(Sorry this post is so long! You can download a pdf of this post here.)
I’ve wanted to do a post on birth control for a while. Several people have asked me what methods we use, since we have opted not to do any hormonal birth control. I wanted to help by giving some more detail on the options available should one choose to go this route, for whatever reason.
First, let me say if this topic makes you uncomfortable, please stop reading right now. I’m not going to be so vague as to not be able to communicate my point because I’m afraid of offending some people. However, I understand that this might be TMI (too much information) for some, so consider yourself warned! I am writing mainly for other married (or soon to be married) women and their husbands.
Second, I want to make it clear that I do not want this to be a debate about birth control. This is an intensely personal topic, one between a wife, her husband, and God. If a couple has prayed about it and has peace about their decision, then I have no problem with that. My hope is to provide information for those who don’t know, so they can make an educated decision. I ask that the comments reflect this; I will delete any comments that are merely trying to instigate spite.
I just want to lay a little groundwork so everyone knows where I am coming from. Paul and I are both pro-life, and we believe life begins at fertilization. We both recognize that no birth control is 100% effective, and we acknowledge that God could choose to give us a child at any time. If He did, we would be thrilled because we believe children are blessings from God. That being said, we also realize that we can use the resources available to us to decrease our chances of getting pregnant for now. This is a personal decision, and we are trying to be open to God’s timing for us.
Also, something else important to note: not any one method is right for every couple every time. It’s important for each couple to explore what works best for them, and acknowledge that as time and circumstances change, the â€œbestâ€ method might change (ESPECIALLY after childbirth).
I’m not really going to discuss hormonal birth control (i.e. the “pill”) here. This category includes: the Pill, Lunelle Injection, Ortho Evra Contraceptive Patch, NuvaRing, Morning-After Pill, Depo-Provera, Norplant, Implanon, Jadelle, and IUDs (intrauterine devices). I wrote a blog post about the pill a year ago, which prompted me think about both the ethics and the side effects. Paul and I both feel strongly that hormonal methods were not an option for us, which led to our decision to explore other methods.
All that being said, there are two categories of non-hormonal birth control: barrier/chemical methods, and natural methods. These can be used by themselves or in conjunction with each other. The barrier and chemical methods include spermicides, the diaphragm, cervical cap, sponge, female condom, and the male condom. Natural methods include withdrawal, calendar/rhythm method, and FAM (fertility awareness method). I am going to summarize them here, but please please do your own research as well. There is so much information out there that I couldn’t possibly include everything here.
But Ashley, I really can’t get pregnant right now!
Oh sister, I totally hear ya! When I vocalized my choice not to go on the pill, I was met with many disapproving stares and told that we were being unwise. I think for me, the biggest fear of getting pregnant before we plan are the â€œI told you soâ€s that we’re sure to get. However, I need to remember that God is in control and He will take care of us, no matter what! We are living by our convictions, and we are letting God take care of the rest. I have done a lot of research, and have found that if we are not sloppy and use the methods correctly, they can be very effective. (The condom, for example, is effective as high as 98% of the time; used in conjunction with other methods like spermicides and FAM, that percentage is even higher.) Most importantly: God doesn’t look at your baby as an â€œinconvenienceâ€ and neither should you! Keep an open mind – â€œWe’re not trying for children right now, but if God should give us one we’d be happy.â€
One note about effectiveness percentages: I took my information from several websites, including this one. The lower percentage is with â€œtypical useâ€ (taking human error into account), and the higher percentage is perfect use (when it is consistently used perfectly).
Barrier and Chemical Methods
Barrier methods basically prevent pregnancy by decreasing the chances of a sperm reaching an egg to fertilize it. They are often used in conjunction with a chemical method (spermicide) to increase the effectiveness. Generally, you can get them over-the-counter at your local drugstore or online at places like Amazon.com.
Spermicide is made of a chemical called nonoxynol-9, which basically immobilizes or kills the sperm before fertilization. It comes as a gel, foam, or film, and can be used in conjunction with all the barrier methods. Many male condoms are lubricated with spermicides. A negative side effect is that spermicides can cause irritations if used very frequently (multiple times a day). The cost is about $1 per contraceptive film to $10 for multiple-use package of gel or foam. When used alone, they are effective about 71-85% of the time.
The diaphragm is a round latex cap put over the female cervix, and is fitted by a doctor. It can be put in anytime and remain up to 8-10 hours. Because the sperm can get around the edges of the diaphragm, it is necessary to use a spermicide in conjunction. This method is about 84-94% effective when used correctly, and the cost is about $20-$30 (including the case), in addition to the cost of a doctor visit (for the fitting) and the spermicidal gel. Also, I am told that the diaphragm has to be refitted after having intercourse for the first time, as the vagina stretches/changes shape. This might be a better method for a couple who has been married for a little while.
The cervical cap is similar to a diaphragm, only smaller. It must also be used with a spermicide, and can be inserted for up to 2 days without additional gel. It also requires fitting by a doctor, and I would assume it would have the same drawbacks as the diaphragm. It is 84-91% effective.
The sponge, which was made popular by Elaine on Seinfeld (â€œsponge-worthyâ€), covers the cervix, thus preventing sperm from reaching the egg and releasing nonoxynol-9 (spermicides) to immobilize the sperm. It doesn’t need a prescription, and can remain up to 30 hours. Prices run about $7.50-$9 for a package of three sponges. In general, it is 84-91% effective.
The female condom is a pouch that is inserted in the vagina that allows for entry but prevents the sperm from reaching the cervical fluid. They are thicker and more resilient to breakage than male condoms, but have a looser fit so are generally not as effective. It can be inserted up to 8 hours before intercourse, and should not be used with the male condom. The cost is about $1.50-$2 per condom, and they are about 79-95% effective.
