How Not to Get Pregnant : Five Things You Can Do to Most Effectively Prevent Pregnancy

If your sex⁠ (sex: Different things people choose to do to actively express or enact sexuality and sexual feelings; often this involves genitals, but not always. ) life includes the kind of sex that can create a pregnancy⁠ (pregnancy: The state of carrying a developing embryo or fetus within the uterus. Medically, someone is considered to be pregnant when an egg has been fertilized by sperm, cells divide, and the fertilized egg is implanted within the lining of the uterus.) , and you don’t want to become pregnant — and also don’t want to give birth or become a parent — then you’re probably already doing at least something to prevent any or all of those things from happening. But if you’re currently living or may soon be living in one of the countries or areas where your access to abortion⁠ (abortion: A procedure to intentionally end a pregnancy before a birth. Miscarriage is also sometimes called "spontaneous abortion," even though it is usually not intended.) , contraception⁠ (contraception: Devices, medications or behaviors used to intentionally aim to prevent pregnancy, including the condom, the cervical barrier, the implant, the patch, the pill, the rhythm method, the ring, the shot, the IUD, spermicide and withdrawal.) , or other sexual⁠ (sexual: About or relating in some way to sex or sexuality.) healthcare is limited or at risk, what you’re doing may not feel like enough now or at some point in the future. The fact is, in some cases, it may not be enough.

By all means, an effective method of contraception, all by itself, goes a long way. Those who can access and can consistently and correctly use a very effective and reliable form of contraception are very unlikely to become pregnant. But that group of people can be smaller than it may seem.

Some people, for example, may think they are using a method correctly, but not fully understand what correct use involves or know when they’re doing something that makes their method less effective. Others may currently be able to access their method, but could find themselves unable to do that in the future if their access to healthcare (including their ability to see a care provider, pay for birth control⁠ (birth control: Any number of methods people use to intentionally prevent unwanted pregnancy, including the condom, the cervical barrier, the implant, the patch, the pill, the rhythm method, the ring, the shot, the IUD, spermicide and withdrawal.) , or get the method they need or prefer) changes. Then there are those who can’t consistently or correctly use a method effectively for any number of reasons: they may be with a partner⁠ (partner: In a sexual context, a person with whom someone is having some kind of sex. The term "partner" can be used for all kinds of relationships, not just serious ones. "Partner" can also mean the person someone is with in a romantic or familial partnership.) who sabotages their method or who sexually assaults them; they may be using a method that just isn’t a good fit for their needs or abilities; or they may only have access to less effective or less foolproof methods.

If you can swing all five things listed in this article, pregnancy is going to be as close to impossible as it can get. Even if you can just be sure to always do the first thing in this list and then use whatever method or methods of contraception you can access — or, at least, always have emergency contraception⁠ (emergency contraception: A method of contraception used to prevent pregnancy after sex or rape has already occurred, rather than used before or during, like most types of contraception. Includes emergency contraception pills and IUDs.) (EC) and abortion pills on hand — you will be very, very well protected.

1. Only be sexually intimate with partners who wholly respect your sexual and reproductive autonomy, who are 100% on board with your desire not to get pregnant, and who will fully support whatever choices you want to make when it comes to pregnancy prevention and pregnancy.

Partners who are either not in full agreement with you, are apathetic about whether you become pregnant, or even want something wholly different for you than you want for yourself are just not safe people to be around if you want to avoid pregnancy. At best, these kinds of partners might do unhelpful and deeply inconsiderate things like being unwilling to help you pay for BC you need or pick up Plan B⁠ (Plan B: A brand of emergency contraception pill.) for you if you need it.

Or, they might push boundaries or engage in outright boundary violations around things like what kinds of sex you are comfortable having and what kinds of protection from pregnancy you want or need. Some may even engage in sexual assault⁠ (sexual assault: When someone is attacked, or attacks someone else, in a sexual way.) , stealthing⁠ (stealthing: When a condom is removed during sex without the other person’s knowledge or consent.) , or other kinds of reproductive coercion or contraceptive sabotage which aren’t only abuses, they are also crimes. With a partner like this, even if you’re only trying to have certain kinds of sex or are using a method of contraception for the kinds that can cause pregnancy, they can undo your wants or practices with their own behavior, particularly if and when they do not give you a choice in the matter.

There’s a direct link between experiencing intimate partner violence (IPV) and increased risk of unintended pregnancy.

