Birth Control Bingo
Here's the reality: according to the Alan Guttmacher Institute and other reliable sources, a sexually active young adult who does not use contraceptives has an 85-90% chance of becoming pregnant within just one year. According to Unintended Pregnancy Among U.S. Adolescents: Accounting for Sexual Activity, by Lawrence B. Finer, director of domestic research at the Guttmacher Institute, the unintended pregnancy rate among teens who are sexually active (147 per 1,000) is more than twice the national figure for all sexually active women of reproductive age (69 per 1,000). The rate among sexually active 18–19-year-olds (162 per 1,000) is more than double the national figure.
There are also substantially greater numbers of unintended pregnancies among those aged 20–24 than among younger people, and rates of teen pregnancy are higher for LGBTQ youth than heterosexual (straight) youth. So, while most discussion about birth control and unintended pregnancy is addressed to straight or gender-conforming people, this isn't just about them. This is about everyone and anyone who engages in the kinds of sex where pregnancy can happen.
So, it's probably obvious that if you're having the kinds of sex that can create a pregnancy -- that's genital intercourse or other direct genital-to-genital contact where one person has a vulva, and another, a penis -- and are not prepared to become pregnant or do not want to become pregnant, finding a method or methods of birth control that works for you is key.
Wondering which method is just right for you, and how on earth you'd figure that out? We're here to help.
While we still don't have as many options as we should, there are a good deal of user-friendly, safe and effective methods to choose from. But it can be confusing to figure out what's best for you, especially when you're a younger person, new to the whole idea of birth control or without a great sexual healthcare provider. It's particularly tricky when some methods make corporations the big megabucks; advertisements for those methods usually make them sound like the best thing since sliced bread, and like all other methods stink. Your best friend might love their method, but it may be the worst method for you ever. What method is right for a person is highly individual: we all have different lifestyles, personalities, agency, sex lives, relationships, health histories and one size does not fit all when it comes to contraception.
The best method for anyone is always going to be the method that particular person can use properly and consistently, can afford and access, which fits best with their own life, sexual interactions or relationships, health history, needs and concerns, and which -- obviously -- is also as effective as they want and need it to be.
A sexual/reproductive healthcare provider is the best person to talk to about choosing a method, and in the case of many methods, you'll need to consult them anyway, either for a prescription, an insertion or fitting. Many general physicians can also give this kind of care and information. Suffice it to say, since pregnancy isn't the only risk out there, if you're sexually active you'll want to be seeing that healthcare provider every year anyway for your preventative sexual health care and sexually transmitted infection screenings.
Even for methods where you'll need the assistance of a healthcare provider, it can be helpful to get a good idea about what methods you most want to use first, and which may be best for you, so you can then consult with them assertively and informedly. And let's be honest: not all healthcare providers rock. Some aren't too great about consulting patients about methods, but have their own preferences, so will tend to privilege their wants over yours and just suggest the method for you they like. With younger patients, some doctors feel like it's better they make a choice than you. That's another way it's helpful to have a good idea of what YOU want in advance: it makes it a lot easier to be confident with a doctor when you have a good idea of what will and will not work for you and what you, yourself, want.
We'll walk you through a few pages of questions so that we can give you a good idea of which methods are probably the right methods for you and you alone. We'll also give you help with combining methods for extra-effectiveness, special tips on use, young-adult specific information on a method when applicable, and links to more information on all these methods here at Scarleteen and elsewhere.
Ready to roll? Okay! Get started by clicking which of the following statements sounds most like you:
• I absolutely, positively, can take NO risks in becoming pregnant (or in getting a partner pregnant), and/or know that I do not want to become pregnant (or create a pregnancy) right now, or possibly ever.
• OR I am a person who could become pregnant, and I do NOT want to become pregnant right now, but understand that no method of birth control is 100% effective. I want to find the best method for me understanding that even the most effective methods of contraception used properly may still leave me at some small risk of pregnancy and I can deal with those possible risks.
• OR I am a person who could co-create a pregnancy, but not become pregnant myself, but who has the kind of sex where I could co-create a pregnancy, and I do NOT want to create a pregnancy for a partner right now, but understand that no method of birth control is 100% effective. I want to find the best method for me understanding that even the most effective methods of contraception used properly may still leave a partner at some small risk of pregnancy and I can deal with those possible risks.
Already have a method in mind, or one you already use, and want more information about it?
You can get a rundown on any of the following methods by giving them a click:
- Cervical Barriers (Diaphragms and Cervical Caps)
- Combined Oral Contraceptives (The Pill)
- the Contraceptive Implant (Implanon)
- the Contraceptive Patch
- Depo-Provera (The Shot or Jab)
- Emergency Contraception (Plan B or the Morning-After-Pill)
- Fertility Awareness (FAM)
- Intrauterine Devices (IUD, IUC or IUS)
- Progesterone-Only Oral Contraceptives (Minipills)
- the Sponge
- the Vaginal Ring (Nuvaring)
Want to make any of these methods more effective by adding another? Look here.
Don't forget: Statistically, sexually active young adults are as, if not more, likely to acquire a sexually transmitted infection (STI) as you are to become pregnant. Although 15-24-year-olds represent only one-quarter of the sexually active population, they account for nearly half of all new STIs each year, and of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15-24-year-olds (AGI). Often people have some funny ideas about who is most likely to get an STI, but the fact of the matter is that younger people -- of any sexual orientation, any economic class, any kind of relationship -- have been the highest risk group for some time now.
Condoms are the only method of birth control which also provide protection against STIs. It's pretty typical for younger people to ditch condoms if they have another method of birth control, so just remember that STIs are still a risk if you're using another method. You can read all about safer sex here -- Safe, Sound & Sexy: A Safer Sex How-To -- but the rule of thumb most medical experts and prevention organizations suggest, which we also encourage at Scarleteen, is six months of safer sex, six months of sexual monogamy, and then TWO full STI screenings for each partner -- once at the start of that six months, once at the end -- before ditching latex barriers.
* We don't include Tubal Ligation or Vasectomy in these lists. This is not because we don't think young people should have the right to decide that they never want to have or bear children, nor because we think that younger people can't soundly make that decision. Rather, this is because it is nigh unto impossible for most younger people -- and in this case, I mean people under 25 and childfree -- to find a physician who will perform a sterilization. But if you'd like information on sterilization, you can find it here, and if you feel that is what is best for you, we encourage you to talk to your healthcare provider about that option.