What is birth control, and how does it work?
Birth control works to prevent pregnancy in different ways.
- Hormonal birth control methods work by preventing ovulation, so that a woman is temporarily infertile.
- Barrier methods of birth control prevents the man's sperm from reaching an egg.
- Barrier methods include
- diaphragms,
- condoms, and
- cervical caps.
- Spermicide is a chemical that destroys sperm to prevent them from reaching the egg.
- Birth control methods such as intrauterine devices work by preventing a fertilized egg from implanting in the uterus and causing a pregnancy.
How long does it take for birth control to begin working?
Some kinds of birth control start to work with the first use, such as barrier methods. Hormonal methods of birth control such as pills, implants, or the patch may not begin working immediately.
Their effectiveness depends upon the time in your monthly cycle when you begin using the contraception. Sometimes it is recommended that women use an alternate method of contraception for the first week after beginning the pill or hormonal contraception.
Can you get pregnant on birth control?
There is no form of birth control that is 100% effective, so it is possible to get pregnant while using most types of birth control.
However, many types of birth control, when used correctly, are highly effective in preventing pregnancy. For example, the birth control pill is over 99% effective in preventing pregnancy when taken correctly. For all forms of birth control it is important to have a basic understanding how they work and how to use them correctly.
1 Abstinence / Outercourse
(100% effective when used perfectly / 100% effective when used imperfectly)
A person doesn't have to be a virgin to practice abstinence. Sometimes, someone who has been having sex decides to stop doing so. A person who has been having sex can still choose abstinence to prevent pregnancy and sexually transmitted diseases (STDs) in the future.
Abstinence and outercourse are safe, effective, and free ways to prevent pregnancy. But some people have a hard time avoiding sex.
Abstinence and outercourse have lots of benefits.
Both abstinence and outercourse are simple, free, and work really well to prevent pregnancy. In fact, abstinence is the only 100% effective way to avoid pregnancy and STDs. And outercourse really lowers your risk a lot.
There are other benefits of abstinence. People choose abstinence to:
wait until they feel ready for a sexual relationship
wait to find the right partner
enjoy their partner’s company without having to deal with a sexual relationship
focus on school, their job, or hobbies
follow their personal, moral, or religious beliefs and values
get over a breakup
heal from the death of a partner
follow their doctor’s advice during or after a sickness, infection, or medical procedure
Outercourse has benefits, too. It can:
let couples give each other sexual pleasure without causing pregnancy or spreading STDs
increase trust and closeness between partners
prevent pregnancy if you don’t have another kind of birth control available
help you better understand your (and your partner’s) body
help you learn how you (and your partner) like to be touched and what feels good
Abstinence and outercourse have special advantages for teens and younger people. Abstinence is a great way to avoid the risks that come with sex — like pregnancy and STDs — until you’re ready to prevent and/or handle them. Abstinence can also help you focus on things that are most important to you, like friends, school, sports, activities, having fun, and planning for your future. People who hold off on having sex in their teens and have fewer sexual partners in their lifetime are less likely to get an STD.
Abstinence and Outercourse Summary
Complete abstinence is the only way to guarantee protection against STDs. This means avoiding all types of intimate genital contact. Someone practicing complete abstinence does not have any type of intimate sexual contact, including oral sex. So there is no risk of getting an STD.
100% effective
Cost is $0
Dedication required
Takes willpower
Also protects you from STDs
2 | Implants
(99.91% effective when used perfectly / 99.91% effective when used imperfectly)
The birth control implant is a tiny, thin rod about the size of a matchstick. It’s also called Nexplanon and there’s a slightly older version called Implanon. A doctor inserts the implant under the skin of your upper arm. It releases the hormone progestin to stop you from getting pregnant.
The hormones in the birth control implant prevent pregnancy in two ways:
Progestin thickens the mucus on your cervix, which stops sperm from swimming through to your egg. When sperm can’t meet up with an egg, pregnancy can’t happen.
Progestin can also stop eggs from leaving your ovaries (called ovulation), so there’s no egg to fertilize. When eggs aren’t released, you can’t get pregnant.
One of the awesome things about the implant is that it lasts for a long time — up to 5 years — but it’s not permanent. If you decide you want to get pregnant or you just don’t want to have your implant anymore, your doctor can take it out. You’re able to get pregnant quickly after the implant is removed. You can keep track of your insertion and removal dates using our birth control app.
Does the implant prevent STDs?
