Birth Control and Contraception

Adapted from “New Dimensions in Women’s Health” by Linda Lewis Alexander & Judith H. LaRosa

Birth control is an important issue for most women. Being able to control reproductive functioning is a necessary component of career preparation and family growth management. Many methods of contraception are available today. No one contraceptive method is perfect. Contraception is a shared responsibility. The best method is one that a woman and her partner feel comfortable using and one that they will use correctly and consistently. The risk for sexually transmitted diseases must also be assessed with contraceptive decision making.

Perspectives on Contraception

Not all forms of sexual activity require contraceptive measures. These activities include abstinence from sexual activities and sex without intercourse. Not all couples engage in sexual intercourse. For example, sexual gratification and excitement may occur with hand holding, hugging, petting, kissing, mutual masturbation, and oral-genital sex. Ejaculation on, next to, or inside the vaginal opening has inherent risks for pregnancy and a requirement for contraception if pregnancy is not desired.

Clarification of the subtle differences in terms is a necessary beginning for a discussion of contraception. Although the terms “birth control” and “contraception” are generally used interchangeable, each conveys a slightly different perspective about fertility control. Birth control is an umbrella term that refers to procedures that prevent the birth of a baby, so birth control would include all available contraceptive measures as well as sterilization, the intrauterine device (IUD), and abortion procedures. Contraception is a more specific term for any procedure used to prevent fertilization of an ovum.

Contraceptive decision making is not easy. Choices are often necessary between highly effective contraceptive methods that have some degree of risk and other methods that have few side effects but may detract from sexual enjoyment and that may have a higher failure rate. There are various mechanisms for contraception, including condoms, oral contraceptives, spermicides, diaphragms, and sponges. The four primary mechanisms by which birth control can be accomplished are:

  1. Prevent sperm from entering the female reproductive system. Strategies that use this mechanism include abstinence, withdrawal, condom, and male sterilization.
  2. Prevent sperm from fertilizing an ovum once it has entered the female reproductive system. Strategies that use this mechanism include diaphragm, cervical cap, contraceptive sponge, and spermicides.
  3. Prevent the ovum from reaching the sperm. Strategies that use this mechanism include oral contraceptives and female sterilization.

Prevent progression of a fertilized egg. Strategies that use this mechanism include the IUD and abortion.