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BIRTH CONTROL METHODSP

Pre-Coital Birth Control Methods:

Cervical cap, female condoms, male condoms, Contraceptive sponge, Depo-Provera,  Diaphragm,  Implanon, Intrauterine Device, Lunelle,  Hormonal Oral Contraception (The Pill &Mini Pill),  Ortho-Evra, NuvaRing, spermicide, tubal ligation, vasectomy, Essure

Post-Coital Birth Control Methods:

Abortion, Ella, Emergency Contraception, Copper-T Intrauterine Device, RU486      

Methods That Don't Work

Resources 

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Be Contraception Wise 

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img1FProperly used condoms provide a high level of protection against STI's (sexually transmitted infections), so it’s a smart idea to use one in combination with other forms of birth control.

 

img29Never use oil-based lubricants with latex contraceptive barriers. Oil disintegrates latex!

 

img30Hormonal contraceptives and contraceptive devices that need to be fitted to your body must always be prescribed for you by your doctor. Never use another person’s hormonal contraceptives or fitted device.

 

img27You can make the whole process of using barrier contraceptives like diaphragms or condoms more comfortable by heating the contraceptive devices in warm (not hot) water before use. Do not remove condoms from their packaging when doing so. Do not wash spermicide off the diaphragm; apply spermicide right before insertion.

 

 

Pre-Coital Methods

 

Cervical Cap

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Effectiveness: 90% with perfect use.

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A cervical cap is a latex or rubber cup with a wide rim. It must be sized and prescribed by a doctor. For optimal effectiveness, cervical caps should be used with spermicide. They have the advantage of being able to remain in the vagina for forty-eight hours without removal, during which sex may occur multiple times. They should be removed no later than 48 hours after insertion to minimize the risk of Toxic Shock Syndrome. (See Menstruation for information on Toxic Shock Syndrome).

img292 img217

Pros:

Reusable.

Can remain in place up to 48 hours (but no longer).

Doesn’t interfere with the hormonal cycle.

 

Cons:

Cannot be used for sex during menstruation.

Must be left in for six hours after penile-vaginal sex.

Does not protect against STIs.                                                                                  

May increase the risk of urinary infection.

                                                              

 

Condom (female)

Effectiveness: 95% with perfect use.

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Female condoms are thin, flexible polyurethane tubes shaped to fit inside the vaginal canal. They have an inner ring at the top of the condom which fits behind the pubic bone over the cervix, and a ring around the bottom, or opening of the condom, that remains outside the vaginal canal after insertion.

 

Female condoms provide the most thorough vaginal canal barrier coverage available. They're sold in most adult stores, and through most pharmacies and medical supply outlets.

 

How to Use a Female Condom

To place inside properly, squeeze the inner or top ring between the thumb and forefinger. Insert the condom as far into the vagina as you can, making sure it’s covering the cervix and the ring is anchored behind the pubic bone. The bottom ring should remain outside of the vaginal opening.

 

When removing the condom, gently close and twist the open ring at the base to keep fluids inside it. Holding it closed, carefully pull the condom out so that no fluids spill into the vagina or onto the surrounding area. This is easiest done when standing up.

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When removing a female (or male) condom, gently  close and twist the bottom ring to keep fluids inside.

To use for anal sex, remove the inner ring. Insert partially with finger, and complete insertion with pleasure toy or penis.

 

img8 For optimal effectiveness, female condoms should be used

with a spermicide.

 

Pros:

Provides a high degree of protection against sexually transmitted infections.

Does not interfere with the hormonal cycle.

Can be placed in well before sexual activity.

Does not require a doctors’ prescription.

 

Con:

May take some practice getting used to.

 

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Condom (male)

Effectiveness: 98% with perfect use.

Male condoms are sheaths made of latex or other flexible materials that unroll over the penis like a glove.

 

Check Your Condom for Tears or Holes


Don't test the condom before putting it on by inflating or stretching it- this may damage it. Instead, carefully check the condom for holes or tears after it has been unrolled on your penis. A new, properly stored condom is probably sound, but double-checking its integrity is a smart habit to develop for your peace of heart and mind.

