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Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
. Birth control has been used since ancient times, but effective and safe methods of birth control only became available in the 20th century. Planning, making available, and using birth control is called
family planning Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marita ...
. Some cultures limit or discourage access to birth control because they consider it to be morally, religiously, or politically undesirable. The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
and
United States Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency, under the United S ...
provide guidance on the safety of birth control methods among women with specific medical conditions. The most effective methods of birth control are sterilization by means of
vasectomy Vasectomy, or vasoligation, is an elective surgical procedure for male sterilization or permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into the urethra and ...
in males and
tubal ligation Tubal ligation (commonly known as having one's "tubes tied") is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus th ...
in females,
intrauterine device An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting rever ...
s (IUDs), and implantable birth control. This is followed by a number of hormone-based methods including oral pills, patches,
vaginal ring Vaginal rings (also known as intravaginal rings, or V-Rings) are polymeric drug delivery devices designed to provide controlled release of drugs for intravaginal administration over extended periods of time. The ring is inserted into the vagina a ...
s, and injections. Less effective methods include physical barriers such as
condom A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of in ...
s, diaphragms and birth control sponges and
fertility awareness method Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gyn ...
s. The least effective methods are
spermicide Spermicide is a contraceptive substance that destroys sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicid ...
s and withdrawal by the male before ejaculation. Sterilization, while highly effective, is not usually reversible; all other methods are reversible, most immediately upon stopping them.
Safe sex Safe sex is sexual activity using methods or contraceptive devices (such as condoms) to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer se ...
practices, such as with the use of male or
female condom An internal condom (also known as a femidom or female condom) is a barrier device that is used during sexual intercourse as a barrier contraceptive to reduce the probability of pregnancy or a sexually transmitted infection (STI). Meant as an al ...
s, can also help prevent
sexually transmitted infections Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral se ...
. Other methods of birth control do not protect against sexually transmitted diseases.
Emergency birth control Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy. There are different forms of EC. Emergency contraceptive pills (ECPs), sometimes simply referred to as emergency contraceptives (ECs), o ...
can prevent pregnancy if taken within 72 to 120 hours after unprotected sex. Some argue not having sex is also a form of birth control, but
abstinence-only sex education Abstinence-only sex education is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. Comprehensive sex education, ...
may increase
teenage pregnancies Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female adolescent or young adult under the age of 20. This includes those who are legally considered adults in their country. The WHO defines adolescence as the period bet ...
if offered without birth control education, due to non-compliance. In
teenagers Adolescence () is a transitional stage of physical and psychological development that generally occurs during the period from puberty to adulthood (typically corresponding to the age of majority). Adolescence is usually associated with the te ...
, pregnancies are at greater risk of poor outcomes. Comprehensive
sex education Sex education, also known as sexual education, sexuality education or sex ed, is the instruction of issues relating to human sexuality, including emotional relations and responsibilities, human sexual anatomy, Human sexual activity, sexual acti ...
and access to birth control decreases the rate of unwanted pregnancies in this age group. While all forms of birth control can generally be used by young people,
long-acting reversible birth control Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include injections, intrauterine devices (IUDs), and subdermal contraceptiv ...
such as implants, IUDs, or vaginal rings are more successful in reducing rates of teenage pregnancy. After the delivery of a child, a woman who is not exclusively breastfeeding may become pregnant again after as few as four to six weeks. Some methods of birth control can be started immediately following the birth, while others require a delay of up to six months. In women who are breastfeeding, progestin-only methods are preferred over combined oral birth control pills. In women who have reached
menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...
, it is recommended that birth control be continued for one year after the last period. About 222 million women who want to avoid pregnancy in
developing countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
are not using a modern birth control method. Birth control use in developing countries has decreased the number of deaths during or around the time of pregnancy by 40% (about 270,000 deaths prevented in 2008) and could prevent 70% if the full demand for birth control were met. By lengthening the time between pregnancies, birth control can improve adult women's delivery outcomes and the survival of their children. In the developing world, women's earnings,
assets In financial accountancy, financial accounting, an asset is any resource owned or controlled by a business or an economic entity. It is anything (tangible or intangible) that can be used to produce positive economic value. Assets represent value ...
, and
weight In science and engineering, the weight of an object is the force acting on the object due to gravity. Some standard textbooks define weight as a Euclidean vector, vector quantity, the gravitational force acting on the object. Others define weigh ...
, as well as their children's schooling and health, all improve with greater access to birth control. Birth control increases
economic growth Economic growth can be defined as the increase or improvement in the inflation-adjusted market value of the goods and services produced by an economy in a financial year. Statisticians conventionally measure such growth as the percent rate of ...
because of fewer dependent children, more women participating in the
workforce The workforce or labour force is a concept referring to the Pooling (resource management), pool of human beings either in employment or in unemployment. It is generally used to describe those working for a single types of companies, company or ...
, and less use of scarce resources.


Methods

Birth control methods include
barrier methods Safe sex is sexual activity using methods or contraceptive devices (such as condoms) to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer se ...
,
hormonal birth control Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The original ...
, intrauterine devices (IUDs), sterilization, and behavioral methods. They are used before or during sex while
emergency contraceptive Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy. There are different forms of EC. Emergency contraceptive pills (ECPs), sometimes simply referred to as emergency contraceptives (ECs), ...
s are effective for up to five days after sex. Effectiveness is generally expressed as the percentage of women who become pregnant using a given method during the first year, and sometimes as a lifetime failure rate among methods with high effectiveness, such as
tubal ligation Tubal ligation (commonly known as having one's "tubes tied") is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus th ...
. The most effective methods are those that are long acting and do not require ongoing health care visits. Surgical sterilization, implantable hormones, and intrauterine devices all have first-year failure rates of less than 1%. Hormonal contraceptive pills, patches or vaginal rings, and the
lactational amenorrhea method Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal infertility that occurs when a woman is amenorrheic (not menstruating) and fully breastfeeding. Physiology Hormonal pathways and neuroendocrine control ...
(LAM), if adhered to strictly, can also have first-year (or for LAM, first-6-month) failure rates of less than 1%. With typical use, first-year failure rates are considerably higher, at 9%, due to inconsistent use. Other methods such as condoms, diaphragms, and spermicides have higher first-year failure rates even with perfect usage. The
American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C. Background The Academy was founded ...
recommends
long acting reversible birth control Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include injections, intrauterine devices (IUDs), and subdermal contraceptive ...
as first line for young individuals. While all methods of birth control have some potential adverse effects, the risk is less than that of
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
. After stopping or removing many methods of birth control, including oral contraceptives, IUDs, implants and injections, the rate of pregnancy during the subsequent year is the same as for those who used no birth control. For individuals with specific health problems, certain forms of birth control may require further investigations. For women who are otherwise healthy, many methods of birth control should not require a
medical exam In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient ...
—including birth control pills, injectable or implantable birth control, and condoms. For example, a
pelvic exam A pelvic examination is the physical examination of the external and internal female pelvic organs. It is frequently used in gynecology for the evaluation of symptoms affecting the female reproductive and urinary tract, such as pain, bleeding, dis ...
,
breast exam Breast self-examination (BSE) is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling. BSE was once promoted hea ...
, or blood test before starting birth control pills does not appear to affect outcomes. In 2009, the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
(WHO) published a detailed list of medical eligibility criteria for each type of birth control.


