There are several ways to approach the conversation of birth control. I strongly advise you to consider “you,” your lifestyle, and your current situation. Are you a student or always on the go? Do you have trouble remembering to take medications? Do you have a significant, complex medical history? Are you in the postpartum period?
Birth control methods are categorized in different ways. You can categorize as hormonal vs non-hormonal, mechanism of actions, how it is administered, etc. The way I’m going to organize birth control for this blog is by effectiveness.
Tier 1 birth control methods are the most effective. They provide the most extended duration of contraception after initiation and require the fewest number of return visits. This category includes permanent sterilization and long-acting reversible contraceptives (LARC) such as IUDs. You can just set it and forget it. There are nonhormonal and hormonal IUDs. The Mirena IUD is also effective in treating heavy menstrual cycles.
Tier 2 birth control methods are moderately effective when used flawlessly. They consist of systemic hormonal contraceptives, such as the pill, the patch, the shot, or the ring. You must take the medication or insert the ring on a set schedule.
(Photo: Office of California Surgeon General)
Tier 3 birth control methods are the least effective; however, a few options in this group also protect from sexually transmitted infections (STIs). These methods include barrier methods, such as condoms, diaphragms, spermicides, and fertility awareness. With correct, concise, and consistent use, the Tier 3 methods will work just fine. It’s just that people get lazy and complacent and start slipping up.
Then we have “Pull and Pray” …yes, I said it. “Pull and Pray” IT IS NOT THE BEST WAY. You know what I mean; if you don’t, use your imagination. LOLOLOL. One of my favorite patients told me that was the contraceptive of choice during her postpartum checkup.
I encourage you to speak with your provider about the several contraceptive options. Unwanted, unplanned pregnancies are PREVENTABLE, but you must do your part and be responsible.
There are emergency contraceptives available, such as Plan B. It's important to note that if you are already pregnant, IT WILL NOT WORK. IT WORKS BY DELAYING OVULATION. IT must be taken within 72 hours (3 days) after unprotected sex. The sooner it is taken the better it works.
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