NurseAsk Nurse Lisa

Birth Control

“Txin achigalix anĝaĝigumin anuxtanatxin ax̂saasaduukux̂tin. / Huzugaan txin achigax̂agacha mada ama txin sakaaĝatada.”

“Always learn and maintain a balance.”

– Unangan/Unangas value11

Last updated April 2021

What is Birth Control?

Birth control, also known as contraception, is any method, medicine or device used to prevent unplanned pregnancy. There are many types of birth control, which can be categorized by level of effectiveness at preventing pregnancy:  

Chart that indicates the effectiveness of each form of birth control.
Image source: UCSF, April 2019

While the main use of birth control is to prevent pregnancy, there are also some other health benefits to taking birth control. Some forms of birth control, like condoms, can help protect against sexually transmitted infections (STIs) and diseases (STDs) . Other forms of birth control, like hormonal birth control, can help to regulate periods, reduce acne or even reduce pain from medical conditions like endometriosis.

There are many types of birth control, which we will explore below. The best form of birth control is one that is selected with a health care provider. Sometimes this is through trial and error, where a person will try various forms of birth control to find what is right for them. 

When deciding which form of birth control is the right fit for any person, it is important to consider:

Can this birth control be managed daily, weekly or monthly? Can it be accessed regularly? Will it fit within your existing routine?

Why take birth control? Is it for pregnancy prevention, hormone regulation, STI prevention or all of these?

What is the health care provider’s recommendation? Are there certain types of birth control that are medically necessary, advised or avoided? How will different forms of birth control impact the user’s body, such as hormonal methods?

What Are the Different Kinds of Birth Control?

We’ll list the categories of birth control by the way they reduce the user’s risk for unplanned pregnancy. These methods include:

Barrier Methods

Barrier methods help keep sperm from physically reaching the egg through the use of a safer sex tool. Barrier methods typically don’t involve hormones, and are considered to be short-term birth control. This means that barrier method condoms need to be removed after each use. Some barrier methods like condoms, spermicide or the sponge, are easily available at places like clinics, online shopping, or even at drug stores. Other barrier methods may require a prescription from a provider, like diaphragms or cervical caps.

  • is a single-use, non-prescription safer sex tool that is placed over an erect penis before or during sexual activity.
  • reduces the risk of STIs and pregnancy if used correctly and consistently.3
  • is readily available at places like clinics, drug stores, online shopping.
  • may be ordered for free by Alaskans, and shipped discreetly, through the iknowmine store.
  • is not recommended to use with internal condoms or silicone-based lube. Using either of these with an external condom may actually result in a hole in the condom, leaving the user exposed to an increased risk for pregnancy and STIs!
  • about 18 out of 100 individuals who use this method of birth control may become pregnant.
  • is a single-use, non-prescription, and lubricated pouch that is placed into the vagina or anus before vaginal or anal sex.
  • may be readily available at places like clinics, drug stores, and online shopping.
  • reduces the risk of STIs and pregnancy if used correctly and consistently.3
  • is not recommended to use with external condoms or silicone-based lube. Using either of these with an internal condom may actually result in a hole in the internal condom, leaving the user exposed to an increased risk for pregnancy and STIs!
  • about 21 out of 100 individuals who use this method of birth control may become pregnant.
  • are substances, used before vaginal sex, that works by killing sperm cells. They are placed into the vagina typically no more than an hour before vaginal intercourse, and may be left in place for up to 8 hours after sex.3
  • come in different forms, like foams, creams, gels, or tablets. 
  • are best used with a condom, diaphragm or cervical cap for better protection against pregnancy.3
  • do not protect users from STIs or HIV.
  • may be readily available at places like clinics, drug stores, and online shopping.
  • about 28 out of 100 individuals who use this method of birth control may become pregnant.
  • are dome-shaped and flexible disks designed to cover the cervix. Diaphragms are meant to be used with spermicide in order to stop sperm from meeting the egg.
  • need to be placed and left inside the vagina before having sex and at least 6 hours after having sex.3 Leaving it in for longer than 48 hours carries a risk of toxic shock syndrome, which is a rare but serious infection.3
  • need to be fitted by a doctor, who will prescribe the correct diaphragm size.
  • do not protect users from STIs or HIV.
  • When used correctly, with spermicide, users may lower their risk of pregnancy.3
  • about 12 out of 100 individuals who use this method of birth control may become pregnant.
  • are a soft latex or silicone cups designed to cover the cervix. Cervical caps are meant to be used with spermicide in order to stop sperm from meeting the egg.
  • need to be placed and left inside the vagina before having sex and at least 6 hours after having sex.3 Leaving it in for longer than 48 hours carries a risk of toxic shock syndrome, which is a rare but serious infection.3
  • need to be fitted by a doctor, who will prescribe the correct cap size.
  • do not protect users from STIs or HIV.
  • When used correctly, with spermicide, users may lower their risk of pregnancy.3
  • about 17 to 23 out of 100 individuals who use this method of birth control may become pregnant.