Hormonal

Hormonal contraception Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The origin ...
is available in a number of different forms, including oral pills, implants under the skin, injections, patches,
IUDs An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting revers ...
and a
vaginal ring Vaginal rings (also known as intravaginal rings, or V-Rings) are polymeric drug delivery devices designed to provide controlled release of drugs for intravaginal administration over extended periods of time. The ring is inserted into the vagina a ...
. They are currently available only for women, although hormonal contraceptives for men have been and are being clinically tested. There are two types of oral birth control pills, the
combined oral contraceptive pill The combined oral contraceptive pill (COCP), often referred to as the birth control pill or colloquially as "the pill", is a type of birth control that is designed to be taken orally by women. The pill contains two important hormones: progest ...
s (which contain both
estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal acti ...
and a
progestin A progestogen, also referred to as a progestagen, gestagen, or gestogen, is a type of medication which produces effects similar to those of the natural product, natural female sex hormone progesterone in the body. A progestin is a ''synthetic co ...
) and the
progestogen-only pill Progestogen-only pills or progestin-only pills (POP) are contraceptive pills that contain only synthetic progestogens (progestins) and do not contain estrogen (medication), estrogen. They are colloquially known as mini pills. Although such pills ...
s (sometimes called minipills). If either is taken during pregnancy, they do not increase the risk of
miscarriage Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the death of an embryo or fetus before it is able to survive independently. Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical lo ...
nor cause
birth defects A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
. Both types of birth control pills prevent
fertilization Fertilisation or fertilization (see spelling differences), also known as generative fertilisation, syngamy and impregnation, is the fusion of gametes to give rise to a new individual organism or offspring and initiate its development. Proce ...
mainly by inhibiting
ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized ...
and thickening cervical mucus. They may also change the lining of the uterus and thus decrease implantation. Their effectiveness depends on the user's adherence to taking the pills. Combined hormonal contraceptives are associated with a slightly increased risk of
venous Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...
and arterial blood clots. Venous clots, on average, increase from 2.8 to 9.8 per 10,000 women years which is still less than that associated with pregnancy. Due to this risk, they are not recommended in women over 35 years of age who continue to smoke. Due to the increased risk, they are included in decision tools such as the
DASH score Pulmonary embolism (PE) is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include shortness of breath, chest pain particularly upon breathin ...
and
PERC rule Pulmonary embolism (PE) is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include shortness of breath, chest pain particularly upon breathing ...
used to predict the risk of blood clots. The effect on sexual drive is varied, with increase or decrease in some but with no effect in most. Combined oral contraceptives reduce the risk of
ovarian cancer Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different c ...
and
endometrial cancer Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most o ...
and do not change the risk of
breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a re ...
. They often reduce menstrual bleeding and painful menstruation cramps. The lower doses of estrogen released from the vaginal ring may reduce the risk of breast tenderness,
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
, and headache associated with higher dose estrogen products. Progestin-only pills, injections and intrauterine devices are not associated with an increased risk of blood clots and may be used by women with a history of blood clots in their veins. In those with a history of arterial blood clots, non-hormonal birth control or a progestin-only method other than the injectable version should be used. Progestin-only pills may improve menstrual symptoms and can be used by breastfeeding women as they do not affect
milk production A dairy is a business enterprise established for the harvesting or processing (or both) of animal milk – mostly from cows or buffaloes, but also from goats, sheep, horses, or camels – for human consumption. A dairy is typically located on ...
. Irregular bleeding may occur with progestin-only methods, with some users reporting no periods. The progestins
drospirenone Drospirenone is a progestin and antiandrogen medication which is used in birth control pills to prevent pregnancy and in menopausal hormone therapy, among other uses. It is available both alone under the brand name Slynd and in combination with ...
and
desogestrel Desogestrel is a progestin medication which is used in birth control pills for women. It is also used in the treatment of menopausal symptoms in women. The medication is available and used alone or in combination with an estrogen. It is taken ...
minimize the
androgen An androgen (from Greek ''andr-'', the stem of the word meaning "man") is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This inc ...
ic side effects but increase the risks of blood clots and are thus not first line. The perfect use first-year failure rate of injectable progestin is 0.2%; the typical use first failure rate is 6%. File:Plaquettes de pilule.jpg, alt=birth control pill packages, Three varieties of
birth control pills Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. Female Two types of female oral contraceptive pill, taken once per day, are widely available: * The combin ...
in calendar oriented packaging File:Birth Control Pills.png, Birth control pills File:BirthControlPatch.JPG, alt=a contraceptive patch, A transdermal
contraceptive patch A contraceptive patch, also known as "the patch", is a transdermal patch applied to the skin that releases synthetic oestrogen and progestogen hormones to prevent pregnancy. They have been shown to be as effective as the combined oral contrac ...
File:NuvaRing in hand.jpg, alt=a vaginal ring, A
NuvaRing Ethinylestradiol/etonogestrel, sold under the brand names NuvaRing among others, is a hormonal vaginal ring used for birth control and to improve menstrual symptoms. It contains ethinylestradiol, an estrogen, and etonogestrel, a progestin. It i ...
vaginal ring


Barrier

Barrier contraceptive Safe sex is sexual activity using methods or contraceptive devices (such as condoms) to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer se ...
s are devices that attempt to prevent
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
by physically preventing
sperm Sperm is the male reproductive cell, or gamete, in anisogamous forms of sexual reproduction (forms in which there is a larger, female reproductive cell and a smaller, male one). Animals produce motile sperm with a tail known as a flagellum, whi ...
from entering the
uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
. They include male
condom A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of in ...
s,
female condom An internal condom (also known as a femidom or female condom) is a barrier device that is used during sexual intercourse as a barrier contraceptive to reduce the probability of pregnancy or a sexually transmitted infection (STI). Meant as an al ...
s,
cervical cap The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the ''os''. Terminology The term ''cervical cap'' has been ...
s, diaphragms, and
contraceptive sponge The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Sponges work in two ways. First, the sponge is inserted into the vagina, so it can cover the cervix and prevent any sperm from entering the uterus. Secondl ...
s with
spermicide Spermicide is a contraceptive substance that destroys sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicid ...
. Globally, condoms are the most common method of birth control.
Male condoms A condom is a sheath-shaped Barrier contraception, barrier device used during sexual intercourse to reduce the probability of pregnancy or a Sexually transmitted disease, sexually transmitted infection (STI). There are both male and female con ...
are put on a man's erect
penis A penis (plural ''penises'' or ''penes'' () is the primary sexual organ that male animals use to inseminate females (or hermaphrodites) during copulation. Such organs occur in many animals, both vertebrate and invertebrate, but males do n ...
and physically block ejaculated sperm from entering the body of a sexual partner. Modern condoms are most often made from
latex Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latexes are found in nature, but synthetic latexes are common as well. In nature, latex is found as a milky fluid found in 10% of all flowering plants (angiosperms ...
, but some are made from other materials such as
polyurethane Polyurethane (; often abbreviated PUR and PU) refers to a class of polymers composed of organic chemistry, organic units joined by carbamate (urethane) links. In contrast to other common polymers such as polyethylene and polystyrene, polyurethan ...
, or lamb's intestine.
Female condom An internal condom (also known as a femidom or female condom) is a barrier device that is used during sexual intercourse as a barrier contraceptive to reduce the probability of pregnancy or a sexually transmitted infection (STI). Meant as an al ...
s are also available, most often made of
nitrile In organic chemistry, a nitrile is any organic compound that has a functional group. The prefix ''cyano-'' is used interchangeably with the term ''nitrile'' in industrial literature. Nitriles are found in many useful compounds, including met ...
, latex or polyurethane. Male condoms have the advantage of being inexpensive, easy to use, and have few adverse effects. Making condoms available to teenagers does not appear to affect the age of onset of sexual activity or its frequency. In Japan, about 80% of couples who are using birth control use condoms, while in Germany this number is about 25%, and in the United States it is 18%. Male condoms and the diaphragm with spermicide have typical use first-year failure rates of 18% and 12%, respectively. With perfect use condoms are more effective with a 2% first-year failure rate versus a 6% first-year rate with the diaphragm. Condoms have the additional benefit of helping to prevent the spread of some sexually transmitted infections such as
HIV/AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...
, however, condoms made from animal intestine do not. Contraceptive sponges combine a barrier with a spermicide. Like diaphragms, they are inserted vaginally before intercourse and must be placed over the
cervix The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...
to be effective. Typical failure rates during the first year depend on whether or not a woman has previously given birth, being 24% in those who have and 12% in those who have not. The sponge can be inserted up to 24 hours before intercourse and must be left in place for at least six hours afterward. Allergic reactions and more severe adverse effects such as
toxic shock syndrome Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyeliti ...
have been reported. File:Kondom.jpg, A rolled up male
condom A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of in ...
. File:Condom unrolled durex.jpg, alt=an unrolled condom, An unrolled male
latex Latex is an emulsion (stable dispersion) of polymer microparticles in water. Latexes are found in nature, but synthetic latexes are common as well. In nature, latex is found as a milky fluid found in 10% of all flowering plants (angiosperms ...
condom A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of in ...
File:Préservatif féminin.jpg, alt=a female condom, A polyurethane
female condom An internal condom (also known as a femidom or female condom) is a barrier device that is used during sexual intercourse as a barrier contraceptive to reduce the probability of pregnancy or a sexually transmitted infection (STI). Meant as an al ...
File:Contraceptive diaphragm.jpg, alt=a diaphragm, A diaphragm vaginal-cervical
barrier A barrier or barricade is a physical structure which blocks or impedes something. Barrier may also refer to: Places * Barrier, Kentucky, a community in the United States * Barrier, Voerendaal, a place in the municipality of Voerendaal, Netherl ...
, in its case with a quarter U.S. coin. File:Éponge spermicide.jpg, alt=a contraceptive sponge, A
contraceptive sponge The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Sponges work in two ways. First, the sponge is inserted into the vagina, so it can cover the cervix and prevent any sperm from entering the uterus. Secondl ...
set inside its open package.


Intrauterine devices

The current
intrauterine device An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting rever ...
s (IUD) are small devices, often 'T'-shaped, containing either copper or
levonorgestrel Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand name Plan B One-Step among ...
, which are inserted into the uterus. They are one form of
long-acting reversible contraception Long-acting reversible contraceptives (LARC) are methods of birth control that provide effective contraception for an extended period without requiring user action. They include injections, intrauterine devices (IUDs), and subdermal contraceptiv ...
which are the most effective types of reversible birth control. Failure rates with the
copper IUD Intrauterine device (IUD) with copper, also known as intrauterine coil or copper coil, is a type of intrauterine device which contains copper. It is used for birth control and emergency contraception within five days of unprotected sex. It is one ...
is about 0.8% while the levonorgestrel IUD has a failure rates of 0.2% in the first year of use. Among types of birth control, they, along with birth control implants, result in the greatest satisfaction among users. As of 2007, IUDs are the most widely used form of reversible contraception, with more than 180 million users worldwide. Evidence supports effectiveness and safety in adolescents and those who have and have not previously had children. IUDs do not affect
breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...
and can be inserted immediately after delivery. They may also be used immediately after an
abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
. Once removed, even after long term use, fertility returns to normal immediately. While
copper IUDs Intrauterine device (IUD) with copper, also known as intrauterine coil or copper coil, is a type of intrauterine device which contains copper. It is used for birth control and emergency contraception within five days of unprotected sex. It is o ...
may increase menstrual bleeding and result in more painful cramps,
hormonal IUDs A hormonal intrauterine device (IUD), also known as a intrauterine system (IUS) with progestogen and sold under the brand name Mirena among others, is an intrauterine device that releases a progestogenic hormonal agent such as levonorgestrel int ...
may reduce menstrual bleeding or stop menstruation altogether. Cramping can be treated with painkillers like
non-steroidal anti-inflammatory drugs Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of ...
. Other potential complications include expulsion (2–5%) and rarely perforation of the uterus (less than 0.7%). A previous model of the intrauterine device (the Dalkon shield) was associated with an increased risk of
pelvic inflammatory disease Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be no ...
, however the risk is not affected with current models in those without
sexually transmitted infections Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral se ...
around the time of insertion. IUDs appear to decrease the risk of
ovarian cancer Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different c ...
.


