By Kendall McKenzie
Birth control is one of the greatest inventions of the modern world, and if you use it, you’re probably not interested in only being kinda-sorta protected from pregnancy. Chances are, you want it to work really, really well. The good news? There are more birth control options than ever before. The bad news? The most common reason birth control fails is because we screw it up. This handy guide will help you avoid common contraception pitfalls and beef up your pregnancy preventing superpowers!
LARC It Up
LARC stands for Long Acting Reversible Contraceptives — birth control methods that are highly effective, long-term, and easily removable if you decide you want to get pregnant.
LARCs available in the U.S. right now include the birth control implant (Implanon and Nexplanon), and intrauterine devices, or IUDs (Mirena, Skyla, and ParaGard). These methods are over 99 percent effective at preventing pregnancy, which is pretty much as good as it gets.
The reason LARCs work so well is because they eliminate the element of user error that’s responsible for so many birth control mishaps (and unintended pregnancies). Once an implant or IUD is in place, your work is done until it expires or you want it removed — they’re the “Set It and Forget It” of the birth control world. And, depending on which LARC you go with, you’re covered from three to twelve years.
Many people like hormonal LARCs because they often reduce or even eliminate your period, as well as help with cramps. There’s also a hormone-free LARC: the ParaGard (or Copper-T) IUD is the most effective non-hormonal method available, other than sterilization. Unlike hormonal LARCs, the ParaGard may cause heavier, longer, and/or crampier periods. But as with all types of birth control, everyone's body reacts differently, and people have varying needs and side effects they're willing to deal with. Talking with your doctor can help you figure out which method is best for you.
Long story short: LARCs will give you the best possible protection against pregnancy.
This can be a tough sell for folks who think doubling up is overkill, but hear me out. No form of birth control is 100 percent effective, even if used perfectly. There’s always a possibility of pregnancy, even if it’s really small. So, why not throw condoms in the mix, and give sperm the ol’ one-two punch? Trust me, no one ever wakes up the next morning and thinks, “I wished I’d used less protection.”
And then there’s the whole sexually transmitted infections thing, which is kind of a big deal. Condoms are the only method of birth control that also prevent STIs, including HIV. Most people with STIs don’t have symptoms, so getting tested and using condoms is your safest bet. Whatever your current sexual arrangement is, if there’s even the slightest risk for STI exposure, it’s a really good idea to use condoms every time you have sex. And, if you also feel like getting pregnant right now would be the worst thing in the world, it’s a really good idea to use both birth control and condoms every time you have penis-in-vagina sex.
Concerned about pleasure and sensation? Luckily, there’s a dazzling menagerie of fun condom shapes, textures, and materials that are designed to treat you both to all the good-feels. Adding water-based or silicone lubricant (found at sex shops and in the condom aisle at drug stores) inside and outside the condom makes them feel way better — and helps prevent breakage.
Condoms only kill the mood if you let them. You can roll the condom on for your partner and make it a sexy part of foreplay. Besides, how hot is it really going to be if you’re stressing about STIs and pregnancy the whole time? Protected sex = good sex.
Even if you’re on birth control and know you don’t need to use condoms — you’re in a closed relationship where everyone involved has been tested, for example — it’s worth keeping some rubbers around in the event that you need back up contraception (like if you miss a few pills but still want to get busy). Just remember to check those expiration dates before you use ‘em.
Emergency contraception (aka EC, the morning-after pill, Plan B) is your best bet for preventing pregnancy up to five days (120 hours) after you’ve had unprotected sex for whatever reason — forgot to use a condom, messed up your birth control, etc.
There are a few types of emergency contraception, and some work better than others. People of all ages and genders can now buy the Plan B One-Step morning-after pill over-the-counter at drugstores and pharmacies, while other brands have different restrictions.
The most effective morning-after pill available is called ella. Most morning-after pills work better the sooner you take them, but ella is just as effective for all five days after unprotected sex. Unlike Plan B, ella requires a prescription no matter your age, but you can get the prescription online and order it for next-day delivery.
Because timing is so crucial, it’s a good idea to have EC around just in case an accident happens. It’s easier than ever to get it over-the-counter now, so why not keep a box in your medicine cabinet? Thanks to the Affordable Care Act, morning-after pills are covered 100 percent with no copay under most insurance plans if you get a prescription. So, the next time you’re at the doctor for whatever reason, you can ask for a prescription to have on hand. BAM — free birth control backup. Go you!
A ParaGard (non-hormonal) IUD inserted up to five days after unprotected sex can also be used as emergency contraception. It’s actually the most effective kind of emergency contraception, but a health care provider must insert it and it’s sometimes tough to get an appointment on short notice. Depending on your weight, an IUD may be your best emergency contraception option — morning-after pills don’t work as well for people with a higher body mass index (BMI).
True story: I once went off birth control for a few months during a dry spell, but one unexpected thing lead to another and I ended up having to scramble around trying to get emergency contraception the morning after a condom broke (I would have so much rather been at brunch). This is a very common tale — so be prepared, friends. We can have the best of intentions, but sometimes “situations” pop up before we can hustle our butts to the gyno.
If you’re not on birth control (or want to go off birth control) because you’re worried about undesirable side effects, talk to your doctor about different brands or methods. There are more options than ever before, and many types of birth control provide non-contraceptive benefits as well. It’s common to try a few kinds before finding one that works best for you, or have your needs change over time. For example, when I first started taking birth control I chose a certain brand of pill known to clear up skin because I was rockin’ some gnarly acne. In my 20s, I got a ParaGard (Copper-T) IUD because I wanted a method that was hormone-free. After seven years, I recently switched to the Mirena IUD because I was totally over getting my period. All of these methods were right for me at those times. Keep an open mind, and don’t be afraid to ask your doctor lots of questions.
Real talk: Birth control usually fails because we mess it up. The majority of birth control methods are very effective at preventing pregnancy if used perfectly — but, we’re not perfect, and there are plenty of ways to accidentally reduce our contraception’s effectiveness.
Fear not, though! The solution is as simple as using your method as correctly as possible, as well as having a backup available (like condoms or emergency contraception) in case of a mistake. If you’re on the pill, be sure to always take it every day. Some types of birth control pills, like mini-pills, need to be taken within the same three-hour window every day. Don’t leave a birth control ring out of your vagina for more than three hours, and be sure to change rings on time. Patches must be changed weekly and checked to make sure they’re sticking right. Make an appointment to get your shot far in advance, and be sure to actually go. Etc., etc.
There are countless reminder apps that can help you stay on schedule with refilling your prescription, taking your pill, getting your shot, and changing your ring or patch. Enlist your partner(s) to remind you and help you get to the doctor or pharmacy — it’s the least they can do, right? And, shout out again to LARCs for allowing you sidestep all of these issues, making them the most low-maintenance and effective options available.
Be honest with your doctor (and yourself) about your sexual practices and how likely you are to use your method correctly. If your life is super hectic, you might not be able to remember a pill every day. If you don’t want to put your fingers in your vagina, the ring is probably not a great choice. Planned Parenthood has a fun quiz that provides birth control recommendations based on your personal needs.
That’s it! A+, everyone. Now go forth and hump feeling smart, confident, and secure.
Kendall at Planned Parenthood
Beyond serving as a go-to source for vital reproductive care, the folks at Planned Parenthood— a team of knowledgeable experts in medicine, sexual health, and law — are passionate, informed advocates for knowing your own body. Planned Parenthood is here to tackle the big issues.