Short-acting Hormonal Methods

Short-acting hormonal methods reduce the user’s risk for pregnancy by stopping the ovulation and fertilization of the egg, but do not protect against STIs. These methods work by increasing the production of a certain type of hormone made in the body. These are considered to be ‘short-acting,’ which means that the user has to take this form of birth control on a very regular basis, like daily, weekly, or monthly. It might help to use a birth control reminder app, or phone reminders, to keep track of when to take a short-acting hormonal birth control. Stopping the use of a short-acting hormonal method of birth control may greatly increase a person’s risk for pregnancy if another method is not used, like a condom.

  • uses two hormones, called estrogen and progestin, to stop the ovaries from releasing eggs and thickens cervical mucus to keep sperm from reaching to the egg.3
  • is taken orally, as a pill, at the same time every day. It must be taken for up to seven days to become effective in pregnancy prevention. If a dose is missed, the user will need to use another method of birth control, like a condom, until they have regularly taken their dose for about seven days.7
  • is available by prescription from a health care provider to reduce the user’s risk for pregnancy.
  • about nine out of 100 individuals who use this method of birth control may become pregnant.3
  • uses a single hormone, progestin, to thicken cervical mucus to keep sperm from reaching the egg.3
  • is taken orally, as a pill, at the same time every day. It must be taken for up to seven days to become effective in pregnancy prevention.7 If a dose is missed, the user will need to use another method of birth control, like a condom, until they have regularly taken their dose for about seven days.
  • is available by prescription from a health care provider to reduce the user’s risk for pregnancy.3
  • about nine out of 100 individuals who use this method of birth control may become pregnant.3
  • uses two hormones, called estrogen and progestin, to stop the ovaries from releasing eggs and thickens cervical mucus to keep sperm from reaching the egg.3
  • is a small patch worn for one week at a time, for three weeks’ total, either on the lower abdomen, buttocks, upper arm or upper back.It is recommended to not wear a patch every four weeks so that the user may have a menstrual period.3
  • may require another form of birth control, like a condom, if it comes off at any time during its use.3
  • is available by prescription from a health care provider to reduce the user’s risk for pregnancy.3
  • about 9 out of 100 individuals who use this method of birth control may become pregnant.3
  • uses a single hormone, progestin, to stop the ovaries from releasing eggs and thickens cervical mucus.3
  • is an injection, given in the buttocks or arm, every three months by a health care provider to reduce the user’s risk for pregnancy.3
  • about six out of 100 individuals who use this method of birth control may become pregnant.3
  • uses two hormones, called estrogen and progestin, to stop the ovaries from releasing eggs and thickens cervical mucus to keep sperm from reaching the egg.3
  • is a flexible ring, about two inches around, that is inserted into the vagina for three weeks at a time and taken out for one week so that the user may have a menstrual period. After this week is over, a new ring is inserted for three weeks, repeating the cycle.3
  • may require another form of birth control, like a condom, if the ring falls out or stays out for more than three hours, until the ring has been in place for seven days in a row. 3
  • is available by prescription from a health care provider to reduce the user’s risk for pregnancy.
  • about nine out of 100 individuals who use this method of birth control may become pregnant.3

Long-acting Contraceptive

Long-acting contraceptives reduce the user’s risk for pregnancy in different ways, but do not protect against STIs. Some of these methods work by increasing the production of a certain type of hormone made in the body. Others work through the use of non-hormonal intervention. These are considered to be ‘long-acting,’ which means that the user only has to monitor this form of birth control in their body once every few years, as directed by their health care provider. Although the provider may offer reminders of when it is time to switch-out the use of a long-acting reversible contraceptive, it might help to use a birth control reminder app, or phone reminders.

