Dear Alice,

I have been on Depo-Provera for about nine months. Recently I was supposed to get my shot, but I could not afford to get it and I will not be able to afford it for at least another two to four weeks. I had gotten pregnant when I was 17 and I was on the pill. I have a steady boyfriend who I have been living with for one year. I am really scared that I am going to get pregnant again. I love my daughter, but I don't know if I want another baby right now. I am just entering my second year of college. What is the chance of my getting pregnant? Thanks

Scared

Dear Scared,

First of all, even though you may feel anxious and as though you're lacking control in this situation, know that you have options. Generally, the 150 milligrams (mg) shot of Depo-Provera gives more than three months’ worth of birth control (the shots are administered at 11 to 13 week intervals), and there may some "overtime" protection built in as some of the side effects linger after the 13 weeks. With that being said, if you wait longer than 13 weeks between shots, pregnancy is possible and the risk increases with time. Although this window may vary from person to person, the best way to avoid pregnancy is to use back-up methods of birth control.

Considering your desire not to get pregnant right now, you and your boyfriend might consider using condoms or abstaining from vaginal sex until you get your next shot. You might also explore new ways of being together and pleasing each other that don't involve intercourse, such as manual or oral stimulation. Who knows... this new exploration may be a perfect opportunity for your relationship to grow and become stronger! If you do have sex without protection, you also have the option to use emergency contraception (EC) up to 120 hours (five days) after sex that occurred when a birth control method failed or wasn’t used (see Emergency contraception basic information in the Go Ask Alice! archives for more information).

Scared, do you have health insurance? If you do, many plans now cover contraception and sexual health services at no additional cost. However, if you don’t have health insurance, perhaps you can discuss with your health care provider what other birth control options are available to you during this time and whether different payment options might help avoid this conundrum in the future. If you think this the Depo-provera shot will always be too expensive while you are in school, you and your provider can discuss other birth control options that could work for you, your boyfriend, and your budget. Check out the Contraception section of the Go Ask Alice! archives for more information about the different options. 

As a college student, you may contact your school's health or medical services to make an appointment to see a health care provider. If you feel that your provider is not receptive to giving help or advice, you may want to try contacting Planned Parenthood. Whatever you decide to do, you're ultimately the one in control and you have a range of options to choose from to avoid getting pregnant.

Alice!

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