Sterilization

Surgical sterilization is available in the form of
tubal ligation Tubal ligation (commonly known as having one's "tubes tied") is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus th ...
for women and
vasectomy Vasectomy, or vasoligation, is an elective surgical procedure for male sterilization or permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into the urethra and ...
for men. Tubal ligation decreases the risk of
ovarian cancer Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different c ...
. Short term complications are twenty times less likely from a vasectomy than a tubal ligation. After a vasectomy, there may be swelling and pain of the scrotum which usually resolves in one or two weeks. Chronic scrotal pain associated with negative impact on quality of life occurs after vasectomy in about 1-2% of men. With tubal ligation, complications occur in 1 to 2 percent of procedures with serious complications usually due to the
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
. Neither method offers protection from sexually transmitted infections. Sometimes,
salpingectomy Salpingectomy refers to the surgical removal of a Fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception. This procedure is now sometimes preferred over its ovarian tube-sparin ...
is also used for sterilization in women. This decision may cause regret in some men and women. Of women who have undergone tubal ligation after the age of 30, about 6% regret their decision, as compared with 20-24% of women who received sterilization within one year of delivery and before turning 30, and 6% in
nulliparous In biology and human medicine, gravidity and parity are the number of times a woman is or has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity). These terms are usually coupled, sometimes with additional te ...
women sterilized before the age of 30. By contrast, less than 5% of men are likely to regret sterilization. Men who are more likely to regret sterilization are younger, have young or no children, or have an unstable marriage. In a survey of biological parents, 9% stated they would not have had children if they were able to do it over again. Although sterilization is considered a permanent procedure, it is possible to attempt a
tubal reversal Tubal ( he, תֻבָל, ''Ṯuḇāl'', ), in Genesis 10 (the "Table of Nations"), was the name of a son of Japheth, son of Noah. He is known to be the father of the Caucasian Iberians (ancestors of the Georgians) according to primary sources ...
to reconnect the
fallopian tubes The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In ot ...
or a
vasectomy reversal Vasectomy, or vasoligation, is an elective surgical procedure for male sterilization or permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into the urethra and ...
to reconnect the
vasa deferentia The vas deferens or ductus deferens is part of the male reproductive system of many vertebrates. The ducts transport sperm from the epididymis to the ejaculatory ducts in anticipation of ejaculation. The vas deferens is a partially coiled tube w ...
. In women, the desire for a reversal is often associated with a change in spouse. Pregnancy success rates after tubal reversal are between 31 and 88 percent, with complications including an increased risk of
ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. ...
. The number of males who request reversal is between 2 and 6 percent. Rates of success in fathering another child after reversal are between 38 and 84 percent; with success being lower the longer the time period between the vasectomy and the reversal.
Sperm extraction Testicular sperm extraction (TESE) is a surgical procedure in which a small portion of tissue is removed from the testicle and any viable sperm cells from that tissue are extracted for use in further procedures, most commonly intracytoplasmic sperm ...
followed by
in vitro fertilization In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) ...
may also be an option in men.


Behavioral

Behavioral methods involve regulating the timing or method of intercourse to prevent introduction of sperm into the female reproductive tract, either altogether or when an egg may be present. If used perfectly the first-year failure rate may be around 3.4%, however if used poorly first-year failure rates may approach 85%.


Fertility awareness

Fertility awareness method Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gyn ...
s involve determining the most fertile days of the
menstrual cycle The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
and avoiding unprotected intercourse. Techniques for determining fertility include monitoring
basal body temperature Basal body temperature (BBT or BTP) is the lowest body temperature attained during rest (usually during sleep). It is usually estimated by a temperature measurement immediately after awakening and before any physical activity has been undertaken. ...
,
cervical secretions The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...
, or the day of the cycle. They have typical first-year failure rates of 24%; perfect use first-year failure rates depend on which method is used and range from 0.4% to 5%. The evidence on which these estimates are based, however, is poor as the majority of people in trials stop their use early. Globally, they are used by about 3.6% of couples. If based on both basal body temperature and another primary sign, the method is referred to as symptothermal. First-year failure rates of 20% overall and 0.4% for perfect use have been reported in clinical studies of the symptothermal method. A number of
fertility tracking Fertility awareness (FA) refers to a set of practices used to determine the fertility, fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to birth control, avoid pregnancy, to fertilisation, achieve p ...
apps are available, as of 2016, but they are more commonly designed to assist those trying to get pregnant rather than prevent pregnancy.


Withdrawal

The
withdrawal method ''Coitus interruptus'', also known as withdrawal, pulling out or the pull-out method, is a method of birth control in which a man, during sexual intercourse, withdraws his penis from a woman's vagina prior to ejaculation and then directs his ...
(also known as coitus interruptus) is the practice of ending intercourse ("pulling out") before ejaculation. The main risk of the withdrawal method is that the man may not perform the maneuver correctly or in a timely manner. First-year failure rates vary from 4% with perfect usage to 22% with typical usage. It is not considered birth control by some medical professionals. There is little data regarding the sperm content of
pre-ejaculatory fluid Pre-ejaculate (also known as pre-ejaculatory fluid, pre-seminal fluid or Cowper's fluid, and colloquially as ''pre-cum'') is a clear, colorless, viscous fluid that is emitted from the urethra of the penis during sexual arousal. It is similar in c ...
. While some tentative research did not find sperm, one trial found sperm present in 10 out of 27 volunteers. The withdrawal method is used as birth control by about 3% of couples.


Abstinence

Sexual abstinence Sexual abstinence or sexual restraint is the practice of refraining from some or all aspects of Human sexual activity, sexual activity for medical, psychological, legal, social, financial, philosophical, moral, or religious reasons. Sexual abstin ...
may be used as a form of birth control, meaning either not engaging in any type of sexual activity, or specifically not engaging in vaginal intercourse, while engaging in other forms of non-vaginal sex. Complete sexual abstinence is 100% effective in preventing pregnancy. However, among those who take a pledge to abstain from
premarital sex Premarital sex is Human sexual activity, sexual activity which is practiced by people before they are Marriage, married. Premarital sex is considered a sin by a number of religions and also considered a Sexual mores, moral issue which is taboo i ...
, as many as 88% who engage in sex, do so prior to marriage. The choice to abstain from sex cannot protect against pregnancy as a result of
rape Rape is a type of sexual assault usually involving sexual intercourse or other forms of sexual penetration carried out against a person without their consent. The act may be carried out by physical force, coercion, abuse of authority, or ag ...
, and public health efforts emphasizing abstinence to reduce unwanted pregnancy may have limited effectiveness, especially in
developing countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
and among disadvantaged groups. Deliberate
non-penetrative sex Non-penetrative sex or outercourse is sexual activity that usually does not include sexual penetration. It generally excludes the penetrative aspects of vaginal, anal, or oral sexual activity, but includes various forms of sexual and non-sexua ...
without vaginal sex or deliberate
oral sex Oral sex, sometimes referred to as oral intercourse, is sexual activity involving the stimulation of the genitalia of a person by another person using the mouth (including the lips, tongue, or teeth) and the throat. Cunnilingus is oral sex per ...
without vaginal sex are also sometimes considered birth control. While this generally avoids pregnancy, pregnancy can still occur with
intercrural sex Intercrural sex, which is also known as coitus interfemoris, thigh sex (or thighing) and interfemoral sex, is a type of non-penetrative sex in which the penis is placed between the receiving partner's thighs and friction is generated via thrust ...
and other forms of penis-near-vagina sex (genital rubbing, and the penis exiting from
anal intercourse Anal sex or anal intercourse is generally the insertion and thrusting of the erect penis into a person's anus, or anus and rectum, for sexual pleasure.Sepages 270–271for anal sex information, anpage 118for information about the clitoris. Ot ...
) where sperm can be deposited near the entrance to the vagina and can travel along the vagina's lubricating fluids.
Abstinence-only sex education Abstinence-only sex education is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. Comprehensive sex education, ...
does not reduce
teenage pregnancy Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female adolescent or young adult under the age of 20. This includes those who are legally considered adults in their country. The WHO defines adolescence as the period bet ...
. Teen pregnancy rates and STI rates are generally the same or higher in states where students are given abstinence-only education, as compared with
comprehensive sex education Comprehensive sexuality education (CSE) is a sex education instruction method based on-curriculum that aims to give students the knowledge, attitudes, skills, and values to make appropriate and healthy choices in their sexual lives. The intention i ...
. Some authorities recommend that those using abstinence as a primary method have backup methods available (such as condoms or emergency contraceptive pills).


Lactation

The
lactational amenorrhea method Lactational amenorrhea, also called postpartum infertility, is the temporary postnatal infertility that occurs when a woman is amenorrheic (not menstruating) and fully breastfeeding. Physiology Hormonal pathways and neuroendocrine control ...
involves the use of a woman's natural postpartum infertility which occurs after delivery and may be extended by
breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...
. This usually requires the presence of no periods, exclusively breastfeeding the infant, and a child younger than six months. The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
states that if breastfeeding is the infant's only source of nutrition, the failure rate is 2% in the six months following delivery. Six uncontrolled studies of lactational amenorrhea method users found failure rates at 6 months postpartum between 0% and 7.5%. Failure rates increase to 4–7% at one year and 13% at two years. Feeding formula, pumping instead of nursing, the use of a
pacifier A pacifier is a rubber, plastic, or silicone nipple substitute given to an infant to suckle upon between feedings to quiet its distress by satisfying the need to suck when it does not need to eat. Pacifiers normally have three parts: an elongate ...
, and feeding solids all increase its failure rate. In those who are exclusively breastfeeding, about 10% begin having periods before three months and 20% before six months. In those who are not breastfeeding, fertility may return four weeks after delivery.