 

 

How to Use a Male Condom 220px-CondomUse2_alternative

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1. Condoms have a distinctive nipple or bump at the tip: this should face away from the penis, so that it pokes out, not in.

 

2. The tip of the condom should have about a half inch of free space in it to accommodate lubricant and ejaculate.

 

3. Gently put pressure on the condom to room remove air from the tip. Place the rolled condom over the head of the penis.

Then unroll the condom down the length of the penis to the very base.

 

4. The condom should be large enough to cover the entire penis when erect. Condom sizes, in both the size of the sheath and the ring at the base, vary. Try different condoms until you find one with a ring and a sheath that are not too tight or too loose for you. They should be snug during erection, but not overly constrictive.

 

4. If your erection softens or begins to slip during penetration, hold the base firmly with your hand to keep it in place.

 

5. After ejaculation, hold the ring at the base of the condom to keep the condom in place while withdrawing your penis so that you don't spill any ejaculate into or onto your partner. Move away from your partners’ body before removing the condom from your penis.

 

img8 Always throw away condom once you've used it – never reuse a condom.

 

imgA Always use a new condom for a new opening – vaginal, anal or oral. Never go

     from one opening to another using the same condom.

 

imgC1 For optimal effectiveness, always use a spermicide with condoms.

 

imgE Condoms should be stored in a cool, dark, dry place, protected from the sun and heat.

     Always check the expiration date to make sure that a condom is not too old to use safely.

 

Pros:

Provides a high degree of protection against sexually transmitted infections.

Currently the only form of birth control that allows men to choose whether or not they want to parent a child.

Relatively inexpensive and available.

May help sustain erection.

 

Cons:

May take some practice getting used to.

May reduce some sensitivity.

 

To view a video on how to use a male condom, see Safer Sex and go to How to Use Safer Sex Aids.   

Warning: some lubricants can seriously damage condoms and other forms of latex contraceptives/barriers

If it wasn’t specially made for lubrication during sex, it isn’t safe to use with a condom.

Not safe to use:

  • Baby oil
  • Vaseline
  • Sun-cream
  • Cocoa butter
  • Lipstick/gloss
  • And any oil based preparation

Safe to use:

  • Pasante lube
  • Replens
  • Durex Play
  • Body Silk
  • KY gel
  • Sutherland gel
  • And other water-based preparations

 

Contraceptive Sponge

Effectiveness: 80% with perfect use. 

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The contraceptive sponge is a polyurethane device that resembles a miniature life preserver, with a strap that hangs down for convenient removal. It’s saturated with spermicide that foams up when water is added to it. The sponge offers double contraceptive measures with its spermicide ingredient and the barrier protection provided by the sponge, which is placed in front of the cervix to block sperm. 

 

The sponge must remain in place for at least six hours after intercourse to prevent pregnancy. It should be removed no later than 24 hours after insertion to prevent Toxic Shock Syndrome.

 

The sponge may be used for multiple acts of intercourse.

 

Pros:

Can be used during sex for up to twenty-four hours.

Relatively inexpensive.

 

Cons:

Does not offer substantial protection against sexually transmitted infections.

 

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Depo-Provera (Depot medroxyprogesterone acetate)

Effectiveness: 99% with perfect use.

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Depo-Provera is an injection of the hormone progestin. It is administered every twelve weeks, though its’ effectiveness range is thought to be about fourteen weeks. Administration is usually begun within five days of the last onset of menses.

 

After discontinuation, it may take twelve months or longer for Depo-Provera to wear off and fertility to resume.

 

 

Pros:

Lasts for fourteen weeks.

May be a good alternative for women who want to use hormonal contraception but react adversely to estrogen. 

 

Cons:

Should not be used by women who want the option of immediate pregnancy after discontinuation.

Provides no protection against sexually transmitted infections.

May cause weight gain, headache or dizziness.

Breakthrough bleeding may occur.

 

Diaphragm

Effectiveness: 95% with perfect use.

A diaphragm is a palm-sized latex, silicone or rubber cup that is placed over the cervix to prevent sperm from entering the uterus. To insert, the edges of the cup are squeezed together between thumb and index finger so that the cup becomes narrow enough to fit into the vaginal canal.