• Women* who experience intimate partner violence experienced 5.6 times higher rates of unintended pregnancy, compared to women who did not experience IPV.
• Intimate partner violence is associated with a 51% increase in the risk of pregnancy and a 30% increase in the risk of unintended pregnancies that resulted in live birth.
• 27% of those aged 18-22 who had become pregnant reported experiencing threats from their partner, and 30% reported being physically assaulted by their partner.
• About 6% of people with a recent live birth experienced emotional, physical, or sexual violence during pregnancy by a current intimate partner.
• 40% of pregnant [people] who have been exposed to abuse report that their pregnancy was unintended, compared to just eight percent of non-abused [pregnant people].

If and when a person is in a controlling or otherwise abusive relationship⁠ (relationship: An ongoing interaction or association with another person, place or thing.) or interaction, or with a partner who doesn’t support what they want reproductively, not only does sexual assault sometimes occur in those relationships or interactions, but the people being abused or controlled within them sometimes feel they must say yes to sex with those partners (and some also won’t be using methods of contraception because their partners will not let them). And in situations such as these, pregnancy is as likely, even a little more likely, statistically speaking, as it is with wholly consensual sex. And when people are in an ongoing relationship with these kinds of partners, if they do get pregnant, those partners may also keep them from terminating a pregnancy. Particular to the age group we primarily serve, reproductive coercion is associated with 5 times the increased odds of adolescent pregnancy.

• “In the US: 8.4 % of women (10.1 million) and 9.7% of men (11.1 million) reported experiencing reproduct[ive] coercion.
• [As a member of a group already identified as experiencing reproductive coercion of some type], 4.6% of women reported that, in their lifetime, an intimate partner tried to get them pregnant when they did not want them to.
• 6.4% of women reported that an intimate partner refused to use a condom⁠ (condom: A thin sheath or tube of latex or another material, worn over the penis during sex to prevent or reduce the risk of pregnancy and/or sexually transmitted infections.) with them.”
• Stealthing prevalence: One scoping review found rates of NCCR victimization ranged from 7.9% to 43% for women. In one study, 46% of men who said they have a history of stealthing reported unplanned pregnancies [of sexual partners].

*“Women” is used in these studies, but these statistics refer to anyone who has the capacity to become pregnant.

In brighter news, the opposite — supportive people and sexual partners — is unsurprisingly associated with lower rates of unintended pregnancy.

We just can’t take for granted that any or every partner will be supportive of our reproductive autonomy⁠ (autonomy: The state or condition of being independent and/or having the right to independence.) or our wants and needs when it comes to pregnancy. Unfortunately, plenty of partners won’t be. To find out⁠ (out: Short for ‘out of the closet’. When someone’s LGBTQ+ identity is known to other people.) if someone is fully supportive and on board, you’ll need to have a frank talk with them, ideally before you start becoming sexual with them. If they say anything in this talk, or more generally, that clearly tells you they aren’t these kinds of supportive, or you even just don’t feel fully confident in their support, then your best bet is to nix them as a partner. Doing so will not only help you most effectively prevent pregnancy, but given the correlations between reproductive non-support and overall abuse⁠ (abuse: Purposeful harm or mistreatment of another person, which can be verbal, emotional, physical or sexual. An ongoing pattern or cycle of such mistreatment or harm can characterize an abusive relationship.) , you’ll probably also spare yourself an abusive relationship, to boot.

So, above and beyond all else — especially in this era — if you want to avoid pregnancy as effectively as you can, the most important thing to do is staying away from any partners who aren’t supportive of what you want reproductively (and sexually: these two tend to go hand in hand when it comes to power and control), and only choosing to be with people who are 100% on board with what you want and need. Simply choosing a partner who is supportive of what you do and don’t want, and of contraceptive use, reduces your risk of pregnancy pretty massively all by itself.

2. Use the most reliable forms of contraception available to you consistently and correctly.

People often ask us: “What’s the most effective method of birth control?” While there is one answer to that (it’s permanent sterilization such as vasectomy⁠ (vasectomy: Surgical blocking of the vasa deferentia (each vas deferens) for permanent birth control.) or tubal ligation), in another way, there isn’t really one answer for everyone, because contraception being effective often has as much to do with how people use it as which method they use.