Emergency

Emergency contraceptive Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy. There are different forms of EC. Emergency contraceptive pills (ECPs), sometimes simply referred to as emergency contraceptives (ECs), ...
methods are medications (sometimes misleadingly referred to as "morning-after pills") or devices used after unprotected sexual intercourse with the hope of preventing pregnancy. Emergency contraceptives are often given to victims of
rape Rape is a type of sexual assault usually involving sexual intercourse or other forms of sexual penetration carried out against a person without their consent. The act may be carried out by physical force, coercion, abuse of authority, or ag ...
. They work primarily by preventing ovulation or fertilization. They are unlikely to affect implantation, but this has not been completely excluded. A number of options exist, including high dose birth control pills,
levonorgestrel Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand name Plan B One-Step among ...
,
mifepristone Mifepristone, also known as RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion during pregnancy and manage early miscarriage. This combination is 97% effective during the first 63 days of p ...
,
ulipristal Ulipristal acetate, sold under the brand name Ella among others, is a medication used for emergency contraception (birth control) and uterine fibroids. As emergency contraception it should be used within 120 hours of vaginally penetrating inter ...
and IUDs. Providing emergency contraceptive pills to women in advance does not affect rates of sexually transmitted infections, condom use, pregnancy rates, or sexual risk-taking behavior. All methods have minimal side effects.
Levonorgestrel Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand name Plan B One-Step among ...
pills, when used within 3 days, decrease the chance of pregnancy after a single episode of unprotected sex or condom failure by 70% (resulting in a pregnancy rate of 2.2%).
Ulipristal Ulipristal acetate, sold under the brand name Ella among others, is a medication used for emergency contraception (birth control) and uterine fibroids. As emergency contraception it should be used within 120 hours of vaginally penetrating inter ...
, when used within 5 days, decreases the chance of pregnancy by about 85% (pregnancy rate 1.4%) and is more effective than levonorgestrel.
Mifepristone Mifepristone, also known as RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion during pregnancy and manage early miscarriage. This combination is 97% effective during the first 63 days of p ...
is also more effective than levonorgestrel, while copper IUDs are the most effective method. IUDs can be inserted up to five days after intercourse and prevent about 99% of pregnancies after an episode of unprotected sex (pregnancy rate of 0.1 to 0.2%). This makes them the most effective form of emergency contraceptive. In those who are
overweight Being overweight or fat is having more body fat than is optimally healthy. Being overweight is especially common where food supplies are plentiful and lifestyles are sedentary. , excess weight reached epidemic proportions globally, with mo ...
or
obese Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...
, levonorgestrel is less effective and an IUD or ulipristal is recommended.


Dual protection

Dual protection is the use of methods that prevent both
sexually transmitted infection Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are Transmission (medicine), spread by Human sexual activity, sexual activity, especi ...
s and pregnancy. This can be with condoms either alone or along with another birth control method or by the avoidance of penetrative sex. If pregnancy is a high concern, using two methods at the same time is reasonable. For example, two forms of birth control are recommended in those taking the anti-
acne Acne, also known as ''acne vulgaris'', is a long-term Cutaneous condition, skin condition that occurs when Keratinocyte, dead skin cells and Sebum, oil from the skin clog hair follicles. Typical features of the condition include comedo, black ...
drug
isotretinoin Isotretinoin, also known as 13-''cis''-retinoic acid and sold under the brand name Accutane among others, is a medication primarily used to treat severe acne. It is also used to prevent certain skin cancers (squamous-cell carcinoma), and in th ...
or
anti-epileptic drugs Anticonvulsants (also known as antiepileptic drugs or recently as antiseizure drugs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of b ...
like
carbamazepine Carbamazepine (CBZ), sold under the trade name Tegretol among others, is an anticonvulsant medication used primarily in the treatment of epilepsy and neuropathic pain. It is used as an adjunctive treatment in schizophrenia along with other medi ...
, due to the high risk of
birth defect A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
s if taken during pregnancy.


Effects


Health

Contraceptive use in
developing countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
is estimated to have decreased the number of
maternal death Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
s by 40% (about 270,000 deaths prevented in 2008) and could prevent 70% of deaths if the full demand for birth control were met. These benefits are achieved by reducing the number of unplanned pregnancies that subsequently result in unsafe abortions and by preventing pregnancies in those at high risk. Birth control also improves child survival in the developing world by lengthening the time between pregnancies. In this population, outcomes are worse when a mother gets pregnant within eighteen months of a previous delivery. Delaying another pregnancy after a
miscarriage Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the death of an embryo or fetus before it is able to survive independently. Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical lo ...
however does not appear to alter risk and women are advised to attempt pregnancy in this situation whenever they are ready.
Teenage pregnancies Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female adolescent or young adult under the age of 20. This includes those who are legally considered adults in their country. The WHO defines adolescence as the period bet ...
, especially among younger teens, are at greater risk of adverse outcomes including early birth,
low birth weight Low birth weight (LBW) is defined by the World Health Organization as a birth weight of an infant of or less, regardless of gestational age. Infants born with LBW have added health risks which require close management, often in a neonatal intensi ...
, and death of the infant. In 2012 in the United States 82% of pregnancies in those between the ages of 15 to 19 years old are unplanned. Comprehensive
sex education Sex education, also known as sexual education, sexuality education or sex ed, is the instruction of issues relating to human sexuality, including emotional relations and responsibilities, human sexual anatomy, Human sexual activity, sexual acti ...
and access to birth control are effective in decreasing pregnancy rates in this age group. Birth control methods, especially hormonal methods, can also have undesirable side effects. Intensity of side effects can range from minor to debilitating, and varies with individual experiences. These most commonly include change in menstruation regularity and flow, nausea, breast tenderness, headaches,  weight gain, and mood changes (specifically an increase in depression and anxiety). Additionally, hormonal contraception can contribute to bone mineral density loss,  impaired glucose metabolism, increased risk of venous thromboembolism. Comprehensive sex education and transparent discussion of birth control side effects and contraindications between healthcare provider and patient is imperative.


Finances

In the developing world, birth control increases
economic growth Economic growth can be defined as the increase or improvement in the inflation-adjusted market value of the goods and services produced by an economy in a financial year. Statisticians conventionally measure such growth as the percent rate of ...
due to there being fewer dependent children and thus more women participating in or increased contribution to the
workforce The workforce or labour force is a concept referring to the Pooling (resource management), pool of human beings either in employment or in unemployment. It is generally used to describe those working for a single types of companies, company or ...
- as they are usually the primary
caregiver A caregiver or carer is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commo ...
for children. Women's earnings, assets,
body mass index Body mass index (BMI) is a value derived from the mass (weight) and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is expressed in units of kg/m2, resulting from mass in kilograms and he ...
, and their children's schooling and body mass index all improve with greater access to birth control.
Family planning Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marita ...
, via the use of modern birth control, is one of the most
cost-effective Cost-effectiveness analysis (CEA) is a form of economic analysis that compares the relative costs and outcomes (effects) of different courses of action. Cost-effectiveness analysis is distinct from cost–benefit analysis, which assigns a monetar ...
health interventions. For every dollar spent, the United Nations estimates that two to six dollars are saved. These cost savings are related to preventing unplanned pregnancies and decreasing the spread of sexually transmitted illnesses. While all methods are beneficial financially, the use of copper IUDs resulted in the greatest savings. The total medical cost for a pregnancy, delivery and care of a newborn in the United States is on average $21,000 for a vaginal delivery and $31,000 for a
caesarean delivery Caesarean section, also known as C-section or caesarean delivery, is the Surgery, surgical procedure by which one or more babies are Childbirth, delivered through an incision in the mother's abdomen, often performed because vaginal delivery wou ...
as of 2012. In most other countries, the cost is less than half. For a child born in 2011, an average US family will spend $235,000 over 17 years to raise them.


Prevalence

Globally, as of 2009, approximately 60% of those who are married and able to have children use birth control. How frequently different methods are used varies widely between countries. The most common method in the developed world is condoms and oral contraceptives, while in Africa it is oral contraceptives and in Latin America and Asia it is sterilization. In the developing world overall, 35% of birth control is via female sterilization, 30% is via IUDs, 12% is via oral contraceptives, 11% is via condoms, and 4% is via male sterilization. While less used in the developed countries than the developing world, the number of women using IUDs as of 2007 was more than 180 million. Avoiding sex when fertile is used by about 3.6% of women of childbearing age, with usage as high as 20% in areas of South America. As of 2005, 12% of couples are using a male form of birth control (either condoms or a vasectomy) with higher rates in the developed world. Usage of male forms of birth control has decreased between 1985 and 2009. Contraceptive use among women in
Sub-Saharan Africa Sub-Saharan Africa is, geographically, the area and regions of the continent of Africa that lies south of the Sahara. These include West Africa, East Africa, Central Africa, and Southern Africa. Geopolitically, in addition to the List of sov ...
has risen from about 5% in 1991 to about 30% in 2006. As of 2012, 57% of women of childbearing age want to avoid pregnancy (867 of 1,520 million). About 222 million women however were not able to access birth control, 53 million of whom were in sub-Saharan Africa and 97 million of whom were in Asia. This results in 54 million unplanned pregnancies and nearly 80,000 maternal deaths a year. Part of the reason that many women are without birth control is that many countries limit access due to religious or political reasons, while another contributor is
poverty Poverty is the state of having few material possessions or little income. Poverty can have diverse social, economic, and political causes and effects. When evaluating poverty in ...
. Due to restrictive
abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
laws in Sub-Saharan Africa, many women turn to unlicensed abortion providers for
unintended pregnancy Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception. Sexual activity without the use of effective contraception through choice or coercion is the predominant cause of unintended pregnancy. Wor ...
, resulting in about 2–4% obtaining
unsafe abortion An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, a ...
s each year.


