Contraception, or birth control, is a term for the various methods used to prevent women from becoming pregnant.
Different methods of contraception work in different ways, such as:
- Preventing sperm from getting to the eggs – such as condoms, diaphragms and intrauterine devices (IUDs).
- Keeping the woman's ovaries from releasing eggs that could be fertilised – birth control pills work this way.
- Sterilisation, which permanently prevents a woman from getting pregnant or a man from being able to get a woman pregnant.
The ideal birth control method will depend on factors such as your health, frequency of sexual activity, number of sexual partners and desire to have children in the future. Talk with your healthcare provider about the best form of birth control for you.
Methods of contraception
Methods of contraception range from abstinence (not having sex); through natural fertility awareness; barrier methods such as condoms and diaphragms; intra-uterine devices (IUD); and hormonal methods, including the oral contraceptive pill, intra-uterine systems (IUS), long-acting injection or implants.
Condoms are often recommended to be used as an additional measure to help protect against sexually transmitted infections (STIs). Vasectomy for men or tubal ligation for women are permanent (usually non-reversible) contraceptive methods (sterilisation).
Emergency contraception is also available after unprotected sex or due to contraceptive failure (eg, burst condom). It is not a routine method of contraception.
Abstinence is the only 100% sure way of preventing pregnancy and STIs. It is an option for couples who do not want to have sex because they don't feel ready or they don't want to use other forms of contraception, or for religious or any other personal reason.
Chance of getting pregnant: 0%
Natural contraception means working out 'safer' times to have sex. If a woman has a very regular cycle, eggs will be released (ovulation) approximately 14 days before the next period and can be fertilised for up to two days afterwards. A sperm can fertilise an egg four or five days after you have sex. So if the woman has a 28-day cycle, she can get pregnant from day 10 to day 17. If her cycle is shorter or longer, count back 14 days from the period.
A woman can also tell when she is ovulating by taking her temperature every day with a special ovulation thermometer that shows fractions of degrees or by looking at how much and how thick the discharge from her vagina is at different times of the month. This method is also used by some women to help them conceive, by identifying their fertile times.
You need detailed advice on this method: it takes commitment and great care. Natural Fertility New Zealand can provide skilled help and support.
Chance of getting pregnant: 2-24%.
Withdrawal is sometimes called 'coitus interruptus' and means the man pulls his penis out of the vagina before he ejaculates. It takes a lot of self control and can fail if the man does not withdraw fast enough or some sperm leak out before he ejaculates.
Chance of getting pregnant: 25%.
Barrier methods of contraception stop the sperm from reaching the woman's tubes. They also give some protection against STIs. However, they can interrupt sex and be fiddly to put on until you get used to them. You must remember to have them with you and to use them every time. They include condoms or sheaths, and diaphragms or caps.
Condoms or sheaths
Male condoms are usually made of latex rubber, and are put on over a man's erect penis before intercourse to stop the sperm going into the woman's vagina. Condoms can also help prevent STIs and may be used for this reason alone, along with other methods of contraception. Condoms should always be used with lubricants to make them less likely to break. Use only water-based lubricants - others can damage the condoms. Some thrush treatments can also damage condoms (ask your pharmacist for advice). Latex-free condoms are also available, for people who are allergic to rubber. Condoms are cheap and easy to buy, but they can burst or slip off. The man also has to withdraw soon after climaxing and hold the condom on his penis while withdrawing, to prevent any leakage of sperm.
Chance of getting pregnant: 2-15% depending on correct use.
The female condom is a lubricated condom made of thin polyurethane which is used by the woman by inserting it into the vagina before sex. It can help protect against STIs as well as against pregnancy. The female condom is available via Family Planning.
Chance of getting pregnant: 5-15% depending on correct use.
Diaphragms or caps
Diaphragms or caps are rubber domes that a women inserts high into her vagina, covering the opening of the womb (cervix). They should be used with spermicide cream or jelly and left in the vagina for at least six hours after intercourse. They must be fitted by your doctor or Family Planning clinic and stored carefully. You should have your diaphragm or cap checked every year, and if your weight changes by more than 3kg, as it may not fit you correctly. They give some protection against STIs. To use them, you need to feel OK about inserting your finger into your vagina and touching your genitals. Some people find them messy and fiddly. They can cause bladder infections.
Chance of getting pregnant: 4-20%, depending on proper use and using spermicides.
Read more about diaphragms and caps.
Spermicides include creams or gels that kill sperm. Spermicides should only be used with diaphragms. Spermicides are no longer recommended for use with condoms.