 

Diaphragms come in different sizes and must be fitted individually by a doctor, who will prescribe the right fit. You are an active participant in this fitting process; tell your doctor when the diaphragm fits comfortably inside your vagina, and when it doesn’t. You may wear a diaphragm for a couple of years before it needs to be replaced, and it should feel like a natural part of you.

 

A diaphragm should be replaced every two years. But it’s a good habit to examine your diaphragm every time before insertion, checking for any tears or holes while you coat it with spermicide.

 

Women need to be able to recognize when their diaphragm cup is properly placed over their cervix. A surprising number of users do not realize that they are misplacing their diaphragm and missing the cervix entirely! When you are fitted for your diaphragm, tell your doctor that you want to see them place it over your cervix. You can then do this yourself in the future with a mirror and a speculum (available at medical outlet stores). Also learn to feel the nub of your cervix in your vaginal canal with your fingers and to place the diaphragm so that the cervix is securely covered. Make sure that you can feel the bump of the cervix through the diaphragm.

 

This is also important because occasionally during rigorous penile thrusting a penis can dislodge its placement. You need to be able to feel when this has occurred by touch, and adjust the diaphragm back into its protective position immediately.

 

img4BFor maximal effectiveness, a diaphragm should always be used with a spermicide.

 

One of the agreeable things about using a diaphragm is that it can be inserted up to six hours before vaginal penetration, and used without removal during multiple acts of intercourse if used with a new application of spermicide each time. (This is easily accomplished with a plastic applicator. Make sure your doctor or pharmacist provides you with one!)

 

A diaphragm should be left in for at least six hours after last ejaculation to provide barrier protection against pregnancy. Diaphragms must be taken out no later than twenty-four hours after insertion to avoid the risk of Toxic Shock Syndrome.

 


      Diaphragm compared to the size of a quarter

Pros:

Relatively inexpensive and long-lasting.

Can be used whenever desired.

Can be put in well before sex.

Does not interfere with the natural .hormonal cycle.

Non-invasive.

Can be used during menstruation.

 

Cons:

Must be fitted by a doctor.

Does not protect against sexually transmitted infections.

May increase risk of urinary infection.

Must add more spermicide after ejaculation if penile – vaginal sex continues.

 

Implanon

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Effectiveness: 99% with perfect use.

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Implanon is a subdermal implant that gradually releases the hormone etonogestrel into the system, suppressing ovulation and disrupting the uterine conditions required for conception.

 

It is inserted before the fifth day following the onset of menses, and must be replaced every three years.

 

Pros:

May be suitable for women who want a hormonal contraceptive but cannot tolerate estrogen.

Long lasting.

Begins working as soon as it is implanted.

 

Cons:

May have break-through bleeding.

Does not protect against sexually transmitted infections.

Higher risk of ectopic pregnancy.

The same risks as all oral contraceptives.

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Intrauterine Device (IUD)

Effectiveness: 99% with perfect use.

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The IUD is a T-shaped device that is inserted into the uterus by a doctor. It works by causing an inflammatory reaction that inhibits the implantation of a zygote. A string that is attached to the IUD remains hanging outside of the cervix, where it should be checked regularly to make sure the IUD is still properly in place.

 

IUDs are the most commonly used form of contraception worldwide. Two forms are available:

 

The Progestasert IUD (below left) steadily releases the hormone progesterone into the uterus for twelve months, after which it must be replaced. This release of progesterone interferes with conception by thinning the endometrial tissue of uterine wall. In addition, the presence of the IUD device acts as a foreign body in the womb, causing an inflammatory reaction that interrupts conception.

 

The Copper-T IUD (below right) functions as a disruptive inflammatory presence in the uterus, deterring the endometrial implantation of a zygote from occurring. It may be used for ten years before replacement.

 

img117 img4E

Oral administration of Zithromax or doxycycline is recommended an hour before IUD insertion to reduce the possibility of infection.

 

Pros:

Once inserted, it can usually be left in the uterus for a long time without additional cost or fuss.

 

Cons:

Not recommended for women with pelvic inflammatory disease, extensive endometriosis, or scarring from either condition.

