Hey everybody! Want to read a post about birth control choices? If not, may as well click away now!
Since realizing that I was going to become sexually active as soon as I found someone I liked enough, I’ve thought a lot about birth control options. I’m the kind of person who likes to weigh choices over and over, considering them from every angle, so it was a pretty natural thing to do. But I never hear other women talking about their own birth control choices; at most maybe they mention what they’re using, or something they had a bad experience with.
Methods I have used
Condoms: Still a part of my life in the poly world: like many poly folk, we have a rule about using condoms with new partners, and not stopping using them without discussing it with the other partners. It’s primarily about preventing infection, not preventing pregnancy, but when I wasn’t on any other form of birth control it served double-duty. The interruption in spontaneity doesn’t bother me, but the increased dryness does. Still, sex with a condom is way better than no sex at all: it’s a price I’m quite willing to pay.
Withdrawal: A much-maligned strategy, for couples where the male partner knows his body and can exercise control. You’ll still hear conflicting reports about whether there’s sperm in pre-ejaculate: there isn’t conclusive evidence, but the most likely answer is “sometimes, from a previous ejaculation.” Either way, it is possible to get pregnant from perfect use of withdrawal, but the odds are low: the perfect-use rate is 96%, which is close to the perfect-use rate for condoms. I like it because it’s free and doesn’t require me to do anything, not even go to a doctor every few months. I would like it less if I didn’t trust my partner’s “perfect use” abilities, and I would never, never recommend it to teenagers. The biggest disadvantage is that it might be less fun for the man: it is for mine, which is the primary reason I went on to a different method.
Fertility awareness: Another much-maligned strategy. As with withdrawal, its effectiveness depends on how well you know your body and how good your self-control is. I used a lazy-but-cautious form of fertility awareness, keeping only a very small window of “safe” times. For this reason, I probably won’t ever use it as my primary form of birth control: to do it effectively, you should be charting your temperature and all your cycles and cervical fluid, and while I like the idea of knowing my body that closely, I’m not disciplined enough about daily tasks to carry it out.
The Sponge: I liked this one. It was easy to use, I had control over it, and I didn’t have any comfort issues. The major downside was the cost: something like $12 for a pack of three. That would be okay if I was single and only occasionally having sex, but not something I wanted to consider long-term.
You’ll notice that all these methods are non-hormonal. For a while I was dead set against using hormonal methods of birth control: I was afraid of undiscovered side effects, and I didn’t like the idea of constantly medicating my body when it’s just operating the way it’s supposed to. My take on this changed somewhat as I learned more about reproductive biology: it became less “don’t disturb the magic and mystery of the reproductive cycle!” and more “here’s why the body does these things at this time, and here’s all the things that can change that, and just because it’s natural doesn’t mean that it’s the healthiest thing for you.” (Kate Clancy writes a lot of good stuff about women’s reproductive physiology: this post contains links to a lot of great information, by herself and others.) This ideological shift, combined with what I learned about some other non-hormonal methods I was considering (more on that in a minute), got me looking at hormonal methods again. And so we come to…
What I’m using now
NuvaRing: I just started it, which is what prompted this post. In a month or so I’ll come back with a fuller report on how I like it. It’s the first hormonal birth control I’ve taken, and I chose it for two reasons: it’s lower-dose than any of the others, and it’s instantly removable. If I find I don’t like its effects, I can take it out and the hormonal effects start breaking down after several hours. Also I like that it can be used continuously, without a withdrawal bleed every month. If I’m going to be messing with my hormones, I’m going to enjoy the full benefits, goshdarnit! I like it so far: I don’t feel it at all, insertion was no problem, and I’ve noticed no other effects.
What I’ve considered using
Diaphragm/cervical cap: This was going to be my method of choice once I finally made it to a doctor. Both methods are very similar to the sponge, which I liked, but more cost-effective for someone who has sex more than once a week. What changed my mind was learning that spermicide may increase risk of HIV infection: frequent use can cause minor abrasions which make HIV transmission easier. The risk given my circumstances is pretty low: while I’m non-monogamous (risk factor), none of my partners are hugely promiscuous, and I trust them all to use condoms with outside partners, and I’m not going to be exposing myself to spermicide every day. But low risk isn’t no risk, and gosh it’d suck to get HIV, so I bumped any spermicide-dependent birth control methods down several rungs on the preference ladder.
IUD: This one I might go with after I’ve had all the children I want to have. Several years ago I was planning on using the copper IUD once I became sexually active: over many years it becomes cost-effective, I liked that it was non-hormonal, and I liked that I wouldn’t have to do anything about it once it was placed. Non-monogamy, and my late onset of sexual activity, changed my calculations here too: some people don’t recommend the IUD for the non-monogamous, as it can increase the risk of complications if you do get an STI. Also, I’m now thinking it will be less than five years, not more, that I decide it’s babytime, so it makes less sense financially. And finally, my calculations of “prefer less hormonal interference” and “prefer less menstrual difficulty” have flip-flopped: before, I wanted no hormones even if it might make my periods heavier and more painful, and so planned on using the copper IUD. Now, I’ll probably opt for Mirena if I do get an IUD.
So! Now you know all you’d ever want to know about my ruminations about / experiences with different forms of birth control. If you’d like to share your own, please do! I’m genuinely interested to hear other people’s experiences and considerations… which is why I posted this in the first place.