  • is a small, flexible, plastic device that is shaped like a ‘T’ and placed in the uterus by a healthcare provider.
  • this IUD has copper wrapped around it, which changes the way sperm cells move so they cannot swim to the egg.
  • may be used for up to 10 years at a time, with normal fertility returning after removal.
  • may be used as emergency contraception, up to five days after unprotected sex, to reduce the user’s risk for pregnancy.3
  • less than one out of 100 individuals who use this IUD may become pregnant.
  • is a small, flexible, plastic device that is shaped like a ‘T’ and placed in the uterus by a healthcare provider.
  • this IUD contains the hormone progestin, which thickens the cervical mucus and thins the uterine lining, so that sperm has a hard time swimming to the egg.
  • may be used for anywhere between three to five years, depending on which kind of IUD is inserted, to reduce the user’s risk for pregnancy.3 Normal fertility returns after removal.8
  • less than one out of 100 individuals who use this IUD may become pregnant.3

• is a thin, small, plastic rod that contains the hormone progestin, which prevents the ovaries from releasing eggs and thickens the cervical mucus to keep sperm from reaching the egg. 3
• is placed just under the skin on the inside of the upper arm by a health care provider. 3
• may be used for up to three years at a time to reduce the user’s risk of pregnancy. 3 Normal fertility returns after removal.6
• less than one out of 100 individuals who use this IUD may become pregnant.3

  • is a surgery designed for a person with female reproductive organs, where the fallopian tubes, which houses the eggs, are tied or cut. Since the fallopian tube is blocked off, the egg cannot leave and meet a sperm cell, thus preventing pregnancy.
  • is intended to be a permanent form of birth control, but sometimes may be reversed.
  • less than one out of 100 individuals who have tubal ligation may get pregnant.3
  • is a surgery designed for a person with male reproductive organs, where the tubes that carry sperm are cut or sealed off. Since the tubes are blocked off, the sperm cannot leave and meet an egg, thus preventing pregnancy.
  • will allow for the tubes to still carry semen, but without sperm cells.It may take about 3 months to clear sperm out of an individual’s system, so it is important to continue to use another method of birth control until a test shows there are no longer any sperm.
  • less than 1 out of 100 individuals whose partner has had a vasectomy may become pregnant.3

Self-awareness Methods

There are other forms of contraceptives that do not involve outside intervention, prescriptions, hormones, or safer sex tools. These methods of birth control do not protect against STIs.

  • is when an individual chooses not to engage in sexual activities, resulting in the separation of sperm from an egg.
  • is the most effective9 and simplest10 way to prevent pregnancy.
  • can happen even if a person has had sex before.
  • is when a person with male reproductive organs monitors their status of ejaculation likelihood during sexual activities, and chooses to ejaculate their semen somewhere else, other than in or around the vagina.
  • about 22 out of 100 individuals who use this form of birth control may become pregnant.5
  • is when a person with female reproductive organs monitors their monthly fertility pattern, and either avoids any sexual activity or uses another form of birth control during the number of days in the month when they are fertile.
  • about 24 out of 100 individuals who use the rhythm method may become pregnant.9  The rhythm method is not as effective at preventing pregnancy as other forms of birth control, but may be a better option for those who have side effects or religious objections to using medical forms of birth control.

May be used as a method of birth control for users who have recently given birth, if the following three conditions are met by the user:

  • has delivered a baby less than six months prior.
  • actively breastfeeds a baby with no long intervals between feedings, like no more than six hours between feedings at night.
  • has had no menstrual periods after delivering a baby.1

Emergency Contraception

Emergency contraception is used when individuals have unprotected sex, or if a used birth control method fails. Emergency contraception doesn’t protect against STIs, but it helps to reduce the user’s risk of pregnancy if taken up to three to five days after unprotected sex. There are both hormonal and non-hormonal types of emergency contraception.

