Birth Control Basics

What is birth control?

Birth control (or contraception) is any regimen or medicine used to prevent pregnancy. 

Most birth control options are used by people with internal reproductive anatomy such as a uterus, vulva, and vagina, while only a few options are available for those with external reproductive anatomy such as a penis and testes. However, more research is being done to expand options for those with external reproductive anatomy. 

Why might people choose to use birth control?

Birth control is often used to prevent pregnancy. Some contraceptive methods can also be used to help reduce the chances of contracting a sexually transmitted infection or disease (STI or STD). In addition to protecting against pregnancy and STIs, some types of birth control may also be used to help manage reproductive hormonal cycles or acne. Other options may even help to regulate conditions like endometriosis or polycystic ovary syndrome (PCOS). 

When referring to sperm-producing and egg-producing partners, the only birth control method that is 100 percent effective in preventing pregnancy is abstinence from penile-vaginal sex. Other types of sex like oral or anal sex are unlikely to result in pregnancy. However, it’s important to note that STIs can still be spread through contact with semen, vaginal fluids, and genitals more generally.  

How do the different birth control methods work?

There are 4 broad categories that contraception can typically fall into: medication and long-acting reversible contraceptives (LARCs), barrier methods, surgical options, and lifestyle choices.  

Medication and LARCs

These options can be split into two sub-categories: hormonal and non-hormonal. While both methods work to prevent pregnancy, the way they work differs slightly. Hormonal options typically work by reducing or preventing ovulation. This occurs through taking medications that contain hormones like estrogen or progesterone to delay or prevent parts of the menstrual cycle from occurring. Nonhormonal methods work by actively blocking sperm from reaching an egg. Some medication and LARC methods include: 

• Birth control pill (oral contraceptives) 
• Injectable shot 
• Vaginal ring 
• Patch 
• Implant 
• Intrauterine device (IUD) 
• Emergency contraception pill 

Barrier 

Barrier methods often work by placing a physical barrier between sperm and vagina or cervix to minimize the chances of that sperm reaching and fertilizing an egg. Other barrier methods may simply reduce the viability of sperm and make it difficult for them to travel to meet an egg. Barrier methods can be effective in reducing the likelihood of contracting a STI. However, when it comes to preventing pregnancy, they’re often most effective when paired with another form of birth control such as medication or a LARC. Common barrier methods include: 

• External condom 
• Internal condom 
• Diaphragm or cervical cap 
• Sponge 
• Spermicide or contraceptive gel 

Surgical 

If you’re searching for something more permanent, surgeries on reproductive anatomy may be the best option. Surgical contraceptive options for both internal and external reproductive anatomy include: 

• Tubal ligation 
• Vasectomy 

Lifestyle 

While lifestyle options are typically the least effective at preventing pregnancy—aside from abstinence—they are often the most cost effective. These methods are often free of charge but may take more planning and documentation to track the menstrual cycle. Lifestyle options that may be used as contraception include: 

• Abstinence 
• Outercourse 
• Breastfeeding (lactation amenorrhea method) 
• Withdrawal 
• Fertility awareness (FAM) 

Where can I get contraception if I have health insurance?

In the United States, the Affordable Care Act requires that birth control options approved by the Food and Drug Administration be covered by insurance plans. This is because they are often prescribed by a health care provider. Discussing needs and preferences with your provider will help determine which contraception method is best for you and your lifestyle. 

Options often covered by insurance include: 

• Internal barrier methods 
• Hormonal methods and LARCs 
• Tubal ligation 
• Emergency contraception (sometimes known as “Plan B”) 

Education and counseling on birth control is also covered. However, if you receive insurance benefits from your employer, coverage may vary. Speaking with a human resources supervisor at your workplace can help to clarify your insurance plan. 

Insurance plans aren’t required to cover: 

• Drugs for inducing abortion 
• Vasectomy 

Where can I get contraception if I don't have health insurance?

Even if you don’t have insurance, you can still access birth control options. 

• External condoms are available at most drugstores for purchase. You may find free external condoms at local health centers and university clinics.
• Federally qualified health centers may provide birth control options for low-income individuals.
• Reproductive health organizations like Planned Parenthood often provide condoms at their locations, as well as consultations for other types of birth control.
• Oral contraceptives can be ordered from online subscription services. 
• An over-the-counter birth control pill has been approved and may be available in drugstores soon. 
• Emergency contraception is often available for purchase in drugstores. a