Intrauterine methods (devices placed inside the uterus) stop the sperm from reaching the egg and make it hard for the egg to bury itself in the lining of the womb. They do not interfere with sex (although the man may be able to feel the string), are very effective and can stay in place for up to five years. They must be fitted by a doctor or at a Family Planning clinic. They are most suitable for women who have had a baby and who only have one sex partner. There are two main types: intrauterine contraceptive devices and intrauterine systems.
Intrauterine contraceptive devices (IUDs, IUCDs, coils, loops)
Intrauterine contraceptive devices are small, plastic and copper devices put into the uterus (womb). They have a small nylon 'tail' that comes out through the opening of womb and is used to remove the device. They are usually changed every three to five years. They may make your periods longer and heavier.
There is a small (1%) risk of pelvic infection when the IUD is inserted but careful insertion by a doctor can minimise this risk.There is also a greater risk of pelvic infection due to an STI if an IUD is present, so this method of contraception is better for those in stable, single-partner relationships. If you become pregnant with an IUD in, see your doctor immediately. Read more...
Chance of getting pregnant: 1%.
Intrauterine systems (IUS)
Intrauterine systems are small plastic systems which are inserted in the uterus and release progesterone. They are suitable for women with heavy periods, because they usually make the periods lighter, or may result in you having no periods. They may cause irregular bleeding at first.
Chance of getting pregnant: less than 1%.
The contraceptive pill ('the pill')
Combined oral contraceptive pill
The combined contraceptive pill contains the female hormones oestrogen and progestogen and stops the ovaries from releasing an egg each month. It is usually taken for 21 to 22 days a month (active pills). Some packets contain seven inactive pills to make up the 28-day cycle, making pill-taking easier to remember.
The pill is simple to use, does not interfere with sex, makes periods more regular and you have less chance of getting cancer of the womb or ovaries. However, you may have very slightly more chance of getting breast cancer and the combined pill can cause blood clots in some women. Those who are over 35, have a family history of such problems, who smoke and/or are overweight are most at risk. It is really important that you know your own medical history and that of your family and you discuss all the risks and benefits of the pill with whoever is prescribing it to you.
Other side effects include headaches, putting on weight, sore breasts, bloating, loss of sexual interest, irregular bleeding and thrush infections. Read more...
Chance of getting pregnant: 1–5%.
Progestogen-only pill or 'mini' pill
The progestogen-only pill works by making the mucous in the opening of the womb thicker and changing the lining of the womb, making it less likely that a sperm fertilises an egg or that the embryo buries itself in the womb lining. It usually has fewer side effects than the combined pill and no risk of blood clots. It may cause irregular bleeding and is not quite as effective as the combined pill. It can be used while you are breast-feeding. Read more...
Chance of getting pregnant: 2–4%.
Missed a pill? Follow the seven-day rule
If you are more than 12 hours late taking a pill, you will need additional contraception according to the seven-day rule which is:
- Take additional contraception (such as using condoms, diaphragm or abstinence) for seven days while continuing to take the pill, making sure the tablets you take are active ones.
- If there are not seven active pills left in the packet use ones out of the next packet.
- This rule also applies if you have diarrhoea or vomiting.
Depo-Provera is progestogen given as a three-monthly injection. It may be used by women who think they may forget to take pills, or prefer not to have to think about it, or who can't take oestrogen. You will have no periods while using this method. You may have a slightly increased risk of getting breast cancer and osteoporosis. Read more...
Chance of getting pregnant: less than 1%.
A contraceptive implant, which releases progestogen, is inserted under the skin of the arm. The implant can provide contraception for three to five years. Implants are only available on prescription, and insertion and removal of the implant has to be done by a doctor. An implant does not provide any protection against STIs. Read more...
Chance of getting pregnant: less than 1%.
Emergency contraception either delays the release of an egg or makes it less likely that it buries itself in the lining of the womb and can be used after you have had unprotected sex or your usual type of contraception has failed (burst condom, missed pill). High dose hormone tablets can be taken up to five days after unprotected sex or contraceptive failure (but are most effective if taken within 24 hours). The pills may make you feel sick or vomit. Another method is inserting a copper IUD. Read more about emergency contraception.
Chance of getting pregnant: emergency contraceptive pills 1-4%; IUD less than 1%.
Sterilisation is a permanent method of contraception which stops a sperm and egg from coming together. In women it is called tubal ligation or sterilisation. Clips are put on the (fallopian) tubes to stop the egg getting to the womb. In men, it is called vasectomy. The tubes (vas deferens) which carry sperm to the penis are cut so there is no sperm in the man's ejaculatory fluid (ejaculate).
Chance of getting pregnant: less than 1%. Read more about tubal ligation.