Not recommended for women at risk from endocarditis.

May increase menstrual cramping, especially the Copper-T.

 Do not provide protection against sexually transmitted infections.                                                                                        

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Lunelle

Effectiveness: 99% with perfect use.

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Lunelle is a monthly injection combining the hormones estrogen and progestin. It must be administered by a health care expert and so requires a monthly visit to your doctor or a qualified health care provider at the exact same time of the month, every month.

 

Pros:

Convenient way to receive a multi-hormonal contraceptive comparable to the pill without actually having to take a pill at the same time every day. 

 

Cons:

Lunelle must be taken at the same time of the month with complete consistency or it will not be effective, so you must be able to get to a doctors’ office or pharmacy with reasonable convenience.

Does not protect against sexually transmitted infections.

You may gain weight or retain water.

Irregular vaginal bleeding may occur.

Same risks as other hormonal methods.

 

Hormonal Oral Contraceptives (The Pill and the Mini Pill) 

Effectiveness: 99% with perfect use.

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There are two main types of hormonal oral contraceptives currently available: combination oral contraceptives that utilize a mixture of the hormones estrogen and progestin; and progestin-only oral contraceptives, also called the “mini-pill”. Combination oral contraceptives are considered slightly more effective, but both are highly effective.

 

You Must Use Another Form Of Birth Control For The First Week

That You Use The Pill

You must use an alternative form of birth control for 7 days while the pills’ hormones become effective in your system. Discuss options with your doctor. Condoms, diaphragms or cervical caps combined with spermicide are usually suitable choices.

 

 

Monophasic and multiphasic (combination hormonal oral contraceptive pills)

Monophasic oral contraceptives contain both an estrogen and a progestin in one pill. Multiphasic oral contraceptives vary the dose of one or both hormones during the monthly cycle. It is thought that the multiphasic pattern more closely simulates the natural hormonal phases of the menstrual cycle. Multiphase contraceptives also contain a lower total dose of hormones per cycle, though they have not been shown to have a lower rate of hormone related adverse effects, or other advantages over the monophasic kind.

 

When to Begin

There are three ways that you can begin taking combination oral contraceptives:

 

           img1F The first day of menstrual bleeding

 

           img1F The first Sunday after menstrual bleeding begins

 

          img1F Immediately if you are not pregnant and have not had  unprotected sex since your last menstrual period

 

This is all to assure that you do not begin taking the pill when you are pregnant. This could cause termination or complications of the pregnancy.

 

What If A Combination Pill Is Missed?

Less than 24 hours since the last pill was taken: Take your pill immediately and take the next pill as normally taken.

 

24 hours since the last pill was taken: Take the pill you missed with the next scheduled pill. If more than 12 hours late, use a second form of birth control for 7 days.

 

More than 24 hours since the last pill was taken: Take the last pill missed and throw out all other missed pills. Return to your normal pill routine but also use a second form of birth control for the rest of the monthly cycle.

 

Progestin Only Oral Contraceptives

Progestin-only oral contraceptives may be a useful alternative to women who have an adverse reaction to estrogen, and women over forty. Progestin is also thought to be acceptable for nursing mothers, because milk production is unaffected by progestin-only agents.

 

When Not To Take Oral Contraceptives

Oral contraceptives are not for everyone. They are associated with certain risks, and your complete medical history must be assessed to determine their applicability to you. These are some of the contraindications that suggest you should avoid them:

 

Combination oral contraceptives

Smoking in women over thirty-five; liver disease; jaundice with past pregnancy or hormone use; breast feeding, undiagnosed abnormal vaginal bleeding; hepatic adenoma; known or suspected pregnancy; known or suspected breast cancer; a genetic predisposition to breast cancer; thrombophlebitis; history of thromboembolic disorders; cardiovascular disease; cerebrovascular disease.

 

Progestin-only oral contraceptives

Cholestatic jaundice of pregnancy or jaundice with past pill use; undiagnosed abnormal vaginal bleeding; hepatic adenoma; known or suspected pregnancy; known or suspected breast cancer, or a genetic predisposition to breast cancer.

