immediately after the abortion procedure

Continuous Breastfeeding

Lactational Amenorrhea (LAM)

6.0%

For babies

• Provides the best nutrition
• Decreases the likelihood of infections
• Allergies, and possibly, asthma
• Increases mother and child bonding

For mothers

• No medical or hormonal side effects
• Requires no supplies or medical supervision

• Not an effective post-abortion method;
• Only effective for six months after delivery
• Can be difficult to exclusively breast-feed
• Temporary method only

• To maintain protection against pregnancy, another method of contraception must be used as soon as menstruation resumes, the frequency of breastfeeds is reduced, bottle feeds are introduced, or the baby reaches 6 months of age

Withdrawal

27.0%

• Can be used when no other method is available
• Can be used in conjunction with consistent condom use for nearly 100% effectiveness

• Requires great self-control, experience, and trust
• Not for men who ejaculate — “come” — prematurely
• Not for men who don’t know when to pull out
• Not recommended for teens 

• Must be used every time (start when intercourse resumes)