Improving access to birth control is at the forefront of our efforts to prevent unintended pregnancy, reduce the need for abortion, and give women control over their reproductive health and lives.
For the 98 percent of American women who use some form of contraception during their lives, birth control is basic, essential health care. More than 40 million women of reproductive age are sexually active and want to prevent unintended pregnancy. [Guttmacher Institute, Facts in Brief: Contraceptive Use(Feb. 2005)]
Contraception is basic preventative health care and should be treated as such as a matter of public policy. The average woman will spend five years pregnant or trying to get pregnant, but nearly three decades trying to avoid pregnancy. Without contraception, she would have between 12 and 15 pregnancies. Her body and the very course of her life would be governed almost solely by reproduction. Access to contraception is critical to women of all ages. Teenagers (aged 15–19) who do not use a contraceptive at first sex are twice as likely to become pregnant as are teenagers who use a method. [Guttmacher Institute, Facts on Contraceptive Use in the United States, 6/2010]
Unfortunately, 40 years after the Supreme Court struck down a ban on birth control, there are still many opponents of reproductive freedom who want to restrict or block women's access to contraception despite the vast majority of American women who use it.
Laws promoting insurance coverage for contraception are crucial to protecting and promoting women's health. By guaranteeing that insurers cover prescription contraception to the same extent as other drugs, contraceptive equity laws help ensure women's access to birth control and ultimately prevent unintended pregnancies and reduce the need for abortion. Today, 27 states now ensure that health-insurance plans that cover prescription drugs provide equitable coverage for contraceptives through laws, regulations, or legal opinions. These laws that say that insurance plans that cover prescription drugs must also cover all contraceptive methods and services.
Virginia does not have a contraceptive equity law. Virginia law requires that insurance companies offer employers a plan that covers contraception, but the law does not mandate that employers purchase these more equitable plans for their employees. Policymakers and advocates must continue to advocate for contraceptive equity laws to help ensure women's access to this basic health care need.
In addition to lack of contraceptive equity, Virginia's so-called "conscience clause" allows pharmacists to decide which prescriptions they will and will not provide. This means that a pharmacist could legally refuse to fill a doctor's prescription for birth control or to stock or distribute emergency contraception. Since when do pharmacists get to step inside the doctor-patient relationship and refuse to fill necessary prescriptions?
Lastly, many low-income women rely on government health care or other public health programs for reliable, affordable access to birth control and other family planning and reproductive health care services. We must oppose proposals to reduce or restrict this coverage and make it harder for low-income women to take care of their health and their families.
Types of Birth Control
Birth control, or contraception, is critical for sexually active women and their partners to prevent pregnancy and sexually transmitted infections (STIs). Your health care provider can help you to determine which method is right for you.
Not all forms of birth control protect against sexually transmitted infections (STIs). When used correctly and consistently, condoms are the best protection against most STIs.
- Abstinence is the decision to not engage in sex, including oral, vaginal, or anal sex. Abstinence is the only method that is 100% effective in preventing pregnancy and STIs.
Birth Control Pills- Birth control pills, also know as "the pill" or oral contraception, is a medication women can take daily to prevent pregnancy. The hormones in birth control pills keep a woman's ovaries from releasing eggs (ovulating) and thicken a woman's cervical mucus. The mucus prevents sperm from joining with an egg (fertilization). Less than 1 out of 100 women will get pregnant each year if they take the pill as directed. About 8 out of 100 women will get pregnant each year with less perfect use of the pill. The pill may be less effective for women who are very overweight, on anti-epileptic medication, or taking antibiotics.
Cervical Cap- The cervical cap, or FemCap®, is a silicone cup shaped like a sailor's hat. The cap is inserted into the vagina and fits over the cervix. For women who have never been pregnant or given birth vaginally, 14 out of 100 who use the cervical cap will become pregnant each year. For women who have given birth vaginally, 29 out of 100 who use the cervical cap will become pregnant each year. Using a condom, spermicide, and withdrawing before ejaculation will increase effectiveness.
Condom (for men)- Condoms are thin latex or plastic sheaths worn on the penis during intercourse. They prevent pregnancy and reduce the risk of STIs. Each year, two out of 100 women will become pregnant if their partners use condoms correctly. Each year, 15 out of 100 women will become pregnant if their partners use condoms incorrectly. Condoms are more effective when used with spermicide or the man withdraws before ejaculating.
Condom (for women)- Female condoms are similar to male condoms, but cover the inside of the vagina or the anus. They prevent pregnancy and reduce the risk of STIs. If the condom is used correctly, five out of 100 women will become pregnant each year. If the condom is used incorrectly, 21 out of 100 will become pregnant each year. They are more effective when used with spermicide or the man withdraws before ejaculating.
Diaphragm- A diaphragm, made of latex, is a shallow, dome-shaped cup with a flexible rim. It is inserted into the vagina and covers the cervix. If a diaphragm is used properly, six out of 100 women will become pregnant each year. If a diaphragm is used incorrectly, 16 out of 100 women will become pregnant each year. Using a condom, spermicide, and withdrawing before ejaculation will increase effectiveness.
