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This is a long overdue thank you note to say huge thanks for taking care of us for the birth of our first child! We are truly grateful for your support, help, and wisdom in helping us achieve our goals for Jasper's birth. Thanks also for your patience and kindness in always answering my list of questions! We think you all are incredible doctors, and we had an excellent experience at Chestatee Regional Hospital (CRH). Jasper’s birth went better than we had hoped. Thanks for working with us through it all. We certainly plan to go back to CRH…one day! - Joni S
|Birth control: which method is right for me?|
Contraception or birth control is the use of a medication, device, or method to prevent pregnancy. Most women of reproductive age in the United States use some form of birth control. However, almost one-half of pregnancies are estimated to be unintended.
EFFECTIVENESS OF BIRTH CONTROL — Most birth control methods are quite effective if used properly. However, contraceptives can fail for a number of reasons, including improper use, failure to follow treatment recommendations, or failure of the medication, device, or method itself.
Certain birth control methods, such as intrauterine devices (IUDs) and injectable contraceptives, have a low risk of failure (pregnancy). This is because using the method correctly or taking the medication on a regular basis is not a major factor. Birth control pills have a low pregnancy rate if they are taken properly (ie, pills are taken every day). However, the actual pregnancy rate is much higher because many women forget to take the pill every day. Other birth control methods such as the condom, diaphragm/cervical cap, and spermicides can be very effective if used properly. However, these methods are also associated with higher "actual" pregnancy rates because of incorrect or inconsistent use.
CHOOSING A BIRTH CONTROL METHOD — It can be difficult to decide which birth control method is best due to the variety of options available. The best method is one that will be used consistently, is acceptable to the woman and her partner, and does not cause bothersome side effects. Other factors to consider include:
BIRTH CONTROL PILLS — Most birth control pills, also referred to as "the pill," contain a combination of female hormones, estrogen and progestin (a progesterone-like medication).
Efficacy — When taken properly, OCs are a very effective form of contraception. Although the failure rate is less than one percent when pills are taken perfectly (same time every day, no missed pills), the actual failure rate is 8 percent due primarily to missed pills or failure to restart the pill after the seven-day pill-free interval.
Women taking the pill should notify their healthcare provider if they experience abdominal pain, chest pain, severe headaches, eye problems, or severe leg pain, as these could be symptoms of several serious conditions including heart attack, blood clot, stroke, liver, and gallbladder disease.
Progestin only pills — Some pills contain only progestin (called the mini-pill), which is useful for women who cannot or should not take estrogen. Progestin only pills (or mini-pills) are as effective as combination pills when taken at the same time every day, but there is a slightly higher failure rate of the mini pill. A backup method of birth control should be used for seven days if a pill is forgotten or taken more than three hours late.
INJECTABLE BIRTH CONTROL — The only injectable contraceptive currently available in the United States is medroxprogesterone acetate or DMPA (Depo-Provera®). DMPA is injected deep into a muscle, such as the buttock or upper arm, once every three months. DMPA is very effective, with a failure (pregnancy) rate of less than one percent.
Side effects — The most common side effects of DMPA are irregular or prolonged bleeding and spotting, particularly during the first three to six months. Up to 50 percent of women completely stop having menstrual periods (amenorrhea) after one year of use.
VAGINAL RING — A flexible plastic vaginal ring (Nuvaring®) contains estrogen and a progestin, which is slowly absorbed through the vaginal tissues. This prevents pregnancy, similar to an oral contraceptive. It is worn inside the vagina for three weeks, followed by one week when no ring is used; the menstrual period occurs during this time. The ring is not noticeable, and it is easy for most women to insert and remove. It may be removed for up to three hours if desired, such as during intercourse, although it is not usually felt by the sexual partner. Risks and side effects are similar to those of oral contraceptives.
BIRTH CONTROL IMPLANT — A single-rod progestin implant, Implanon, is available in the US. It provides three years of protection from pregnancy as progestin is slowly absorbed into the body. Irregular bleeding is the most bothersome side effect.
BARRIER METHODS — Barrier contraceptives physically block or otherwise prevent sperm from entering the uterus. Barrier contraceptives include the condom, diaphragm, and cervical cap.
Diaphragm/cervical cap — The diaphragm and cervical cap fit over the cervix, preventing sperm from entering the uterus. These devices are available in latex (the Prentif cap) or silicone rubber (FemCap) in multiple sizes, and require fitting by a clinician. These devices must be used with a spermicide and left in place for six to eight hours after sexual intercourse. The diaphragm must be removed after this period. However, the cervical cap can remain in place for up to 24 hours.
INTRAUTERINE DEVICES (IUD) — IUDs are inserted by a healthcare provider through the vagina and cervix, into the uterus.
The currently available IUDs are safe and effective. These devices include:
STERILIZATION — Sterilization is a procedure that permanently prevents a person from becoming pregnant or able to have children. Tubal ligation and vasectomy are the two most common sterilization procedures.
Tubal ligation — Tubal ligation is a sterilization procedures for women that surgically cuts, blocks, or seals the fallopian tubes to prevent pregnancy.
Vasectomy — Vasectomy is a sterilization procedure for men that surgically cuts or blocks the vas deferens, the tubes that carry sperm from the testes. Following surgery, another contraceptive (eg, condoms) must be used for approximately three months, until a semen analysis confirms that there are no sperm present.
Pregnancy rate (percent) during first year of use
Data refer to number of pregnancies per 100 women during first year of use
Typical Use: refers to failure rates for women and men whose use is not consistent or always correct. Correct Use: refers to failure rates for those whose use is consistent and always correct.
* Rate reflects cumulative pregnancy rate in the first 6 months following birth.