 

Additional Pros and Cons of Oral Contraceptives:

Pros:

Third generation progestin’s used in combination oral contraceptives are thought to have less androgenic (masculinizing) properties.

Estogen may reduce the risk of osteoporosis.

 

Cons:

Women smokers over thirty-five have an increased risk of cardiovascular disease with combination oral contraceptive use.

Estrogen may cause nausea, breast tenderness and breast enlargement.

Third generation progestin’s used in combination oral contraceptives have been associated with a slight risk in the increase of venous thromboembolism.

Weight gain and depression are associated with all oral contraceptives.

Do not protect against sexually transmitted infections.

 

Drug Interactions with Oral Contraceptives

 Certain drugs lesson the effectiveness of oral contraceptives. When these drugs are taken, you must use another form of birth control for the complete duration of their use, and possibly for a while afterward. Discuss this in detail with your doctor to be sure that you are protected. These are some of the drugs that diminish the effectiveness of oral contraceptives:  antibiotics, penicillin, Bactrim, a number of anti-HIV agents, and several anti-epileptic drugs.

 

 

 

 

 






The Patch (Ortho-Evra)

Effectiveness: 99% with perfect use.

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The patch looks like a large, flesh-toned band aid. Every week it is placed on a different part of the body, where it releases a combination of hormones through the skin that suppress ovulation. One week a month users don’t wear the patch but continue to be protected from conception by the hormones absorbed into their body during the previous three weeks.

 

If you are late applying the patch or if it falls off for the day, you will not be protected for the rest of the week.

 

Pros:

The patch is a simple and effective way to use multi-hormonal contraception without having to take a daily pill. It is fairly resistant to coming off from

daily activities such as showering.

Fertility returns relatively soon after discontinuation.

 

Cons:

May cause some women skin irritation.

Does not protect against sexually transmitted infections.

Has the same risk as other hormonal contraceptives.

Slightly less effective for women who weigh over 198 pounds.

May present a higher risk of stroke than the pill.

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The Ring (NuvaRing) 

Effectiveness: 92% with perfect use.

The NuvaRing is a small, flexible ring that is placed inside the vaginal canal, where it releases the hormones estrogen and progestin. These hormones are absorbed through the vaginal walls into the bloodstream and act to disrupt conception by preventing ovulation.

 

The ring must be inserted once a month, and is worn for three weeks. It is then removed for the fourth week during menstruation. When menstruation concludes, a new ring is inserted.

 

Unlike the diaphragm, sponge, or cervical cap, the rings placement does not have to be exact because its contraceptive value is not due to barrier protection but to the hormones it releases.

 

Pros:

Effective for a full month.

May relieve menstrual cramps and premenstrual symptoms in some women.

Estrogen content may help prevent onset of osteoporosis.

Reduces the risk of endometrial and ovarian cancer.

Reduces probability of endometriosis.

May reduce ectopic pregnancies.

          

Cons:

The NuvaRing is currently under investigation by the FDA because of its association with blood clots and other very serious health concerns.

Does not protect against sexually transmitted infections.

Same health risks as other hormonal contraceptives.

May cause weight gain, nausea, increased menstrual camping.

 

 

 

Spermicide

Spermicide is not a very effective contraceptive by itself, but it greatly increases the effectiveness of barrier contraceptives when used with them.

 

Always use spermicide with a diaphragm, cervical cap, or condom.

 

The most common spermicide is Nonoxynol-9 (N-9), a form of detergent. N-9 is also thought to have STI-suppressant properties. Pure N-9 seriously disrupts the mucosal tissue of the genitals, but most consumer available brands include buffering agents that make N-9 non-irritating. A few people have an adverse skin reaction to its properties in any quantity; this usually manifests through itching, soreness, a rash, or discharge. Discontinue use if any of these symptoms occur, and talk to your doctor or pharmacist about an N-9 free spermicide. There are several alternatives.

 

Tubal Ligation (Female Sterilization)

Effectiveness: 99% with successful surgery.

 

Tubal Ligation

Tubal ligation is a very effective form of permanent contraception which can seldom be reversed. It should be considered a definitive choice not to bear children.  

