Overview of contraception methods | Rongoā ārai hapūtanga

Contraception (rongoā ārai hapūtanga), or birth control, is a term for the various methods used to prevent pregnancy.

Key points about contraception

  1. There are a lot of different contraceptive methods that can be used to prevent pregnancy.
  2. Each type of contraception works differently, but generally they stop a sperm from meeting with an egg, which is how a pregnancy starts.
  3. Some contraception works better than others and each method has its pros and cons.
  4. Anyone of any age can get contraception from a nurse or doctor.
  5. The ideal contraception for you depends on your health, whether you smoke, whether you take any medicines, your preference, whether you want any children in the future, your sexual history or how reliable you need your contraception to be.

What is contraception?

Contraception or birth control is a way to prevent pregnancy. There are different contraceptive methods and you may need different types at different stages of life. Some may be suitable for you but some may not. 

Only barrier methods and abstinence also help prevent sexually transmitted infections (STIs).

How do the different types of contraceptive methods work?

Each type of contraceptive method works differently. Some use hormones and some provide a barrier. Generally, they stop a sperm from meeting with an egg, which is how a pregnancy starts. Some contraception works better than others, eg, the long-acting reversible (LARC) is 99% effective at preventing pregnancy.

Who can get contraception?

Anyone of any age can get contraception from a nurse or doctor. If you want to get contraception, see your GP or visit a Family Planning clinic in your area. If you are under 22 years old and are a New Zealand resident, your visit is free. Your visit will also be confidential.

Find out about fees and charges for Family Planning clinics in New Zealand.

What are the different methods of contraception?

There are a lot of contraceptive methods that can be used to prevent pregnancy, including:

Each method has its pros and cons. Read the table below to find out more about each type of contraception.

Method

Description

Long-acting reversible contraception (LARC)
 

  • There are 2 types of LARC in New Zealand:
    • the implant – currently the Jadelle which can last for 5 years
    • intra-uterine methods these can last for 5–10 years. 
  • LARCs are called ‘fit and forget’ contraception because you don’t need to remember them every day or every month.
  • They are immediately reversible on removal.
  • LARCs are the most reliable form of contraception available.
  • Chance of getting pregnant: 1% or less

Read more about LARC.

Hormonal contraception

These contraceptives use hormones to prevent pregnancy. They include contraceptive pills and the Depo-Provera injection. 

Contraceptive pills

  • There are 2 types of oral contraceptive pills:
    • the combined pill (‘the pill’)
    • the progestogen-only pill (‘the mini pill).
  • You must remember to take a pill every day.
  • Chance of getting pregnant: 8% in general, but less than 1% if used perfectly.

Depo-Provera injection

  • The injection is given every 3 months.
  • Chance of getting pregnant: 1–3% 

Read more about hormonal contraception.

Barrier methods

  • Barrier methods of contraception stop sperm from reaching the fallopian 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 use them every time you have sex.
  • They include condoms (sheaths) and diaphragms or caps.
  • Chance of getting pregnant: 2–21% depending on correct use

Read more about barrier methods

Emergency contraception

Emergency contraception can be used after unprotected sex or if your usual type of contraception has failed and you don’t want to get pregnant. However, it doesn’t protect you against STIs.

The 2 forms of emergency contraception are the emergency contraceptive pill and the copper IUD.

 

Emergency contraceptive pill

  • This should be taken within 72 hours of unprotected sex.
  • Chance of getting pregnant: 2% if you are of average weight and 6% if overweight

Copper IUD

  • This can be inserted within 5 days of ovulation (day 19 of a 28-day cycle) and is recommended for women over 70kg.
  • Chance of getting pregnant: less than 1%

Read more about emergency contraception.

Fertility awareness or natural family planning

  • Fertility awareness means working out ‘safer’ times to have sex.
  • You need detailed advice on this method as it takes commitment and great care. 
  • Chance of getting pregnant: 2–24%

Read more about fertility awareness

Withdrawal method

  • The withdrawal method is sometimes called ‘coitus interruptus’.
  • It means pulling the penis out of the vagina before ejaculation.
  • It takes a lot of self-control and can fail if the penis is not withdraw fast enough or some sperm leak out before ejaculation.
  • This is not a very reliable contraceptive method.
  • Chance of getting pregnant: 25%

Sterilisation 

  • Sterilisation is a permanent method of contraception. 
  • In women, it is an operation called tubal ligation or sterilisation. Clips are put on the (fallopian) tubes to stop the egg getting to the womb. 
  • In men, it is an operation called a vasectomy. Under local anaesthetic the tubes (vas deferens) that carry sperm to the penis are cut so there is no sperm in the fluid they are in (the ejaculate). Although it can sometimes be reversed it should be considered permanent. 
  • Chance of getting pregnant: less than 1%

Read more about tubal ligation and vasectomy.  

Abstinence

  • Abstinence (not having sex) is the only 100% way of preventing pregnancy and STIs.
  • Vaginal sex is the only way you can get pregnant, but STIs can be transmitted through vaginal, oral and anal sex.
  • Abstinence is an option for people who don’t want to have sex because they don't feel ready, don't want to use other forms of contraception or for religious or any other personal reasons.
  • Chance of getting pregnant: 0%

Which contraception method is the best for me?

The ideal birth control method for you depends on factors such as:

  • your health
  • whether you take medicines that may interact with the method
  • whether you smoke
  • how reliable you need your contraception to be
  • how often you have sex
  • how many sexual partners you have
  • your preference
  • whether you want to have children in the future.

Talk with your healthcare provider about the best form of contraception for you. Your nurse or doctor will ask you few questions about your health and family history. They will also ask you some personal questions, such as your sexual relationship with your partner/s and to check you aren’t being pressured into having sex when you don’t want to.

They will also talk about how to prevent STIs, eg, using condoms, and will do screening for STIs if you are sexually active. All appointments are confidential and you are welcome to ask your nurse or doctor anything you would like to know.

What support is available with contraception?

Family Planning NZ provides useful information and resources about contraception on their website. They also have clinics you can visit to talk to someone so you can make informed choices about your sexual and reproductive health. Visit their website or make an appointment by filling out the appointment form.

Learn more

The following links provide further information about contraception. Be aware that websites from other countries may have information that differs from New Zealand recommendations.   

Contraception your choice Family Planning NZ
What is contraception? Family Planning NZ
Overview of contraception & sterilisation HealthInfo Canterbury, NZ
Your contraception guide NHS, UK
Contraception methods Patient Info, UK

References

  1. New Zealand Aotearoa’s guidance on contraception Ministry of Health, NZ, 2020
  2. Contraception: which option for which patient? BPAC, NZ, 2019
  3. Contraception – general overview Patient Info, UK
Credits: Health Navigator Editorial Team.