Yes, we know, we know, we know: if you'd like to prevent unplanned pregnancy and sexually transmitted diseases (STDs), abstinence is the only method that works 100% of the time. We also know that staying home is the only surefire way to avoid getting run over by a car, but because that's no way to live, most of us choose to take our chances and look both ways before crossing the street.
This is true for everything you'll ever encounter: your control over the outside world is limited and no matter what you do, some things won't go your way. Accidents happen. Hermits get electrocuted. I tend to believe that our job, as humans, is to try to experience as much of the world as possible, while taking steps to protect ourselves, so we can continue to have experiences for as long as possible. In the case of sex, there's a middle ground between abstinence and recklessness. It's called birth control.
Bad news first: the burden of selecting birth control and using it most often falls on women. Now the good news: there are lots of options, so you can likely find a method which makes you feel comfortable and fits your lifestyle.
I've rounded up just a few of the most popular and common options below, with a quick overview of their effectiveness, strengths, and limitations. Obviously, some methods, like female sterilization, are extremely effective, but they're also exceptionally rare among childless women. Another option, the diaphragm, was once the most widely-used form of birth control, but because it has a lower effectiveness rate than the condom or the pill, doesn't prevent STDs, and is cumbersome to use, it's fallen out of favor.
I'm pulling most of this information from Planned Parenthood and anecdotal experience, and I'm not any kind of expert or health professional. You should follow up with comprehensive research of your own and consult your doctor before making a decision.
Cost: Free to cheap. You can get high-end condoms at specialty shops*, but most drugstore-brand condoms are available for around $1 each. Free condoms are often available in clinics. New York City distributes free condoms, manufactured by LifeStyles and funded by the NYC Department of Health, in schools, health centers, and even bars.
Effectiveness: High, when used correctly each time. Over the course of a year, only about 2% of women will get pregnant if she and her partner use condoms correctly each and every time. The failure rate goes up to 18% when they aren't used correctly each time.
Drawbacks: Some people find that condoms make sex less enjoyable, or that the experience of putting one on is disruptive and distracting.
Notes: Of all the most popular methods, latex condoms are the single best way to protect yourself against STDs. Keep in mind that female condoms are more effective than male, but (from my experience) relatively uncommon in social practice. Some people prefer the sensation of lambskin condoms to latex, but lambskin is less effective in preventing pregnancy and STDs because the material is porous.
Cost: Varies depending on your insurance plan. You'll have to go in for an exam to get a prescription, and then you can expect to pay between $15 and $50 a month. There are various programs and organizations that provide more affordable options for low-income women and students. Get in touch with Planned Parenthood for more info.
Effectiveness: Higher than condoms, when taken daily. Over the course of a year, only about 1% of women will get pregnant if she doesn't miss a dose. About 9% will get pregnant if they don't use the pill as directed.
Drawbacks: Different kinds of pills have different kinds of side effects and it's impossible to predict how your body will respond. Some women suffer from no side effects, others experience nausea, weight gain, or spotting. The pill might also affect mood or cause changes to your sex drive.
Notes: The pill doesn't protect against STDs, but since it's easy to use and highly effective, it's a popular choice among women in committed monogamous relationships.
Other Hormonal Birth Control Methods
Like The Pill, these other forms of birth control release hormones like estrogen and progestin to prevent ovaries from releasing eggs. They all boast similar levels of effectiveness and could cause nearly identical side-effects. None of them protect against STDs. The major differences between them are cost and application. I've broken those down below.
The Shot: A shot in your arm to inject the hormones. It lasts three months and costs $35-$75 (in addition to the charge for a doctor's visit). Women that don't want to bother taking a pill each day might prefer this method. Unlike similar methods, the shot doesn't contain estrogen (only progestin).
The Ring: A ring is inserted into the vaginal canal for three weeks a month. It costs $15-$80 a month. It's easy to use, but just as easy to make a mistake with the application. Leaving the ring in for longer than three weeks or forgetting to reinsert it will increase your chances of pregnancy.
The Implant: A little rod which is inserted into your arm. This costs between $400-$800, but lasts for three years. It's a great choice if you can afford to pay up front and don't plan on having children for several years — it's a one-time visit to the doctor's office, and then a worry-free three years.
The Patch: A patch you stick to your skin. It costs $15-$80 a month, and needs to be changed weekly. This is a good choice for women that are queasy about some of the more invasive hormonal methods, but don't want to take the Pill daily.
The Hormonal IUD (Mirena): A T-shaped device inserted into your uterus. Mirena lasts for five years, and costs between $500 to $1,000. It's more costly than the Implant, but lasts longer.
The Non-Hormonal IUD (ParaGard)
Cost: Between $500 and $1,000, but it lasts for twelve years.
Effectiveness: Extremely high. Only 1% of women will get pregnant every year.
Drawbacks: Insertion is often painful, and you might experience some cramps or physical discomfort for the first few days. Side effects like spotting tend to go away after three to six months, but others, like heavier periods or more painful cramping might persist. Planned Parenthood says serious side effects are rare, but in some cases the IUD can slip out (increasing the risk of pregnancy) or lead to infections.
Notes: The initial procedure is invasive and unpleasant, and I've known people that have experienced some of the more serious complications. Still, if you can pay the upfront costs, ParaGard is one of the more affordable options in the long run. You can keep it in for up to twelve years, obliterating your chances of pregnancy for over a decade. A doctor can remove it at any time. It doesn't release hormones, so you're bypassing a lot of the side effects associated with hormonal methods. ParaGard doesn't protect against STDs.
*Sex stores don't have to be creepy. Babeland is a sex-positive, women-owned chain of boutiques which sell high-quality products in a comfortable, even pleasant, environment.
images: tomford.com, nyc.gov, inquisitr.com, suite101.com, paragardvsmirena.com, cloudfront.net