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Tubal ligation is a surgical procedure which cuts or seals the fallopian tubes, preventing eggs from traveling through the tubes to the uterus during ovulation. Often a small telescope, called a laparoscope, is inserted through the navel to observe the procedure.

 

Pro:

Virtually complete freedom from unwanted pregnancy. 

 

Cons:

Does not protect from sexually transmitted diseases.

Can seldom be reversed if you later change your mind about having children.

 

Vasectomy (Male Sterilization)

Effectiveness: 99% with successful surgery.

 

Vasectomy is a very effective form of permanent contraception which can seldom be reversed. It should be considered a definitive choice not to bear children.

 

Vasectomy is a surgical procedure that blocks the vas deferens. After a vasectomy, ejaculation continues to occur but your ejaculation will (eventually) no longer contain any sperm.  This will not lessen the intensity of orgasm.

 

Following surgery, it will take about twenty ejaculations before all sperm is cleared from your reproductive system. Before assuming that you cannot impregnate a woman, you should be tested by your doctor for a negative sperm count. If your count still shows sperm present, even at a low level, pregnancy can occur, and you will need to undergo another cycle of ejaculations and then be tested again until a zero sperm count is clinically confirmed.

 

Occasionally surgery is incomplete and a second surgery is required. Very rarely, vasectomy has been known to spontaneously reverse.

 

Pros:

Virtual freedom from unwanted pregnancy.

Long-term contraceptive solution for men who are sure that they don’t want children.

 

Cons:

Not immediately effective. Must be certain that sperm count is zero through repeated testing.

Does not protect against sexually transmitted infections.

Often cannot be reversed if you change your mind about fathering children.

 

Essure

Essure is a relatively new form of birth control. Below is some data on its track record so far. We welcome feedback on your experiences with it

Essure is a surgery-free permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. 

  • Surgery-free—A quick procedure in 10 minutes that can be performed in your doctor’s office
  • Hormone-free—Essure inserts do not contain or release hormones
  • No downtime to recover*—You can go home in 45 minutes after the procedure. Most women return to normal activities in 1-2 days
  • Proven—Essure is 99.83% effective**

Applying Essure

During this quick 10 minute procedure, a doctor places the soft, flexible Essure inserts into your fallopian tubes through the natural pathways of your vagina and cervix, so no incision is necessary. The inserts are made of some of the same material that is used in heart stents and other medical devices. 

Over the next three months, your body works with the inserts to form a natural barrier in your fallopian tubes. This barrier prevents sperm from reaching the egg so that pregnancy cannot occur. During this three-month period, you must continue to use another form of birth control.

At the end of this three month period, you must see your doctor for the Essure Confirmation Test. This test verifies that the inserts are in place and your fallopian tubes are fully blocked.

Important: You must see your doctor for the Essure Confirmation Test before you can rely on Essure for birth control. Until you receive confirmation from your doctor, you must continue to use another form of birth control.

Essure is NOT right for you if:

• You have only one fallopian tube.

• You have one or both fallopian tubes closed or obstructed.

• You have had your “tubes tied” (tubal ligation).

• You are allergic to contrast dye used during x-ray exams.

• You are uncertain about ending your fertility.  

You should delay having the Essure procedure if:

• You are or have been pregnant within the past 6 weeks.

• You have had a recent pelvic infection.

• You are in the second half (weeks 3 and 4) of your menstrual cycle. During that time, there is an increased risk of being pregnant prior to having the Essure procedure.

• You are taking or receiving therapy that suppresses your immune system. Examples include chemotherapy or corticosteroids, such as prednisone. Therapy that suppresses the immune system may make the Essure procedure less effective for birth control.

 Talk to your Doctor about the Essure procedure and whether it is right for you.

 

Post-Coital Birth Control Methods

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Abortion

Effectiveness: 99+% with successful surgery.

 

First Trimester: Menstrual Extraction

Performed within 1-2 weeks of a missed period, menstrual extraction is an in-office procedure. A speculum is inserted to open the vaginal

canal and any fetal tissue is extracted from the uterus with a cannula, or small vacuum. Some cramping may occur, and a local anesthetic or sedative may be administered. Your doctor will examine the extracted tissue to rule out ectopic pregnancy, and to decrease the risk of incomplete abortion.