If someone is using a generally highly effective method, but they aren’t using it according to directions, or they aren’t using it consistently, that method can be less effective than someone using a broadly less effective method, but using it consistently and correctly. So, when choosing a method, ideally you want to choose the most effective method or methods you can access and use, and then be sure to use that method or methods consistently — all the time —and correctly. That means choosing methods that you are pretty darn sure you can always get (or can get and then use for a long time, such as an IUD⁠ (IUD: Intra-uterine device. A long-term birth control method inserted into the uterus by a healthcare provider. Also called an IUS (Intrauterine system) or IUC (Intrauterine contraceptive).) ), that you know how to use correctly and can use correctly, and that you have a generally good experience with so you know you can stick with it.

If you need help figuring out what that method or methods is/are for you, you can use Birth Control Bingo here on the site, our walkthrough to help you find your own best methods which also contains in-depth information on all of your options. If you’d like even more tailored help than that, we’re always happy to help users choose contraceptive methods in any of our direct services.

3. Use the buddy system.

Dual contraception — what we call the buddy system around here — is more effective than just one method alone, especially if any of the methods you’re using leave a lot of room for user error, such as the pill⁠ (the pill: A common term for birth control pills/oral contraceptives. A hormonal medication used to prevent unwanted pregnancy.) , condoms, or cervical barriers. If you use two methods, even if one of those methods fails, be that on its own (after all, no method is 100% effextive, even in perfect use⁠ (perfect use: When a birth control method is used correctly and reliably, the whole time, every time, in accordance with the manufacturer's directions. Many birth control methods will state an effectiveness for "perfect use" vs. "typical use.") ), because you or a partner made a mistake, or because something happened with your ability to access that method (like you ran out of pills and had to wait longer than you should have to get more), that second method can back you up. And if one of those two methods is also condoms, you also get the important added benefit of STI⁠ (STI: Sexually transmitted infections: illness, infection and/or disease which is often or can be transmitted through sexual or other intimate contact, like HIV, Chlamydia or Herpes. Some people call STIs STDs.) protection and prevention. Our piece on the buddy system can show you the combined effectiveness⁠ (effectiveness: How well something works.) rates of any two methods to help you pick two that are right for you.

4. Have advance provision.

Advance provision is just a snazzy term for getting and having contraception, emergency contraception pills, or abortion pills in advance, so you can always have them on hand if and when you need them. That can mean having more than you need of a contraception method you’re already using, like having a few packs of BC pills on hand at a time, or at least one patch or ring ahead of the one you’re currently using. You don't have to be pregnant or sexually active⁠ (sexually active: Someone who has had or is currently having some kind of genital sex with a partner or partners.) at the time to purchase or be prescribed emergency contraception or abortion pills. The shelf life of both Plan B and mifeprostone and misoprostol⁠ (misoprostol: One of two drugs currently used for medication (or medical) abortion.) (medications that can act as abortion pills) is 3 years or more, so if you make sure you have some of each now, it can be there for you — or someone else in your life — for the next few years. 

Sometimes getting any or all of these is pretty easy. But sometimes it isn’t, and when we need certain methods of contraception, emergency contraception (EC) ,or abortion pills, it’s a time-sensitive situation, so finding ourselves surprised by a lack of access can be a potentially huge problem. Maybe you already live in a place where access to one or both of these is anywhere from a pain to outright impossible, or maybe you live somewhere where these are things you can get now, but legislation is proposed or pending which could change that. You might be a young person who can’t drive or otherwise get yourself to where you’d need to go to access BC or abortion pills. Heck, even if you live somewhere where contraception and abortion access is excellent, the peace of mind advance provision can give you can be a real gift. Plus, you never know when a friend who might not have the same kinds of privileges, abilities or access you do might need it. Having advance provision of EC and abortion pills on hand, whether or not you can get pregnant, is a really potent kind of mutual aid that can change things for the better for everyone.

5. You can also limit the kinds of sex you take part in or who you have sex with.

In the event that some of what’s listed above isn’t accessible to you, or you want more protection from pregnancy than all of those things can offer, you also have the option of skipping or limiting the kind of sex that presents pregnancy risks. It’s probably obvious but worth saying that the less often you have that kind of sex, the lower your risk is of getting pregnant. If you don’t have that kind at all, then there’s also obviously no risk. And if you don’t have sex with partners who have the anatomy⁠ (anatomy: The body, parts of the body, or physical structure of organisms like people, animals or plants.) needed to present a pregnancy risk, you also have no risk, just like if you limit sex with those kinds of partners, your risk will be lower.

