September 2022
Sexual Health
Hedda Fay

Pregnancy Prevention

I won’t discuss Roe v. Wade here, I’ll leave that to the legal and political pundits. Let’s talk about pregnancy prevention. Did you know there are many ways for people to avoid becoming pregnant?

Females are the ones carrying the highest pregnancy burden, both physically and socially. Men can help prevent unwanted pregnancies, too. Females can have one pregnancy each year, whereas males can impregnate hundreds of females in a calendar year. Let’s look at ways we can avoid unplanned and unwanted pregnancies.

Abstinence. A sure way to avoid an unexpected pregnancy is to not have sex. People abstain from sex for a variety of personal reasons. Some want a sexual sabbatical, others for work, sports, beliefs, commitments. This is 100% effective.

The pullout method, also known as preejaculation withdrawal, has an estimated 73% success rate. Who knew it was that high? Still not 100%. The pullout game is never solid.

Natural family planning, or the rhythm method, takes some work. It involves the female tracking her monthly cycle, from period to ovulation. This can help determine when they are most fertile and least likely to become pregnant. If the pen and pad are too much, today you can buy an ovulation tracker, which measures estrogen, luteinizing hormone and progesterone to know when’s the best time to become or avoid becoming pregnant. Some products even claim the ability to assist those with irregular cycles and polycystic ovarian syndrome in becoming pregnant. Some manufacturers claim they are 99% effective; the science says the tracking method can be effective 76% of the time.

Spermicides. There are foams, films and suppositories that can prevent pregnancy 82% of the time. Placed inside the vagina before sex, these chemicals block the cervix to prevent the sperm from connecting with an egg.

Emergency contraceptives. People ask us whether the morning-after pill constitutes an abortion. It does not. This pill prevents the egg from becoming fertilized by the sperm. The name is a little misleading because some such drugs can prevent pregnancy when taken up to five days after sex. Now you can even go online and take a quiz to see whether you’re a good candidate for these services, which can be 98% effective.

Barrier protection in the form of condoms, male and female, if used properly,  can prevent pregnancy 95-98% of the time. They’re affordable and easily accessible, especially at Northland Cares, where we give out over 18,000 per year in Yavapai County, free. Use them correctly, check the date, squeeze the sealed packaging to make certain there is air inside that you can feel. Dry condoms don’t work!

Vaginal rings, diaphragms and pessaries. This group of pregnancy-preventers have been around for centuries. In cultures around the world people have used honey, plant leaves, wool covered in oil, acacia gum, fennel, and other methods to block sperm in the vagina. Thankfully today we have diaphragms and vaginal rings to replace the pessaries of yore. Diaphragms are 94% effective, they are small, flexible, often silicone or latex cups that go inside the vagina to block the sperm. Vaginal rings can be used as contraceptives as well, small, flexible rings that females can insert into the vagina. These deliver hormones to the vagina to prevent fertilization, and are about 91% effective in preventing pregnancy.

Permanent birth control. Tubal ligation, having fallopian tubes tied or blocked, is typically done in a healthcare center or hospital and is 99% effective in preventing pregnancy. Males can elect to have a vasectomy, also known as male sterilization, where the small sperm tubes in the scrotum (seminiferous tubules) are cut or blocked off to prevent the sperm from leaving the body. This form of birth control is extremely effective in preventing pregnancy, almost 100%.

Intrauterine devices (IUDs) are small, usually T-shaped devices that fit inside the uterus. These are 99% effective and can last inside the uterus for three to ten years. They come in plastic and copper, and require a medical professional to insert.

Implants are little hormone-filled rods that can be implanted in the upper arm to slowly release the hormone progestin, which will stop the ovaries from releasing eggs. These are nice — no daily pill reminders and fewer side-effects than pills, and they can be removed. They also thicken the mucosa in the cervix, which prevents sperm from entering. For the uninsured, most county health departments provide this service to community members at little or no cost. Implants are 99% effective.

Shots. For those who struggle with pill compliance, this is a great alternative. These inject progestin into an arm or hip, and are 99% effective for three months.

Patches. Hormone patches furnish progestin through the skin (transdermally) and are 99% effective in keeping the ovaries from releasing eggs. Like the implants and shots, the patches also thicken the cervical mucosa.

The Pill. Birth-control pills are 99% effective when taken as prescribed, meaning at the same time each day, to keep the ovaries from releasing eggs.

These prevention methods do not protect against communicable pathogens — no, not even condoms can be 100% effective at that. I want to encourage you to take charge of pregnancy avoidance and be proactive. If you don’t have insurance, go to your local county health department, which has Title X funding and can offset the costs of these prevention methods. Sex does not have to equate with pregnancy.

This is Hedda Fay reminding you that you oversee your body. Be bold, stand up, dust off and take control of your personal reproduction. There are many options, and I’ve listed a few to get you started.

Hedda Fay, the Community Outreach and Program Manager of Northland Cares, answers your questions about sex and sexual health.