Birth Control Options

The development of modern contraceptives (birth control) offers women the ability to avoid unwanted pregnancies with a degree of reliability and safety unmatched in human history.

Until the 1960’s, few contraceptive options were available aside from condoms and diaphragms.

These methods, unfortunately, had one common flaw—their lack of spontaneity. Because the use of condoms and diaphragms requires some degree of discipline and planning many couples find them annoying and elect to occasionally “skip” their use—often resulting in an unplanned pregnancy. The reality is simple– the “heat” of the sexual act isn’t a good time to “plan” anything. Remember, the “plans” you make at your doctor’s office in the midst of an anxiety-provoking office visit might not reflect the reality of how you’ll behave on Friday night with a few beers and the “man of my dreams”.

The introduction of oral contraceptives in 1960, the intrauterine device in 1962, Depo-Provera (1992), the contraceptive patch (2001), the contraceptive ring (2001) and relatively simple and safe methods of permanent sterilization now offer women a vast array of contraceptive options that are reliable, safe and spontaneous.

No method of contraception is risk free. However, one must consider that whatever the risks of a particular method of contraception might be, those risks are small compared to the risks of an unplanned pregnancy. Sexual activity is not risk free. The safe and responsible management of those risks requires a commitment to understanding what these methods can and cannot offer.

Remember that contraceptives are designed to protect against pregnancy. By and large they do not guarantee safety against sexually transmitted disease or spare you the emotional pain of making poor decisions about sexual relationships.

One last thought. Once you enter the arena of sexual activity you assume certain risks. Your job, along with the guidance of a knowledgeable health care provider, is to minimize those risks. Over the years I’ve crossed paths with hundreds of women who stopped their birth control pills because a “friend” told her that they were dangerous or her mother told her that she shouldn’t take birth controls pills and smoke cigarettes. However well-meaning the advice might have been it was generally the wrong advice because it didn’t consider the “cost” of not using a reliable method of contraception. It isn’t ideal for a woman over 35 years old who smokes to also take oral contraceptives—but before you stop those pills use another method or consult a health care provider who can help you avoid an unplanned pregnancy! Remember that your well-meaning friend won’t have to live with the outcome of poor advice—you will.

Looking at “risk”

Experience has shown that when it comes to judging risk, people often focus on the “wrong” things. Studies have shown that parents often believe that having their child visit a friend whose parent keeps a firearm in their home is prohibitively dangerous. But the very same parents might not think twice about sending their daughter or son to the neighbor’s home with an outdoor pool. The reality, however, is that each year 12 times more children die of drowning than accidental gun accidents!

Women often avoid the use of a particular method of contraception – intrauterine device, Depo-Provera, birth control pills—because of their perceived “risk” of that method of contraception. Often the conversation begins with “I heard that they cause cancer”, “I heard they cause infertility”, or “I heard there are risks of heart attacks”. My personal favorite is “I heard that smoking while taking the birth control pill is bad for you”.

Here’s the point. The reality is that smoking and the birth control pills isn’t good for you—the real danger being smoking! The problem isn’t the pill. The combined risk of taking birth control pills and smoking, however, is far less than the risk of an unplanned pregnancy which includes the risk of continuing a pregnancy or having it terminated.

In other words the risk of any form of contraception must be weighed against the risk of not using a reliable method of contraception and becoming pregnant.

We all need help in assessing the best possible choices for our health care. Please seek that advice from a qualified professional.