History


Early history

The Egyptian Ebers Papyrus from 1550 BC and the
Kahun Papyrus The Kahun Papyri (KP; also Petrie Papyri or Lahun Papyri) are a collection of ancient Egyptian texts discussing administrative, mathematical and medical topics. Its many fragments were discovered by Flinders Petrie in 1889 and are kept at the U ...
from 1850 BC have within them some of the earliest documented descriptions of birth control: the use of honey,
acacia ''Acacia'', commonly known as the wattles or acacias, is a large genus of shrubs and trees in the subfamily Mimosoideae of the pea family Fabaceae. Initially, it comprised a group of plant species native to Africa and Australasia. The genus na ...
leaves and lint to be placed in the vagina to block sperm.
Silphium Silphium (also known as ''silphion'', ''laserwort'', or ''laser'') is an unidentified plant that was used in classical antiquity as a seasoning, perfume, aphrodisiac, and medicine. It also was used as a contraceptive by ancient Greeks and Romans ...
, a species of
giant fennel ''Ferula communis'', the giant fennel, is a species of flowering plant in the carrot family Apiaceae. It is related to the common fennel (''Foeniculum vulgare''), which belongs to the same family. ''Ferula communis'' is a tall herbaceous peren ...
native to north Africa, may have been used as birth control in
ancient Greece Ancient Greece ( el, Ἑλλάς, Hellás) was a northeastern Mediterranean civilization, existing from the Greek Dark Ages of the 12th–9th centuries BC to the end of classical antiquity ( AD 600), that comprised a loose collection of cult ...
and the
ancient Near East The ancient Near East was the home of early civilizations within a region roughly corresponding to the modern Middle East: Mesopotamia (modern Iraq, southeast Turkey, southwest Iran and northeastern Syria), ancient Egypt, ancient Iran ( Elam, ...
. Due to its supposed desirability, by the first century AD, it had become so rare that it was worth more than its weight in silver and, by late antiquity, it was fully extinct. Most methods of birth control used in antiquity were probably ineffective. The
ancient Greek Ancient Greek includes the forms of the Greek language used in ancient Greece and the ancient world from around 1500 BC to 300 BC. It is often roughly divided into the following periods: Mycenaean Greek (), Dark Ages (), the Archaic peri ...
philosopher
Aristotle Aristotle (; grc-gre, Ἀριστοτέλης ''Aristotélēs'', ; 384–322 BC) was a Greek philosopher and polymath during the Classical period in Ancient Greece. Taught by Plato, he was the founder of the Peripatetic school of phil ...
( 384–322 BC) recommended applying
cedar oil Cedar oil, also known as cedarwood oil, is an essential oil derived from various types of conifers, most in the pine or cypress botanical families. It is produced from the foliage, and sometimes the wood, roots, and stumps left after logging of tr ...
to the womb before intercourse, a method which was probably only effective on occasion. A
Hippocratic Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history of ...
text ''On the Nature of Women'' recommended that a woman drink a copper
salt Salt is a mineral composed primarily of sodium chloride (NaCl), a chemical compound belonging to the larger class of salts; salt in the form of a natural crystalline mineral is known as rock salt or halite. Salt is present in vast quantitie ...
dissolved in water, which it claimed would prevent pregnancy for a year. This method was not only ineffective, but also dangerous, as the later medical writer
Soranus of Ephesus Soranus of Ephesus ( grc-gre, Σωρανός ὁ Ἑφέσιος; 1st/2nd century AD) was a Greek physician. He was born in Ephesus but practiced in Alexandria and subsequently in Rome, and was one of the chief representatives of the Methodic s ...
( 98–138 AD) pointed out. Soranus attempted to list reliable methods of birth control based on rational principles. He rejected the use of superstition and amulets and instead prescribed mechanical methods such as vaginal plugs and pessaries using wool as a base covered in oils or other gummy substances. Many of Soranus's methods were probably also ineffective. In medieval Europe, any effort to halt pregnancy was deemed immoral by the
Catholic Church The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
, although it is believed that women of the time still used a number of birth control measures, such as
coitus interruptus ''Coitus interruptus'', also known as withdrawal, pulling out or the pull-out method, is a method of birth control in which a man, during sexual intercourse, withdraws his penis from a woman's vagina prior to ejaculation and then directs his ej ...
and inserting
lily ''Lilium'' () is a genus of Herbaceous plant, herbaceous flowering plants growing from bulbs, all with large prominent flowers. They are the true lilies. Lilies are a group of flowering plants which are important in culture and literature in mu ...
root and
rue ''Ruta graveolens'', commonly known as rue, common rue or herb-of-grace, is a species of ''Ruta'' grown as an ornamental plant and herb. It is native to the Balkan Peninsula. It is grown throughout the world in gardens, especially for its bluis ...
into the vagina. Women in the Middle Ages were also encouraged to tie weasel testicles around their thighs during sex to prevent pregnancy. The oldest condoms discovered to date were recovered in the ruins of
Dudley Castle Dudley Castle is a ruined fortification in the town of Dudley, West Midlands, England. Originally a wooden motte and bailey castle built soon after the Norman Conquest, it was rebuilt as a stone fortification during the twelfth century but subs ...
in England, and are dated back to 1640. They were made of animal gut, and were most likely used to prevent the spread of sexually transmitted diseases during the
English Civil War The English Civil War (1642–1651) was a series of civil wars and political machinations between Parliamentarians (" Roundheads") and Royalists led by Charles I ("Cavaliers"), mainly over the manner of England's governance and issues of re ...
.
Casanova Giacomo Girolamo Casanova (, ; 2 April 1725 – 4 June 1798) was an Italian adventurer and author from the Republic of Venice. His autobiography, (''Story of My Life''), is regarded as one of the most authentic sources of information about the c ...
, living in 18th century
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical re ...
, described the use of a lambskin covering to prevent pregnancy; however, condoms only became widely available in the 20th century.