Nope. Nexplanon doesn't protect against STDs. Luckily, using condoms or internal condoms every time you have sex does lower your chances of getting or spreading STDs. So using condoms with your implant is the best way to prevent infection.
Implant Summary
99% effective
Costs up to $1300.00 = ₦472810.00, but can be $0
Put in by a doctor or nurse
Lasts up to 5 years
The implant doesn’t protect you from STDs. Use a condom with your implant to help stop pregnancy and STDs.
3 | Sterilization
(99.5-99.85% effective when used perfectly / 99.5-99.9% effective when used imperfectly)
Want to make sure pregnancy is not in your future? Tubal ligation (sometimes called sterilization, female sterilization, or “getting your tubes tied”) is a safe and effective surgical procedure that permanently prevents pregnancy.
How does tubal sterilization work?
Tubal ligation is a surgical procedure that permanently closes or blocks your fallopian tubes. Every month, an egg leaves one of your ovaries (called ovulation). The egg moves through one of your fallopian tubes for a few days, waiting for sperm to come fertilize it. Pregnancy happens if a sperm cell meets up with one of your eggs, and the fertilized egg implants in your uterus.
When the fallopian tubes are blocked after a tubal ligation, sperm can't get to an egg and cause pregnancy. Tubal ligation is sometimes known as sterilization, female sterilization or “getting your tubes tied.” There are a few different types of sterilization procedures.
You still get your period after tubal ligation — you just can’t get pregnant.
Is sterilization right for me?
Most people who have ovaries and fallopian tubes can safely get sterilized. Your doctor will talk with you about your health to make sure sterilization is right for you. You should only get sterilized if you’re totally sure you don’t want to be able to have kids for the rest of your life.
Sterilization may not be a good choice for you if:
There’s any chance you’ll want to get pregnant in the future.
You’re being pressured by your partner, friends, or family.
You hope sterilization will solve problems that may be temporary — like marriage or sexual issues, short-term mental or physical illnesses, or money problems.
Does sterilization protect against STDs?
Nope. Tubal ligation won’t protect you or your partners from sexually transmitted infections. Use condoms to help lower your chances of getting or spreading STDs.
Sterilization
99% effective
Costs up to $6,000, but can be $0
Surgical procedure
Do it once, lasts forever
Sterilization doesn’t protect you from STDs. Use a condom to help stop STDs.
And if your doctor messes it up, shouldn’t the imperfect percentages reflect that, like 0.1%-85% or so.
4 | The Pill
(99.9% effective when used perfectly / 95% effective when used imperfectly)
The birth control pill works by stopping sperm from joining with an egg (which is called fertilization).
The hormones in the pill stop ovulation. No ovulation means there’s no egg hanging around for sperm to fertilize, so pregnancy can’t happen.
The pill’s hormones also thicken the mucus on the cervix. This thicker cervical mucus blocks sperm so it can’t swim to an egg — kind of like a sticky security guard.
How do I make the pill work best for me?
Forgetting pills, losing the pack, not refilling your prescription on time — these are the main reasons why people might get pregnant when they use the pill. It’s good to plan ahead and think about the best way for you to use the pill correctly. Here are some ways to help you remember to take your pills every day:
Use our birth control reminder app or set an alarm on your phone.
Keep your pill pack next to something you use everyday (like your toothbrush or phone charger).
Keep your pills in your bag so they’re always with you.
Be pill buddies with friends or family members who also take medicine every day, and help each other remember.
Your partner can help remind you.
Do whatever works to help you take your pill on time, all the time.
Want to be super duper sure you don’t accidentally get pregnant? You can also use a condom every time you have penis-in-vagina sex. That way you’ll be protected against STDs too.
Does the pill protect against STDs?
Nope. The pill is really good at preventing pregnancy, but it won’t protect you from sexually transmitted infections.
Luckily, using condoms every time you have sex really lowers your chances of getting or spreading STDs. Condoms also protect against pregnancy — so using condoms + birth control pills together gives you awesome pregnancy-preventing power.
The Pill
91% effective
Costs up to $50, but can be $0
Prescription required
Take once a day
The pill doesn’t protect you from STDs. Use a condom with your pill to help stop pregnancy and STDs.
5 | Condoms
(97% effective when used perfectly / 86% effective when used imperfectly)
Condoms are great at preventing both pregnancy and STDs. If you follow the instructions and use them every time you have vaginal, anal, or oral sex, there’s very little chance of pregnancy, or getting or giving an STD.
How effective are condoms against pregnancy?