  • is a small, flexible, plastic device that is shaped like a ‘T’ and placed in the uterus by a healthcare provider.
  • this IUD has copper wrapped around it, which changes the way sperm cells move so they cannot swim to the egg.
  • may be used as emergency contraception, up to five days after unprotected sex.3
  • works immediately after placement.
  • uses a medication, called ulipristal acetate (brand name: ‘ella’), that delays the release of an egg from the ovary. 4
  • requires medical consultation, or prescription by a health care provider (nurse or doctor) because of the amount of ulipristal acetate in the pill.
  • may be taken up to five days, or 120 hours, after unprotected sex.
  • may be less effective for people if over 195 lbs.4
  • uses a medication containing levonorgestrel, that prevents the release of an egg from the ovary.4
  • these may be purchased over the counter without seeing a health care provider, although they are available through medical consultation.
  • it is best to take these types of morning-after pills within three days, or 72 hours, after unprotected sex.4
  • there are several brands of this type of emergency contraception including: Plan B One Step, Take Action, My Way, Option 2 and others.
  • may be less effective for people if over 155 lbs.4
Chart that indicates the effectiveness of each form of emergency contraception.
Image source: UCSF, April 2019

Where Can I Go for More Information on Birth Control?

To learn more about birth control options and to receive guidance on which method is best for a person’s unique situation, consider speaking to a local health care provider or a trusted adult.

  • Find a local health care provider in Alaska for more information
  • Alaskans may order condoms from the iknowmine store, for free, sent right to your home in a discrete package! Non-profit and Tribal Organization orders are welcome, and available in bulk.
  • Take a look at We R Native’s very own Auntie Amanda’s response to the question ‘What is the best birth control?’
  • Resource for Parents and Caring Adults: Join Talking is Power, a weekly text messaging series for parents and caring adults. We know talking to teens about sensitive topics is never easy, but it’s important to talk to them openly and honestly. Text the word “EMPOWER” to 94449 and you’ll receive culturally appropriate tips and resources, covering sexual health, pregnancy, STDs and consent!

[1]C.S. Mott Children’s Hospital. (2020). Topic Overview. Breastfeeding as birth control. Reference: https://www.mottchildren.org/health-library/hw131799

[2]Cleveland Clinic. (2018). Rhythm Method. What is the biggest drawback to using the rhythm method? Reference: https://my.clevelandclinic.org/health/treatments/17900-rhythm-method#:~:text=The%20rhythm%20method%20is%20a%20type%20of%20birth%20control.,that%20time%20of%20her%20cycle.

[3]Food and Drug Administration [FDA]. (2020). Free Publications for Women. Birth control. Reference: https://www.fda.gov/consumers/free-publications-women/birth-control#ShortActingHormonalMethods

[4]Planned Parenthood. (2021a). Which kind of emergency contraception should I use? What kinds of emergency contraception are there? Reference: https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/which-kind-emergency-contraception-should-i-use

[5]Planned Parenthood. (2021b). Birth Control. Withdrawal (pull out method). Reference: https://www.plannedparenthood.org/learn/birth-control/withdrawal-pull-out-method

[6]Planned Parenthood. (2021c). Birth Control Implant. How effective is the birth control implant? Reference: https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon/how-effective-is-the-birth-control-implant

[7]Planned Parenthood. (2021d). Birth Control Pill. How effective is the birth control pill? Reference: https://www.plannedparenthood.org/learn/birth-control/birth-control-pill/how-effective-is-the-birth-control-pill

[8]Planned Parenthood. (2021e). IUD. What are hormonal IUDs? Reference: https://www.plannedparenthood.org/learn/birth-control/iud/hormonal-iuds

[9]TeensHealth. (2018). For Teens. About birth control. Reference: https://kidshealth.org/en/teens/contraception.html?WT.ac=ctg#catcontraception

[10]TeensHealth. (2019). Abstinence. How does abstinence work? Reference: https://kidshealth.org/en/teens/abstinence.html#catcontraception

[11]UAF. (2021). Alaska Native Values for Curriculum. Alaska Native cultures. Reference: http://ankn.uaf.edu/ancr/Values/index.html

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