Birth control movement

The birth control movement developed during the 19th and early 20th centuries. The
Malthusian League The Malthusian League was a British organisation which advocated the practice of contraception and the education of the public about the importance of family planning. It was established in 1877 and was dissolved in 1927. The organisation was secul ...
, based on the ideas of
Thomas Malthus Thomas Robert Malthus (; 13/14 February 1766 – 29 December 1834) was an English cleric, scholar and influential economist in the fields of political economy and demography. In his 1798 book '' An Essay on the Principle of Population'', Mal ...
, was established in 1877 in the United Kingdom to educate the public about the importance of
family planning Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marita ...
and to advocate for getting rid of penalties for promoting birth control. It was founded during the "Knowlton trial" of
Annie Besant Annie Besant ( Wood; 1 October 1847 – 20 September 1933) was a British socialist, theosophist, freemason, women's rights activist, educationist, writer, orator, political party member and philanthropist. Regarded as a champion of human f ...
and
Charles Bradlaugh Charles Bradlaugh (; 26 September 1833 – 30 January 1891) was an English political activist and atheist. He founded the National Secular Society in 1866, 15 years after George Holyoake had coined the term "secularism" in 1851. In 1880, Brad ...
, who were prosecuted for publishing on various methods of birth control. In the United States,
Margaret Sanger Margaret Higgins Sanger (born Margaret Louise Higgins; September 14, 1879September 6, 1966), also known as Margaret Sanger Slee, was an American birth control activist, sex educator, writer, and nurse. Sanger popularized the term "birth control ...
and Otto Bobsein popularized the phrase "birth control" in 1914. Sanger primarily advocated for birth control on the idea that it would prevent women from seeking unsafe abortions, but during her lifetime, she began to campaign for it on the grounds that it would reduce mental and physical defects. She was mainly active in the United States but had gained an international reputation by the 1930s. At the time, under the
Comstock Law The Comstock laws were a set of federal acts passed by the United States Congress under the Grant administration along with related state laws.Dennett p.9 The "parent" act (Sect. 211) was passed on March 3, 1873, as the Act for the Suppression of ...
, distribution of birth control information was illegal. She
jumped bail Bail is a set of pre-trial restrictions that are imposed on a suspect to ensure that they will not hamper the judicial process. Bail is the conditional release of a defendant with the promise to appear in court when required. In some countries ...
in 1914 after her arrest for distributing birth control information and left the United States for the United Kingdom. In the U.K., Sanger, influenced by Havelock Ellis, further developed her arguments for birth control. She believed women needed to enjoy sex without fearing a pregnancy. During her time abroad, Sanger also saw a more flexible diaphragm in a Dutch clinic, which she thought was a better form of contraceptive. Once Sanger returned to the United States, she established a short-lived birth-control clinic with the help of her sister, Ethel Bryne, based in the Brownville section of
Brooklyn Brooklyn () is a borough of New York City, coextensive with Kings County, in the U.S. state of New York. Kings County is the most populous county in the State of New York, and the second-most densely populated county in the United States, be ...
, New York in 1916. It was shut down after eleven days and resulted in her arrest. The publicity surrounding the arrest, trial, and appeal sparked birth control activism across the United States. Besides her sister, Sanger was helped in the movement by her first husband, William Sanger, who distributed copies of "Family Limitation." Sanger's second husband, James Noah H. Slee, would also later become involved in the movement, acting as its main funder. Sanger also contributed to the funding of research into hormonal contraceptives in the 1950s. She helped fund research Dr. John Rock, and biologist Gregory Pincus that resulted in the first hormonal contraceptive pill, later called Enovid. The first human trials of the pill were done on patients in the Worcester State Psychiatric Hospital, after which clinical testing was done in Puerto Rico before Enovid was approved for use in the U.S.. The people participating in these trials were not fully informed on the medical implications of the pill, and often had minimal to no other family planning options. The newly approved birth control method was not made available to the participants after the trials, and contraceptives are still not widely accessible in Puerto Rico. The increased use of birth control was seen by some as a form of social decay. A decrease of fertility was seen as a negative. Throughout the Progressive Era (1890–1920), there was an increase of voluntary associations aiding the contraceptive movement. These organizations failed to enlist more than 100,000 women because the use of birth control was often compared to eugenics; however, there were women seeking a community with like-minded women. The ideology that surrounded birth control started to gain traction during the Progressive Era due to voluntary associations establishing community. Birth control was unlike the Victorian Era because women wanted to manage their sexuality. The use of birth control was another form of self-interest women clung to. This was seen as women began to gravitate towards strong figures, like the
Gibson girl The Gibson Girl was the personification of the feminine ideal of physical attractiveness as portrayed by the pen-and-ink illustrations of artist Charles Dana Gibson during a 20-year period that spanned the late 19th and early 20th centuries in th ...
. The first permanent birth-control clinic was established in Britain in 1921 by
Marie Stopes Marie Charlotte Carmichael Stopes (15 October 1880 – 2 October 1958) was a British author, palaeobotanist and campaigner for eugenics and women's rights. She made significant contributions to plant palaeontology and coal classification, ...
working with the Malthusian League. The clinic, run by midwives and supported by visiting doctors, offered women's birth-control advice and taught them the use of a
cervical cap The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the ''os''. Terminology The term ''cervical cap'' has been ...
. Her clinic made contraception acceptable during the 1920s by presenting it in scientific terms. In 1921, Sanger founded the American Birth Control League, which later became the
Planned Parenthood The Planned Parenthood Federation of America, Inc. (PPFA), or simply Planned Parenthood, is a nonprofit organization that provides reproductive health care in the United States and globally. It is a tax-exempt corporation under Internal Reve ...
Federation of America. In 1924 the Society for the Provision of Birth Control Clinics was founded to campaign for municipal clinics; this led to the opening of a second clinic in
Greengate, Salford Greengate is an area within the borough of Salford in Greater Manchester, England. It is bounded by the River Irwell, Victoria Bridge Street and Chapel Street, Blackfriars Road and Trinity Way. Greengate is the original historic core of Salford ...
in 1926. Throughout the 1920s, Stopes and other
feminist Feminism is a range of socio-political movements and ideologies that aim to define and establish the political, economic, personal, and social equality of the sexes. Feminism incorporates the position that society prioritizes the male po ...
pioneers, including
Dora Russell Dora, Countess Russell (née Black; 3 April 1894 – 31 May 1986) was a British author, a feminist and socialist campaigner, and the second wife of the philosopher Bertrand Russell. She was a campaigner for contraception and peace. She worked ...
and
Stella Browne Stella Browne (9 May 1880 – 8 May 1955) was a Canadian-born British feminist, socialist, sex radical, and birth control campaigner. She was one of the primary women in the fight for women's right to control and make decisions regarding their s ...
, played a major role in breaking down
taboo A taboo or tabu is a social group's ban, prohibition, or avoidance of something (usually an utterance or behavior) based on the group's sense that it is excessively repulsive, sacred, or allowed only for certain persons.''Encyclopædia Britannica ...
s about sex. In April 1930 the Birth Control Conference assembled 700 delegates and was successful in bringing birth control and abortion into the political sphere – three months later, the Ministry of Health, in the United Kingdom, allowed local authorities to give birth-control advice in welfare centres. The National Birth Control Association was founded in Britain in 1931, and became the
Family Planning Association FPA (Family Planning Association) was a UK registered charity (number 250187) working to enable people to make informed choices about sex and to enjoy sexual health. It was the national affiliate for the International Planned Parenthood Federat ...
eight years later. The Association amalgamated several British birth control-focused groups into 'a central organisation' for administering and overseeing birth control in Britain. The group incorporated the Birth Control Investigation Committee, a collective of physicians and scientists that was founded to investigate scientific and medical aspects of contraception with 'neutrality and impartiality'. Subsequently, the Association effected a series of 'pure' and 'applied' product and safety standards that manufacturers must meet to ensure their contraceptives could be prescribed as part of the Association's standard two-part-technique combining 'a rubber appliance to protect the mouth of the womb' with a 'chemical preparation capable of destroying... sperm'. Between 1931 and 1959, the Association founded and funded a series of tests to assess chemical efficacy and safety and rubber quality. These tests became the basis for the Association's Approved List of contraceptives, which was launched in 1937, and went on to become an annual publication that the expanding network of FPA clinics relied upon as a means to 'establish facts
bout contraceptives Bout can mean: People *Viktor Bout, suspected arms dealer * Jan Everts Bout, early settler to New Netherland * Marcel Bout Musical instruments * The outward-facing round parts of the body shape of violins, guitars, and other stringed instrum ...
and to publish these facts as a basis on which a sound public and scientific opinion can be built'. In 1936, the
United States Court of Appeals for the Second Circuit The United States Court of Appeals for the Second Circuit (in case citations, 2d Cir.) is one of the thirteen United States Courts of Appeals. Its territory comprises the states of Connecticut, New York and Vermont. The court has appellate juri ...
ruled in ''
United States v. One Package of Japanese Pessaries ''United States v. One Package of Japanese Pessaries'', 86 F.2d 737 (2d Cir. 1936) (often just ''U.S. v. One Package''), was an ''in rem'' United States Court of Appeals case in the Second Circuit involving birth control. Background In 1873 Co ...
'' that medically prescribing contraception to save a person's life or well-being was not illegal under the
Comstock Laws The Comstock laws were a set of federal acts passed by the United States Congress under the Grant administration along with related state laws.Dennett p.9 The "parent" act (Sect. 211) was passed on March 3, 1873, as the Act for the Suppression of ...
. Following this decision, the
American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...
Committee on Contraception revoked its 1936 statement condemning birth control. A national survey in 1937 showed 71 percent of the adult population supported the use of contraception. By 1938, 374 birth control clinics were running in the United States despite their advertisement still being illegal.
First Lady First lady is an unofficial title usually used for the wife, and occasionally used for the daughter or other female relative, of a non-monarchical A monarchy is a form of government in which a person, the monarch, is head of state fo ...
Eleanor Roosevelt Anna Eleanor Roosevelt () (October 11, 1884November 7, 1962) was an American political figure, diplomat, and activist. She was the first lady of the United States from 1933 to 1945, during her husband President Franklin D. Roosevelt's four ...
publicly supported birth control and family planning. The restrictions on birth control in the Comstock laws were effectively rendered null and void by
Supreme Court A supreme court is the highest court within the hierarchy of courts in most legal jurisdictions. Other descriptions for such courts include court of last resort, apex court, and high (or final) court of appeal. Broadly speaking, the decisions of ...
decisions ''
Griswold v. Connecticut ''Griswold v. Connecticut'', 381 U.S. 479 (1965), was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States protects the liberty of married couples to buy and use contraceptives withou ...
'' (1965) and ''
Eisenstadt v. Baird ''Eisenstadt v. Baird'', 405 U.S. 438 (1972), was a landmark decision of the U.S. Supreme Court that established the right of unmarried people to possess contraception on the same basis as married couples. The Court struck down a Massachusetts la ...
'' (1972). In 1966, President Lyndon B. Johnson started endorsing public funding for family planning services, and the Federal Government began subsidizing birth control services for low-income families. The Affordable Care Act, passed into law on March 23, 2010, under President
Barack Obama Barack Hussein Obama II ( ; born August 4, 1961) is an American politician who served as the 44th president of the United States from 2009 to 2017. A member of the Democratic Party, Obama was the first African-American president of the U ...
, requires all plans in the Health Insurance Marketplace to cover contraceptive methods. These include barrier methods, hormonal methods, implanted devices, emergency contraceptives, and sterilization procedures.