If you use condoms perfectly every single time you have sex, they’re 98% effective at preventing pregnancy. But people aren’t perfect, so in real life condoms are about 85% effective — that means about 15 out of 100 people who use condoms as their only birth control method will get pregnant each year.
The better you are about using condoms correctly every time you have sex, the better they’ll work. But there’s a small chance that you will get pregnant even if you always use them the right way.
Want even more protection from pregnancy? Check out IUDs and implants, or take this quiz to find the birth control method that’s best for you.
How can I make condoms more effective?
The best way to make condoms work as well as possible is to use them correctly every single time you have vaginal, oral, and anal sex. That means wearing it the whole time, from start to finish. Make sure the condom is rolled on your penis the right way before there’s any skin-to-skin genital contact. Read more about how to use condoms correctly.
Using condoms + another form of birth control (like the pill, IUD, or shot) is a great way to get extra pregnancy prevention AND protection against STDs. Using withdrawal (“pulling out”) while also wearing a condom can help keep sperm out of the vagina and lower the risk for pregnancy.
You shouldn’t use a condom worn on the penis together with a internal condom. Condoms are designed to be used on their own, and doubling up won’t necessarily give you extra protection. One condom used correctly is all the protection you need.
Condom
85% effective
Costs around $2 per condom, but can be $0
No prescription required
Put it on before sex
Condoms help protect you from STDs. Use another birth control method with your condom for even more pregnancy preventing power.
SEE
6 | Pullin’ out
(96% effective when used perfectly / 81% effective when used imperfectly)
If you do it correctly, pulling out is a pretty effective way of preventing pregnancy. But it can be hard to do it the right way every time. Pulling out also doesn’t protect against STDs, so using a condom is a good idea - both to help prevent STDs, and to add extra pregnancy prevention.
How effective is the pull out method?
The better you are about using the pull out method correctly — keeping any ejaculation (cum) away from the vulva and vagina every single time you have sex — the better it will work to prevent pregnancy. For every 100 people who use the pull out method perfectly, 4 will get pregnant.
But pulling out can be difficult to do perfectly. So in real life, about 22 out of 100 people who use withdrawal get pregnant every year — that’s about 1 in 5.
The reality is withdrawal isn’t as effective as other types of birth control, but it’s definitely better than not using anything at all. And pulling out can be easily combined with other methods to give you extra pregnancy preventing power. Using withdrawal AND condoms together, for example, gives you pretty excellent protection against pregnancy.
If you use withdrawal for birth control, it’s a good idea to keep emergency contraception (aka the morning-after pill) around, just in case semen (cum) gets in or near your vagina. Emergency contraception can prevent pregnancy for up to 5 days after unprotected sex.
Want to use a more effective form of birth control? Check out the IUD and the implant. They’re the most effective kinds of birth control.
Withdrawal
78% effective
Cost is $0
Dedication and skill required
Pulling out doesn’t protect you from STDs. Use a condom and withdrawal to help stop pregnancy and STDs.
7 | Diaphragms
(94% effective when used perfectly / 80% effective when used imperfectly)
A diaphragm is a shallow, bendable cup that you put inside your vagina. It covers your cervix during sex to prevent pregnancy.
What’s a diaphragm?
A diaphragm is a form of birth control that’s a shallow cup shaped like a little saucer that's made of soft silicone. You bend it in half and insert it inside your vagina to cover your cervix.
How does a diaphragm prevent pregnancy?
The diaphragm is a barrier that covers your cervix, stopping sperm from joining an egg. In order for a diaphragm to work best, it must be used with spermicide (a cream or gel that kills sperm).
How do diaphragms work with spermicide to prevent pregnancy?
Adding spermicide to your diaphragm before you put it in your vagina makes it much more effective. Spermicide has chemicals that stop sperm from moving so they can't get to an egg. The diaphragm keeps the spermicide in place, near your cervix.
Diaphragm
88% effective
Costs up to $75, but can be $0
Prescription required
Put it in before sex
A diaphragm won’t protect you from STDs. Use a condom with your diaphragm to help stop pregnancy and STDs.
8 | The Rhythm Method
(91-99% effective when used perfectly / 75% effective when used imperfectly)
The rhythm method has to do with planning sex around the woman’s menstrual cycle. Not, as an anonymous friend of mine once thought, having sex to house music.
9 | Female condoms
(95% effective when used perfectly / 79% effective when used imperfectly)
Internal condoms (AKA female condoms) are great at preventing pregnancy and STDs. If you follow the instructions and use them every time you have vaginal or anal sex, there’s very little chance of pregnancy, or getting or giving an STD.