These are some ways of being sexual with someone else do not present ANY real risk of pregnancy:

• kissing⁠ (kissing: Pressing one's lips against someone else's lips or some other body part to express affection and/or to seek out or provide sexual pleasure. May also include the tongue.) and making out⁠ (making out: A vague term, but often a session of extended activity that includes passionate or deep kissing, some kind of other body contact and may even include other kinds of sex, like manual sex (fingering or handjobs).)
• cuddling and stroking any part of the body
• mutual masturbation⁠ (mutual masturbation: When sexual partners masturbate together. Sometimes people also use "mutual masturbation" to mean manual sex (fingering or handjobs) done at the same time.) **
• dry humping
• using sex toys
• manual sex⁠ (manual sex: Sometimes also called digital sex. Kinds of sex involving the hands and fingers to sexually stimulate the genitals or other parts of the body. Fingering, handjobs or "fisting" (deep manual sex) are some kinds of manual sex.) (sexual activity with hands and fingers)**
• oral sex⁠ (oral sex: Use of the mouth, lips or tongue for sexual stimulation. Cunnilingus ("going down on"), fellatio ("blowjobs") and analingus ("rimming") are some common kinds of oral sex.)
• anal sex⁠ (anal sex: Sexual activity involving the anus. Anal sex may include stimulation with fingers, the mouth, a penis, sex toys, or other objects or body parts.) **
• sensation or impact play⁠ (impact play: Doing things like wantedly, consensually and safely being part of hitting, slapping or other ways of striking for pleasure. It can but doesn't have to be part of BDSM.)
• fluid play that doesn’t involve the vulva⁠ (vulva: The name for the external genitals of people assigned female at birth. The vulva includes the mons, external clitoris, inner and outer labia, fourchette and perineum.) or vagina⁠ (vagina: The internal passage leading from the opening of the vulva to the cervix of the uterus.)
• virtual sex like sexting or sex over the phone or video
• role play without penis-in-vagina intercourse⁠ (penis-in-vagina intercourse: A kind of sex (or assault) where a penis is within a vagina, either for the purpose(s) of pleasure, procreation, or both. (PIV))
• being sexual in any way between partners who all have vulvas and vaginas, rather than a penis⁠ (penis: One of the two external reproductive organs of people often assigned male at birth.) (and perhaps obviously, for those with penises who want to avoid causing pregnancy, sex between people who each have penises)

These ways of being sexual with someone else do:

• penis-in-vagina intercourse or other kinds of direct, unprotected penis-to-vagina contact

**Some other ways of being sexual can result in vaginal contact with semen⁠ (semen: Fluid which comes from the urethra of the penis during ejaculation, and which usually contains sperm.) , such as if someone ejaculates unprotected with anal sex and their semen runs down to the vagina, or if someone ejaculates directly onto or very near the vagina during something such as mutual masturbation. Highly fertile people may potentially be at risk with such activities, but these still are more theoretical than actual risks. It’s penis-in-vagina intercourse that almost always causes pregnancy.

Some people who can get pregnant would be and are perfectly happy to live without penis-in-vagina intercourse altogether, and some could take or leave it: for someone like this, just skipping or highly limiting this kind of sex might be the easiest way to reduce or remove their risk of pregnancy. The same goes for someone who either really doesn’t have a gender⁠ (gender: Characteristics that are seen or presented as distinguishing between male and female in a society. Gender may or may not include assigned or chosen: social roles, feelings, behaviors and/or presentation or appearance.) or genital preference when it comes to their sexual partners or prefers partners who don’t have the ability to co-create a pregnancy: choosing only to be sexual with other people with vulvas and vaginas is also an option.

On the other hand, if you’re someone who likes and wants these kinds of sex, or is with or wants to be with a partner or partners who have a penis, then this means of prevention isn’t going to be a good fit for you.

As always, if you’d like help with anything actionable you read in this piece, such as finding abortion pills or EC for advance provision, picking effective methods for yourself, or staying or getting away from partners who are putting you in danger of pregnancy or anything else, we are always here to help you in our direct services. Not wanting to become pregnant, especially in this era, can feel very stressful and even scary sometimes. At Scarleteen we understand how critical it can be to not get pregnant when that isn't wanted or right for you, so we're always here to help everyone in that aim in any way we can.  - H.