Modern methods

In 1909, Richard Richter developed the first intrauterine device made from silkworm gut, which was further developed and marketed in Germany by
Ernst Gräfenberg Ernst Gräfenberg (26 September 1881 – 28 October 1957) was a German-born physician and scientist. He is known for developing the intra-uterine device (IUD), and for his studies of the role of the woman's urethra in orgasm. The G-spot is name ...
in the late 1920s. In 1951, an Austrian-born American chemist, named
Carl Djerassi Carl Djerassi (October 29, 1923 – January 30, 2015) was an Austrian-born Bulgarian-American pharmaceutical chemist, novelist, playwright and co-founder of Djerassi Resident Artists Program with Diane Middlebrook, Diane Wood Middlebrook. He is b ...
at
Syntex Laboratorios Syntex SA (later Syntex Laboratories, Inc.) was a pharmaceutical company formed in Mexico City in January 1944 by Russell Marker, Emeric Somlo, and Federico Lehmann to manufacture therapeutic steroids from the Mexican yams called ''cabe ...
in
Mexico City Mexico City ( es, link=no, Ciudad de México, ; abbr.: CDMX; Nahuatl: ''Altepetl Mexico'') is the capital and largest city of Mexico, and the most populous city in North America. One of the world's alpha cities, it is located in the Valley o ...
made the hormones in progesterone pills using Mexican yams (''
Dioscorea mexicana ''Dioscorea mexicana'', Mexican yam or ''cabeza de negro'' is a species of yam in the genus ''Dioscorea''. ''Dioscorea mexicana'' is a caudiciform dioscorea having either a partly to completely above-ground dome-shaped caudex with a thick, ...
''). Djerassi had chemically created the pill but was not equipped to distribute it to patients. Meanwhile,
Gregory Pincus Gregory Goodwin Pincus (April 9, 1903 – August 22, 1967) was an American biologist and researcher who co-invented the combined oral contraceptive pill. Early life Gregory Goodwin Pincus was born in Woodbine, New Jersey to Jewish parents, who we ...
and John Rock with help from the
Planned Parenthood Federation of America The Planned Parenthood Federation of America, Inc. (PPFA), or simply Planned Parenthood, is a nonprofit organization that provides reproductive health care in the United States and globally. It is a tax-exempt corporation under Internal Reven ...
developed the first birth control pills in the 1950s, such as
mestranol/noretynodrel Mestranol/norethynodrel was the first combined oral contraceptive pill (COCP) being mestranol and norethynodrel. It sold as Enovid in the United States and as Enavid in the United Kingdom. Developed by Gregory Pincus at G. D. Searle & Company, ...
, which became publicly available in the 1960s through the Food and Drug Administration under the name ''Enovid''.
Medical abortion A medical abortion, also known as medication abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage. Medical ...
became an alternative to surgical abortion with the availability of prostaglandin analogs in the 1970s and
mifepristone Mifepristone, also known as RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion during pregnancy and manage early miscarriage. This combination is 97% effective during the first 63 days of p ...
in the 1980s.


Society and culture


Legal positions

Human rights Human rights are Morality, moral principles or Social norm, normsJames Nickel, with assistance from Thomas Pogge, M.B.E. Smith, and Leif Wenar, 13 December 2013, Stanford Encyclopedia of PhilosophyHuman Rights Retrieved 14 August 2014 for ce ...
agreements require most governments to provide family planning and contraceptive information and services. These include the requirement to create a national plan for family planning services, remove laws that limit access to family planning, ensure that a wide variety of safe and effective birth control methods are available including emergency contraceptives, make sure there are appropriately trained healthcare providers and facilities at an affordable price, and create a process to review the programs implemented. If governments fail to do the above it may put them in breach of binding international treaty obligations. In the United States, the 1965 Supreme Court decision ''
Griswold v. Connecticut ''Griswold v. Connecticut'', 381 U.S. 479 (1965), was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States protects the liberty of married couples to buy and use contraceptives withou ...
'' overturned a state law prohibiting dissemination of contraception information based on a constitutional right to privacy for marital relationships. In 1972, ''
Eisenstadt v. Baird ''Eisenstadt v. Baird'', 405 U.S. 438 (1972), was a landmark decision of the U.S. Supreme Court that established the right of unmarried people to possess contraception on the same basis as married couples. The Court struck down a Massachusetts la ...
'' extended this right to privacy to single people. In 2010, the United Nations launched the ''Every Woman Every Child'' movement to assess the progress toward meeting women's contraceptive needs. The initiative has set a goal of increasing the number of users of modern birth control by 120 million women in the world's 69 poorest countries by 2020. Additionally, they aim to eradicate discrimination against girls and young women who seek contraceptives. The
American Congress of Obstetricians and Gynecologists The American College of Obstetricians and Gynecologists (ACOG) is a professional association of physicians specializing in obstetrics and gynecology in the United States. Several Latin American countries are also represented within Districts of ...
(ACOG) recommended in 2014 that oral birth control pills should be
over the counter medications Over-the-counter (OTC) drugs are medication, medicines sold directly to a consumer without a requirement for a medical prescription, prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to co ...
. Since at least the 1870s, American religious, medical, legislative, and legal commentators have debated contraception laws. Ana Garner and Angela Michel have found that in these discussions men often attach reproductive rights to moral and political matters, as part of an ongoing attempt to regulate human bodies. In press coverage between 1873 and 2013 they found a divide between institutional ideology and real-life experiences of women.


Religious views

Religions vary widely in their views of the
ethics Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concerns m ...
of birth control. The
Roman Catholic Church The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
re-affirmed its teachings in
1968 The year was highlighted by protests and other unrests that occurred worldwide. Events January–February * January 5 – "Prague Spring": Alexander Dubček is chosen as leader of the Communist Party of Czechoslovakia. * Januar ...
that only
natural family planning Natural family planning (NFP) comprises the family planning methods approved by the Catholic Church and some Protestant denominations for both achieving and postponing or avoiding pregnancy. In accordance with the Church's teachings regarding s ...
is permissible, although large numbers of Catholics in
developed countries A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
accept and use modern methods of birth control. The Greek Orthodox Church admits a possible exception to its traditional teaching forbidding the use of artificial contraception, if used within marriage for certain purposes, including the spacing of births. Among
Protestants Protestantism is a branch of Christianity that follows the theological tenets of the Protestant Reformation, a movement that began seeking to reform the Catholic Church from within in the 16th century against what its followers perceived to b ...
, there is a wide range of views from supporting none, such as in the Quiverfull movement, to allowing all methods of birth control. Views in
Judaism Judaism ( he, ''Yahăḏūṯ'') is an Abrahamic, monotheistic, and ethnic religion comprising the collective religious, cultural, and legal tradition and civilization of the Jewish people. It has its roots as an organized religion in the ...
range from the stricter
Orthodox Orthodox, Orthodoxy, or Orthodoxism may refer to: Religion * Orthodoxy, adherence to accepted norms, more specifically adherence to creeds, especially within Christianity and Judaism, but also less commonly in non-Abrahamic religions like Neo-pa ...
sect, which prohibits all methods of birth control, to the more relaxed
Reform Reform ( lat, reformo) means the improvement or amendment of what is wrong, corrupt, unsatisfactory, etc. The use of the word in this way emerges in the late 18th century and is believed to originate from Christopher Wyvill#The Yorkshire Associati ...
sect, which allows most.
Hindus Hindus (; ) are people who religiously adhere to Hinduism.Jeffery D. Long (2007), A Vision for Hinduism, IB Tauris, , pages 35–37 Historically, the term has also been used as a geographical, cultural, and later religious identifier for ...
may use both natural and modern contraceptives. A common
Buddhist Buddhism ( , ), also known as Buddha Dharma and Dharmavinaya (), is an Indian religion or philosophical tradition based on teachings attributed to the Buddha. It originated in northern India as a -movement in the 5th century BCE, and ...
view is that preventing conception is acceptable, while intervening after conception has occurred is not. In
Islam Islam (; ar, ۘالِإسلَام, , ) is an Abrahamic religions, Abrahamic Monotheism#Islam, monotheistic religion centred primarily around the Quran, a religious text considered by Muslims to be the direct word of God in Islam, God (or ...
, contraceptives are allowed if they do not threaten health, although their use is discouraged by some.


World Contraception Day

September 26 is World Contraception Day, devoted to raising awareness and improving education about sexual and reproductive health, with a vision of ''a world where every pregnancy is wanted.'' It is supported by a group of governments and international NGOs, including the
Office of Population Affairs The Office of Population Affairs (OPA) is part of the Office of Public Health and Science in the United States Department of Health and Human Services (HHS). It is responsible for reproductive health topics, including adolescent pregnancy, family ...
, the Asian Pacific Council on Contraception, Centro Latinamericano Salud y Mujer, the European Society of Contraception and Reproductive Health, the
German Foundation for World Population DSW (german: Deutsche Stiftung Weltbevölkerung) is an international non-governmental organisation addressing Sexual & Reproductive Health (SRH) and population dynamics. DSW funds its project and advocacy work from private donations and the finan ...
, the International Federation of Pediatric and Adolescent Gynecology,
International Planned Parenthood Federation The International Planned Parenthood Federation (IPPF) is a global non-governmental organisation with the broad aims of promoting sexual and reproductive health, and advocating the right of individuals to make their own choices in family p ...
, the
Marie Stopes International MSI Reproductive Choices, named Marie Stopes International until November 2020, is an international non-governmental organisation providing contraception and safe abortion services in 37 countries around the world. MSI Reproductive Choices as an ...
,
Population Services International Population Services International (PSI) is a 501(c)(3) registered nonprofit global health organization with programs targeting malaria, child survival, HIV, and reproductive health. PSI provides products, clinical services and behavior chan ...
, the
Population Council The Population Council is an international, nonprofit, non-governmental organization. The Council conducts research in biomedicine, social science, and public health and helps build research capacities in developing countries. One-third of its res ...
, the
United States Agency for International Development The United States Agency for International Development (USAID) is an independent agency of the U.S. federal government that is primarily responsible for administering civilian foreign aid and development assistance. With a budget of over $27 bi ...
(USAID), and
Women Deliver Women Deliver is a global advocacy organization that works to generate political commitment and financial investment for fulfilling Millennium Development Goal 5, which is improving maternal health. This is a multifactorial approach, involving acce ...
.


