Overview

Choosing a birth control method is one of the most personal health care decisions a woman makes. In nearly four decades of childbearing years, your need for birth control will most likely change many times. But at each life stage, you can make informed decisions by learning about all your contraceptive options and selecting one or more that best fits your reproductive health needs, and changing it if and when you find it’s necessary to use a different option.

Why Do Unplanned Pregnancies Occur with Contraception?

Many women are not adequately protected from an unwanted pregnancy by their choice of birth control method. In fact, according to the 2002 National Survey of Family Growth, about half of all pregnancies are unplanned. Of these unplanned pregnancies, almost half of the women were using some form of birth control. Reasons for contraception failure include:

Inappropriate Use of Contraceptive
For example, not inserting a diaphragm the right way or not using enough spermicide. Myths or personal concerns about the risks and safety of certain birth control options also contribute to incorrect use of birth control. Women may use a particular method only occasionally, for example, thinking that less frequent use is safer than continuous use. Or they may stop using a particular method because of bothersome side effects.

Failure to Continue Use of the Contraceptive
For example, forgetting to take your birth control pills or not using a condom every time you have sex. Age-related changes can lead women to believe they no longer need to use contraception. For example, women nearing menopause may mistakenly think they are no longer fertile because their menstrual cycles are no longer regular. However, about 38 percent of pregnancies that occur in perimenopausal women are unintended. Although menopause does mark the end of a woman's childbearing years, you have not gone through menopause until 12 consecutive months without a period. You can get pregnant even if your periods are irregular.

Failure of the Contraceptive
In some cases the method itself fails, resulting in an unplanned pregnancy.

How to Choose the Right Birth Control Method

Today, American women have more contraceptive options to choose from than ever before. So you should be able to find one that works well for you and fits your lifestyle. Other things to consider before making a contraception choice:

• Find out how much the contraceptive costs. Do you have to pay for it all at once or can the cost be spread out over a year? Will your health insurance cover it?
• Ask yourself if you can realistically use this method. Are you sure you understand how to use it properly? Will this method embarrass you or your partner? Does it fit with your lifestyle?
• Find out how to use the method correctly and what to do if you forget to use it occasionally.
• Ask your health care professional about side effects. What should you expect? What should you do about them if they occur, and when should you expect them to stop?
• Will this method cause any unacceptable weight gain?

You can probably think of many more questions about birth control. Learn as much as you can about your options and make an informed decision about which method is the best and safest for you. Consider your needs and discuss them with your health care professional during your next medical appointment.

To get you started, here is some basic information about contraceptive options approved by the U.S. Food and Drug Administration (FDA), and resources you can use for more in-depth research. For a comparison of how effective each type of contraception is for preventing pregnancy, please see the chart, "Contraceptive Failure Rates" at the end of this entry.