How effective are internal condoms at preventing pregnancy?
If you use them perfectly every single time you have sex, internal condom effectiveness is 95%. But people aren’t perfect, so in real life they’re about 79% effective — that means about 21 out of 100 people who use internal condoms as their main method of birth control will get pregnant each year.
Looking for a more effective form of birth control? Check out IUDs and implants, or take this quiz to find the birth control method that’s best for you.
How can I make internal condoms more effective?
The best way to make internal condoms work as well as possible is to use them correctly every single time you have vaginal or anal sex. That means wearing it the whole time, from start to finish. Make sure the condom is in place in your vagina or anus the right way before there’s any skin-to-skin genital contact. Read more about how to use internal condoms correctly.
You can make internal condoms better at preventing pregnancy by using them along with another birth control method (like the pill or an IUD). That way you’ve got some protection from STDs, and double protection from pregnancy.
One thing you should definitely NOT do is use a regular condom together with an internal condom. Each kind of condom is designed to be used on its own, and doubling up won’t give you extra protection. One condom used correctly is the best way to go — whichever kind of condom you use.
Keep in mind that drugs and alcohol can make people forget to use condoms (or less able to use them correctly).
10 | The sponge
(80-91% effective when used perfectly / 60-80% effective when used imperfectly)
The birth control sponge (aka the contraceptive sponge or “the sponge” for short), is a small, round sponge made from soft, squishy plastic. You put it deep inside your vagina before sex. The sponge covers your cervix and contains spermicide to help prevent pregnancy. Each sponge has a fabric loop attached to it to make it easier to take out.
The only brand of sponge sold in the U.S. is the Today Sponge.
How does the sponge work?
The sponge prevents pregnancy two ways: It fits snugly against your cervix, blocking the entrance to your uterus so sperm can’t get to your egg. The sponge also contains spermicide, which slows sperm down so it can’t reach your egg.
The sponge can be used by itself, or with condoms. Using the sponge plus a condom gives you extra protection from pregnancy (bonus: condoms prevent the spread of STDs, too).
Sponge
76-88% effective
Costs up to $15 for 3
No prescription required
Put it in before sex
The sponge doesn’t protect you from STDs. Use a condom with your sponge to help stop pregnancy and STDs.
11 | Nothin’
(15% effective when used perfectly / 15% effective when used imperfectly)
Hey, why not let it fly! You’ve got a one in seven shot of escaping pregnancy free! I like those odds!
BONUS
Is breastfeeding a form of birth control?
Breastfeeding isn’t just a healthy way to feed your baby. It can also be a form of birth control — but only done in a certain way.
How does breastfeeding prevent pregnancy?
When you exclusively breastfeed — meaning you nurse at least every 4 hours during the day and every 6 hours at night, and feed your baby only breast milk — your body naturally stops ovulating. You can’t get pregnant if you don’t ovulate.
No ovulation means you won’t have your period, either. That’s why breastfeeding-as-birth control is also called the lactational amenorrhea method (LAM). “Lactational” refers to breastfeeding, and “amenorrhea” means not having your period.
How effective is breastfeeding as birth control?
When you do it perfectly, the LAM birth control method can be about as effective as hormonal contraceptives (like the pill). About 2 out of 100 people who use breastfeeding as birth control get pregnant in the 6 months it can be used after a baby is born.
Breastfeeding won’t prevent pregnancy if you feed your baby anything other than breastmilk. So if you breastfeed but also use formula, LAM isn’t a great birth control method for you. It also doesn’t work if you use a breast pump — you need to nurse your baby if you want your breastfeeding to prevent pregnancy.
It’s important to remember that breastfeeding can only be used as birth control for the first 6 months of a baby’s life, or until your period returns. After that, breastfeeding is way less effective — especially as the baby begins to eat solid foods and sleeps longer at night. Be ready to use another birth control method at 6 months, when your period returns, or if you start feeding your baby food or formula.
How do I start using breastfeeding as birth control?
You can start using LAM as soon as your baby is born. It may take a little while for you to get used to breastfeeding. Lots of people need help in the beginning, especially if it’s your first baby. Most hospitals have people who can help. And you can check out La Leche League for information, resources and support.
Breastfeeding
98% effective
Cost is $0
Dedication required
Works up to 6 months after giving birth
Breastfeeding doesn’t protect you from STDs. Use a condom for help stopping STDs.
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