Misconceptions

There are a number of
common misconceptions Each entry on this list of common misconceptions is worded as a correction; the misconceptions themselves are implied rather than stated. These entries are concise summaries of the main subject articles, which can be consulted for more detail. ...
regarding sex and pregnancy.
Douching A douche is a device used to introduce a stream of water into the body for medical or hygienic reasons, or the stream of water itself. Douche usually refers to vaginal irrigation, the rinsing of the vagina, but it can also refer to the rinsing ...
after sexual intercourse is not an effective form of birth control. Additionally, it is associated with a number of health problems and thus is not recommended. Women can become pregnant the first time they have sexual intercourse and in any
sexual position A sex position is a position of the body that people use for sexual intercourse or other sexual activities. Sexual acts are generally described by the positions the participants adopt in order to perform those acts. Though sexual intercourse ...
. It is possible, although not very likely, to become pregnant during menstruation. Contraceptive use, regardless of its duration and type, does not have a negative effect on the ability of women to conceive following termination of use and does not significantly delay fertility. Women who use oral contraceptives for a longer duration may have a slightly lower rate of pregnancy than do women using oral contraceptives for a shorter period of time, possibly due to fertility decreasing with age.


Accessibility

Access to birth control may be affected by finances and the laws within a region or country. In the United States African American, Hispanic, and young women are disproportionately affected by limited access to birth control, as a result of financial disparity. For example, Hispanic and African American women often lack insurance coverage and are more often poor. New immigrants in the United States are not offered preventive care such as birth control. In the United Kingdom contraception can be obtained free of charge via contraception clinics,
sexual health Sexual and reproductive health (SRH) is a field of research, healthcare, and social activism that explores the health of an individual's reproductive system and sexual wellbeing during all stages of their life. The term can also be further de ...
or GUM ( genitourinary medicine) clinics, via some GP surgeries, some young people's services and pharmacies. In September 2021, France announced that women aged under 25 in France will be offered free contraception from 2022. It was elaborated that they "would not be charged for medical appointments, tests, or other medical procedures related to birth control" and that this would "cover hormonal contraception, biological tests that go with it, the prescription of contraception and all care related to this contraception". From August 2022 onwards contraception for women aged between 17 and 25 years will be free in the
Republic of Ireland Ireland ( ga, Éire ), also known as the Republic of Ireland (), is a country in north-western Europe consisting of 26 of the 32 counties of the island of Ireland. The capital and largest city is Dublin, on the eastern side of the island. A ...
.


Advocacy

Free the Pill Charlotte Ellertson (March 2, 1966 – March 21, 2004) was named one of 50 most influential people in women's health. She is a key reason women achieved “the regulatory, clinical, and policy changes that made these methods more widely availabl ...
, a collaboration between
Advocates for Youth Advocates for Youth is a nonprofit organization and advocacy group based in Washington, D.C., United States, dedicated to sexuality education, the prevention of HIV and of sexually transmitted disease, teenage pregnancy prevention, youth access ...
and
Ibis Reproductive Health Charlotte Ellertson (March 2, 1966 – March 21, 2004) was named one of 50 most influential people in women's health. She is a key reason women achieved “the regulatory, clinical, and policy changes that made these methods more widely availabl ...
are working to bring birth control over-the-counter, covered by insurance with no age-restriction throughout the United States.


Research directions


Females

Improvements of existing birth control methods are needed, as around half of those who get pregnant unintentionally are using birth control at the time. A number of alterations of existing contraceptive methods are being studied, including a better female condom, an improved diaphragm, a patch containing only progestin, and a vaginal ring containing long-acting progesterone. This vaginal ring appears to be effective for three or four months and is currently available in some areas of the world. For women who rarely have sex, the taking of the hormonal birth control
levonorgestrel Levonorgestrel is a hormonal medication which is used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand name Plan B One-Step among ...
around the time of sex looks promising. A number of methods to perform sterilization via the cervix are being studied. One involves putting
quinacrine Mepacrine, also called quinacrine or by the trade name Atabrine, is a medication with several uses. It is related to chloroquine and mefloquine. Although formerly available from compounding pharmacies, as of August 2020 it is unavailable in th ...
in the uterus which causes scarring and infertility. While the procedure is inexpensive and does not require surgical skills, there are concerns regarding long-term side effects. Another substance,
polidocanol Polidocanol is a local anaesthetic and antipruritic component of ointments and bath additives. It relieves itching caused by eczema and dry skin. It has also been used to treat varicose veins, hemangiomas, and vascular malformations. It is formed ...
, which functions in the same manner is being looked at. A device called
Essure Essure was a device for female sterilization. It is a metal coil which when placed into each fallopian tube induces fibrosis and blockage.Free full text Essure was designed as an alternative to tubal ligation. However, it was recalled by Bayer i ...
, which expands when placed in the fallopian tubes and blocks them, was approved in the United States in 2002. In 2016, a
black boxed warning In the United States, a boxed warning (sometimes "black box warning", colloquially) is a type of warning that appears on the package insert for certain prescription drugs, so called because the U.S. Food and Drug Administration specifies that it ...
regarding potentially serious side effects was added, and in 2018, the device was discontinued.


Males

Methods of male birth control include condoms, vasectomies and withdrawal. Between 25 and 75% of males who are sexually active say they would use hormonal birth control if it was available for them. A number of hormonal and non-hormonal methods are in trials, and there is some research looking at the possibility of
contraceptive vaccine Immunocontraception is the use of an animal's immune system to prevent it from fertilizing offspring. Contraceptives of this type are not currently approved for human use. Typically immunocontraception involves the administration of a vaccine tha ...
s. A reversible surgical method under investigation is reversible inhibition of sperm under guidance (RISUG) which consists of injecting a polymer gel,
styrene maleic anhydride Styrene maleic anhydride (SMA or SMAnh) is a synthetic polymer that is built-up of styrene and maleic anhydride monomers. The monomers can be almost perfectly alternating, making it an alternating copolymer, but (random) copolymerisation with less ...
in
dimethyl sulfoxide Dimethyl sulfoxide (DMSO) is an organosulfur compound with the formula ( CH3)2. This colorless liquid is the sulfoxide most widely used commercially. It is an important polar aprotic solvent that dissolves both polar and nonpolar compounds a ...
, into the
vas deferens The vas deferens or ductus deferens is part of the male reproductive system of many vertebrates. The ducts transport sperm from the epididymis to the ejaculatory ducts in anticipation of ejaculation. The vas deferens is a partially coiled tube ...
. An injection with sodium bicarbonate washes out the substance and restores fertility. Another is an
intravas device Vas-occlusive contraception is a form of male contraception that blocks sperm transport in the vas deferens, the tubes that carry sperm from the epididymis to the ejaculatory ducts. Various vas-occlusive contraceptive methods have been research ...
which involves putting a urethane plug into the
vas deferens The vas deferens or ductus deferens is part of the male reproductive system of many vertebrates. The ducts transport sperm from the epididymis to the ejaculatory ducts in anticipation of ejaculation. The vas deferens is a partially coiled tube ...
to block it. A combination of an
androgen An androgen (from Greek ''andr-'', the stem of the word meaning "man") is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This inc ...
and a
progestin A progestogen, also referred to as a progestagen, gestagen, or gestogen, is a type of medication which produces effects similar to those of the natural product, natural female sex hormone progesterone in the body. A progestin is a ''synthetic co ...
seems promising, as do
selective androgen receptor modulator Selective Androgen Receptor Modulators or SARMs are a class of androgen receptor ligands that maintain some of the desirable effects of androgens, such as preventing osteoporosis and muscle loss while reducing risks of developing prostate cancer ...
s.
Ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
and methods to heat the testicles have undergone preliminary studies.


Animals

Neutering Neutering, from the Latin ''neuter'' ('of neither sex'), is the removal of an animal's reproductive organ, either all of it or a considerably large part. The male-specific term is castration, while spaying is usually reserved for female animals. ...
or spaying, which involves removing some of the reproductive organs, is often carried out as a method of birth control in household pets. Many
animal shelters An animal shelter or pound is a place where stray, lost, abandoned or surrendered animals – mostly dogs and cats – are housed. The word "pound" has its origins in the animal pounds of agricultural communities, where stray livestock would ...
require these procedures as part of adoption agreements. In large animals the surgery is known as
castration Castration is any action, surgical, chemical, or otherwise, by which an individual loses use of the testicles: the male gonad. Surgical castration is bilateral orchiectomy (excision of both testicles), while chemical castration uses pharmaceut ...
. Birth control is also being considered as an alternative to hunting as a means of controlling
overpopulation in wild animals Overpopulation or overabundance is a phenomenon in which a species' population becomes larger than the carrying capacity of its environment. This may be caused by increased birth rates, lowered mortality rates, reduced predation or large scale m ...
.
Contraceptive vaccine Immunocontraception is the use of an animal's immune system to prevent it from fertilizing offspring. Contraceptives of this type are not currently approved for human use. Typically immunocontraception involves the administration of a vaccine tha ...
s have been found to be effective in a number of different animal populations. Kenyan goat herders fix a skirt, called an
olor An olor is a piece of cowhide or plastic tied onto a male goat like a skirt. It is used by Kenyan goatherders to prevent bucks from impregnating the female goats during times of drought. References External links

Society of Kenya Contra ...
, to male goats to prevent them from impregnating female goats.


See also

*
Human population planning Human population planning is the practice of intentionally controlling the growth rate of a human population. The practice, traditionally referred to as population control, had historically been implemented mainly with the goal of increasing po ...
*
Immunocontraception Immunocontraception is the use of an animal's immune system to prevent it from fertilizing offspring. Contraceptives of this type are not currently approved for human use. Typically immunocontraception involves the administration of a vaccine tha ...


References


Further reading

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External links

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Bulk procurement of birth control
by the World Health Organization {{Authority control Articles containing video clips Wikipedia medicine articles ready to translate (full) Women's health