Implant (Implanon®)- Implanon® is a thin, flexible plastic hormonal implant about the size of a cardboard matchstick. It is inserted under the skin of the upper arm. It protects against pregnancy for up to three years. Less than one out of 100 women a year will become pregnant using Implanon®.
Intrauterine Device (IUD)- IUDs are small, T-shaped devices made of flexible plastic. A healthcare provider inserts an IUD into a woman's uterus to prevent pregnancy. Two types of IUDs are available in the United States. Mirena® IUDs release a small amount of hormones and protect against pregnancy for five years. ParaGard® IUDs contain copper and protect against pregnancy for 12 years. Less thanone out of 100 women will get pregnant each year if they use the ParaGard® or Mirena® IUDs.
Natural Family Planning- Also known as Fertility Awareness Method, natural family planning seeks to track the natural changes in a woman's body that occur during the menstrual cycle to determine when a woman is most fertile. Fertility is charted by tracking body temperature and cervical mucus, with a calendar. During fertile times, a couple can choose to abstain from vaginal sex or use a barrier method, like condoms or a diaphragm. With typical use, 20 out 100 women will become pregnant each year.
The Patch- The birth control patch is a thin, beige, plastic patch that sticks to the skin. A new patch is placed on the skin once a week for three weeks in a row, followed by a patch-free week. The hormones in the patch prevent ovulation and thicken the cervical mucus. Less than one out of 100 women a year will get pregnant if they use the patch correctly. About eight out of 100 women will get pregnant each year if they do not use the patch as directed. The patch may be less effective for women who are overweight, on anti-epileptic medications, or taking antibiotics.
The Shot- The birth control shot is an injection of hormones that prevents pregnancy. Each shot prevents pregnancy for three months. It is also known by the brand name Depo-Provera®, or the medicine in the shot, DMPA. Less than one out of 100 women will get pregnant each year if they use the birth control shot as directed. About three out of 100 women will get pregnant each year if they use the birth control shot incorrectly.
Spermicide- Spermicide contains chemicals that prevent sperm mobility to stop fertilization. Spermicides are available in different forms including creams, film, foams, gels and suppositories. Spermicide can be used alone or with other birth control methods. It should always be used with a diaphragm or cervical cap. If spermicide is used as directed, 15 out of 100 women will become pregnant each year. If spermicide is not used as directed, 29 out of 100 women will become pregnant each year. When used alone, spermicide is not very effective. Spermicide can be more effective when used with a latex condom or if the man withdraws before ejaculation.
Sterilization- Sterilization (sometimes known as tubal ligation or "having your tubes tied") is a permanent form of birth control for women. It closes off the fallopian tubes to prevent fertilization. Sterilization is nearly 100% effective. Some methods of sterilization are effective immediately while others may take up to three months to prevent pregnancy.
Vaginal Ring-The vaginal ring is a small, flexible ring a woman inserts into her vagina once a month. It is left in place for three weeks and taken out for the remaining week each month. The vaginal ring is commonly called NuvaRing®, its brand name. Less than one out of 100 women will get pregnant each year if they use the ring correctly. About eight out of 100 women will get pregnant each year if they use the ring incorrectly.
Vasectomy- A vasectomy is a permanent form of birth control for men. A vasectomy closes or blocks the tubes (vas deferens) that carry sperm, preventing them from leaving the man's body. A vasectomy is nearly 100 % effective in preventing pregnancy. A vasectomy is not immediately effective as sperm may remain in the tubes. A simple semen analysis determines when there is no more sperm in the semen.
Withdrawal Method- The withdrawal method, also know as "coitus interruptus" or "pulling out," involves pulling the penis out of the vagina before ejaculation. If done properly, only four of 100 women will become pregnant each year. If done incorrectly, 27 of 100 women who use withdrawal will become pregnant each year. Pregnancy can also occur when pre-ejaculate is left in the urethra from a previous ejaculation. Urinating between ejaculations can help increase the effectiveness of withdrawal. Pregnancy can also happen if semen or pre-ejaculate is spilled on the genitals.
Emergency Contraception (EC)- Also known as Plan B© or the "morning after" pill, EC is a large dose of oral contraception. It is a safe and effective way to prevent pregnancy after unprotected intercourse. The hormones in EC prevent a woman from ovulating and thicken her cervical mucus. The mucus blocks sperm, preventing fertilization. It should be taken as soon as possible, but is effective if taken within five days (120 hours). Emergency contraception is birth control, not abortion. Only one out of 100 women will become pregnant after taking EC within 72 hours.
The information on methods of birth control comes from Planned Parenthood Federation of America. "Birth Control," Planned Parenthood Federation of America (PPFA). http://www.plannedparenthood.org/health-topics/birth-control-4211.htm (last accessed August 25, 2008).