 

Vacuum Curettage (Aspiration)

Vacuum and curettage is most commonly performed up to 13 menstrual weeks. The cervix is dilated, or gently stretched open, with a tapered dilator. When it is sufficiently open, a vacuum-like instrument called a cannula is inserted up the vaginal canal and through the cervix to suction fetal tissue out of the uterus. Then a sharp instrument called a curette carefully scrapes out any remaining tissue, and finally, the vacuum is used again to make sure the uterus is empty.

 

Some cramping and discomfort will probably occur, and you may have a local or a general anesthetic during the procedure. Antibiotics are usually administered to prevent infection.

 

Some women can continue with their daily routine after resting an hour or so after this procedure; others who experience post-surgical cramping or disorientation need to take the whole day off to recuperate, and perhaps a day or two more. Respect what your body tells you.

 

Second Trimester: Dilation and Evacuation (D&E)

Dilation and evacuation is commonly performed up to 21 menstrual weeks. It is best performed in two stages: Dilators of increasing size are inserted into the cervix, gradually expanding the opening over a period of several hours. When sufficiently dilated, forceps are inserted into the uterus and a vacuum is used to suction fetal tissue out.

 

Third Trimester: Saline Injection

Saline injection is performed after 16 menstrual weeks, and is used sometimes during the second trimester as well as the third.

 

After the administration of a local anesthetic, a long needle is inserted into the uterus and withdraws some amniotic fluid. This is then replaced with an equal amount of salt (saline) solution. Contractions will begin some hours later, and continue until all fetal tissue is expelled. Cramps can be as intense as labor pain, and painkillers will probably be administered. Ask for them if you need them before they're offered.

 

Hysterotomy

Hysterotomy is performed after 20 menstrual weeks. It is major surgery, involving an operation through which fetal tissue is removed through an incision in the abdomen. It requires a hospital stay during recovery, and women who’ve had this procedure may have to opt for caesarian birth in the future.

 

A hysterotomy is not the same thing as a hysterectomy. A hysterotomy is the surgical removal of fetal tissue; a hysterectomy is the surgical removal of the uterus, and sometimes the ovaries, too. 

 

 Is Vaginal Penetration or Other Forms of Sex Safe Right After an Abortion?

Avoid penile-vaginal penetration for four weeks after an abortion to decrease the risk of infection. Oral sex and non-penetrative manual sex are usually fine, unless your doctor has advised you otherwise.

 

Ella

Effectiveness: 98%+ with perfect use.

Ella contains ulipristal, a non-hormonal drug that blocks the effects of the key hormones necessary for conception. It is effective for 120 hours, or 5 days, after sex, and is considered reliably effective for the full duration of this time span.

  

Side effects may include nausea, abdominal pain, dysmenorrhea (pain or discomfort during menstruation), headache, fatigue, and dizziness. Serious abdominal pain should be reported to your doctor immediately.

 

Ella should not be used by nursing mothers.

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Emergency Contraception (EC, Plan B, or “The Morning-After Pill”)

Effectiveness: 75-89% if taken within 72 hours (3 days) after intercourse. The sooner EC is taken, the more effective it is.

http://upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Levonorgestrel.svg/200px-Levonorgestrel.svg.png

EC is taken over two days; one pill on the first day, a second pill on the next. The pills contain hormones that inhibit or delay ovulation, prevent fertilization of the ovulated egg, and/or disrupt implantation of a fertilized egg in the uterine wall.

 

The main negative side effect is nausea. Nearly 50% of women experience it, and about 20% experience vomiting. If you vomit within two hours after taking a pill, tell your doctor immediately. You will probably need to take another right away. It helps to take an antiemetic an hour before taking each pill, which will help diminish nausea.

 

Other side effects may be breast tenderness, fatigue, spotting, and delayed menstrual cycle.

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EC is less effective for women over 176 pounds.

 

Because Emergency Contraception is not always effective, if 21 days pass without menstruation, have a pregnancy test.

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Copper-T Intrauterine Device (IUD)

Effectiveness: 97%+ with perfect use.