The male condom is currently the only effective birth control for men, and is the most effective of the barrier methods. It is also the method I am most familiar with for myself. They can be used in conjunction with spermicides to guard against possible spills or ruptures. Some couples have trouble with irritation or an allergy to latex (although it’s possible to buy latex-free condoms). Others complain that it â€œdestroys the moodâ€ to have to stop and put one on, but an easy solution is to keep them near the bed and incorporate them into foreplay (in which case, can be used as a mood-enhancer). They can cost about $0.25 each for latex, to $1 for the nonlatex, to $2 for lambskin. Their effectiveness runs about 85-98%.
Natural methods, also called behavioral methods, do not require any kind of product to be bought or inserted, and are generally the most cost effective methods.
The withdrawal method generally should be avoided, because it relies on the man being able to pull out right as he is reaching his sexual peak. For one, this is frustrating to him and for two, it doesn’t take into account that the pre-ejaculate (the bit of fluid that is released before full ejaculation) is rich in sperm.
The calendar/rhythm method assumes every woman has a 28-day cycle and ovulates on the 14th day. So basically, a couple would either avoid sex or use a barrier method on the ovulation days. However, since every woman is different, this method would only work for those who are very regular.
Fertility awareness method (FAM) is a method of charting your cycle to determine ovulation. It can also be referred to as Natural Family Planning (NFP). It can be used as both a birth preventative or a trying-to-conceive method. A great resource if you are considering this method is â€œTaking Charge of Your Fertilityâ€ by Toni Weschler.
Basically, a woman is only fertile about 7 days of the month, and by avoiding intercourse or using barrier methods during those 7 days, the couple can avoid pregnancy very effectively. Since every woman’s cycle is different, this method focuses on paying attention to your own body and noting the signs in order to determine when you ovulate (unlike the rhythm method). There are two main ways this can be done: by recording basal temperature and cervical fluids every day. When a woman ovulates, her basal temperature (the temperature taken right as she wakes up every morning) jumps slightly and stays high the rest of her cycle.
She also needs to watch her cervical fluid to predict ovulation. Basically, no cervical fluid = not fertile (sperm can’t survive). Thick and slippery cervical fluid = high fertility (perfect conditions for sperm to thrive). The sperm can live in fertile fluid for up to 5 days. Once ovulation occurs, the egg can live 24-48 hours, and then the woman is no longer fertile for the rest of her cycle (usually 12-16 days). Other symptoms can point to ovulation, such as breast tenderness and cervix position. Since every woman is different, it’s important to watch your own body for the signs instead of just going by a â€œtextbookâ€ answer. Cycle lengths can vary month by month: stress, for example, can postpone ovulation, making the cycle longer.
You can download charts offline at sites like this one and this one, and you can also get charting software (with a 15 day free trial) and talk to others on message boards. There are even seminars and workshops like this one or this online one which will help you learn this method more effectively. As I mentioned earlier, I highly recommend the book â€œTaking Charge of Your Fertilityâ€, by Toni Weschler. Other books recommended to me, though I haven’t read them myself, are â€œThe Art of Natural Family Planningâ€, by John F. Kippley, and â€œBirth Control for Christians: Making Wise Choicesâ€, by Jennell Williams Paris.
The downside to this method is that you have to be consistent; laziness will mess up your calculations. This method isn’t very forgiving if you â€œaccidentallyâ€ have sex when you are ovulating! According to the research, FAM has an effectiveness rate of 75-98%, but I am not sure that percentage covers this exact method or if it encompasses other less reliable ones (like the rhythm method). The price of FAM is very low: you only need a thermometer and a way of charting your cycles (either by printing off charts or using something like this free online chart).
If you have any questions about FAM, please feel free to contact me and I’ll try to help you as best I can! Right now, we have found that doing a combination of FAM and condoms has worked best for us.
I would hope that you would research any method more fully before completely committing to it yourself. I have gotten most of my information from the books â€œThe Contraception Guidebookâ€ by William R. Cutrer and Sandra L. Glahn (a great summary of each method, including hormonal methods, from a Christian perspective), â€œTaking Charge of Your Fertilityâ€ by Toni Weschler, and â€œIntended For Pleasureâ€ by Ed Wheat, as well as various online sites. Above all, please pray about this with your husband/wife, and come to a decision together that you can all be at peace about. I hope this little summary helped with those who are considering the options! There is a ton of information out there, so just keep researching.
(Please note that I do not endorse all the information on these sites; I am only including them to help you get started on your own research.)
More Information on All Methods:
- Planned Parenthood (easy to understand format)
- Reproductive Health Outlook: Contraceptive Methods (includes an annotated bibliography)
- Epigee Women’s Health Birth Control Guide (free downloadable charts for FAM/NFP)
- EngenderHealth: Family Planning (questions to help figure out which method works best for you)
Natural Family Planning:
- Taking Charge of Your Fertility (site for the book of the same name; information about charting as well as message boards and free downloadable charts)
- Couple to Couple League (information about Natural Family Planning, as well as seminars and links)
- Family of the Americas (diagrams and pictures to help better understand the Natural Family Planning method; also, a comparative list of NFP to artificial methods of birth control)
- Fertility Friend (aimed more at women trying to conceive using Natural Family Planning, but has a lot of information on how to chart, as well as a free online charting service)
- Johns Hopkins Center for Communication Programs: Natural Family Planning (materials, pamphlets, links, publications about Natural Family Planning)
(Sorry this post is so long! You can download a pdf of this post here.)