A Copper-T IUD can be used as emergency contraceptive up to five days after intercourse. Its presence usually disrupts conception, and it can be left in as a means of birth control for up to ten years afterward if you choose.

 

RU486

Effectiveness: 96% with perfect use.

http://upload.wikimedia.org/wikipedia/commons/thumb/f/f3/Mifepristone.svg/320px-Mifepristone.svg.png

RU486 is effective up to about ten weeks after pregnancy begins. It’s a combination of drugs that cause a response similar to a miscarriage, by working to cause uterine contractions, blocking the hormones that would support pregnancy, and preventing embryonic cells from developing.

 

The administration of RU486 is a two-step process. It may be dispensed as an injection at your doctors’ office, followed through by a vaginal insert a few days later at home or at your doctors’ office. Or it can be dispensed orally, with one pill taken at your doctors’ office, and the other taken a few days later at home or at your doctors’ office.

 

The experience is usually similar to an early miscarriage, with some strong cramping, bleeding, and sometimes clots expelled from the vaginal canal. Spotting may continue for a week or two. Side effects may include headache, nausea, and vomiting.

 

If you are not at your doctors’ office when you take the second pill, it’s a wise idea to have a friend with you.

 

Be sure to go to your follow-through check-up 8-15 days after taking the second pill to confirm that termination is complete.

 

Occasionally when medical termination is incomplete, surgery is required to finish the procedure.

 

Women with anemia, liver or kidney problems, suffering from obesity, diabetes, or with Rh-negative blood, are not candidates for RU486.

 

 

Methods That Don’t Work

 

Douche 

When birth control fails, many women instinctively douche on the belief that douching will rinse unwanted sperm out of their vagina. It won’t. Douching just carries the sperm closer to the uterus, increasing the risk of pregnancy.  Instead, use Ella, EC, a Copper IUD, or RU486.

 

Fertility Awareness Method (FAM, or Fertility Charting) 

FAM is based on a theory that doesn’t pan out in practice. It postulates that if a woman knows the exact pattern of her monthly fertility cycle - exactly when she ovulates, and when her ovulation cycle is over- then she’ll know when it’s safe to have unprotected intercourse without the risk of pregnancy. 

The problem is that no one ovulates with absolute regularity, and ovulation can occur more than once during the fertility cycle. This makes using the Fertility Awareness Method a constant gamble.

 

Sex During Menstruation

You can get pregnant during menstruation.

 

Menstruation is the shedding of the endometrial lining, but exactly when ovulation is over is difficult to predict. An egg may still be present during the secretory stage of menstruation - or a second egg may be released.

 

Withdrawal

It is entirely and direly untrue that by withdrawing the penis from the vaginal canal before full ejaculation, you will avoid conception. The penis leaks sperm during sexual stimulation, even before erection, and long before ejaculation. Any penile-vaginal contact can result in pregnancy. Inserting a penis into the vagina, or even rubbing it near the vaginal entrance, is all it takes.

 

Copyright© 2015. All rights reserved.

LINK: SAFER SEX

 

Resources

 

Emergency Contraception Information

1-888-NOT-2-LATE

          

Ann Rose’s Ultimate Birth Control Links

www.ultimatebirthcontrol.com

 

Planned Parenthood

www.plannedparenthood.org

1-800-230-PLAN

 

National Abortion Federation Hotline

1-800-772-9100

 

The Center for Reproductive Rights

www.reproductiverights.org

 

NARAL: Pro-Choice America

www.prochoiceamerica.org

 

 

The Feminist Women’s Health Center

www.fwhc.org

 

Not-2-Late: The Emergency Contraception Website

http://ec.princeton.edu/

1-888-NOT-2-LATE

Information on emergency contraception, including a

location finder

 

OB/GYN.net

www.obgyn.net

 

The Abortion Access Project

www.abortionaccess.org

Fund Abortion Now

 

Fund Abortion Now

www.fundabortionnow.org

Help with financial resources for abortion

 

National Network of Abortion Funds (NNAF)

www.nnaf.org/

Financial aid for women in need of abortion funds

 

Abortion Clinics Online

www.gynpages.com

 
Copyright© 2015. All Rights Reserved.
 
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