A couple’s decision to begin, prevent, or interrupt a pregnancy may be influenced by many factors including maternal medical disorders, risks involved in the pregnancy, and socioeconomic factors.
Contraception can be used by one or both members of a couple to prevent pregnancy temporarily. Some procedures are intended to provide permanent contraception Permanent Contraception In the US, one third of couples attempting to prevent pregnancy, particularly if the woman is > 30, choose permanent contraception with vasectomy or tubal ligation. This form of contraception... read more (sterilization). Abortion Induced Abortion In the US, abortion of a previable fetus is legal, although state-specific restrictions (eg, mandatory waiting periods, gestational age restrictions) exist. In the US, about half of pregnancies... read more (termination of pregnancy) may be considered when contraception has failed or not been used.
Among contraceptive users in the US, the most commonly used methods (1 General reference A couple’s decision to begin, prevent, or interrupt a pregnancy may be influenced by many factors including maternal medical disorders, risks involved in the pregnancy, and socioeconomic factors... read more ) are
Oral contraceptives (OCs): 19%
Female permanent contraception (sterilization): 29%
Male condoms: 13%
Male permanent contraception: 9%
Intrauterine devices (IUDs): 12%
Withdrawal (coitus interruptus): 6%
Progestin injections: 3%
Contraceptive rings or patches: 2%
Subdermal progestin implants: 4%
Fertility awareness methods (periodic abstinence): 2%
Female barrier methods: < 1%
(See table Comparison of Common Contraceptive Methods Comparison of Common Contraceptive Methods A couple’s decision to begin, prevent, or interrupt a pregnancy may be influenced by many factors including maternal medical disorders, risks involved in the pregnancy, and socioeconomic factors... read more .)
In the first year of use, pregnancy rates with typical use are
< 1% with methods unrelated to coitus and not requiring user involvement (IUDs, subdermal progestin implants, permanent contraception)
About 6 to 9% with hormonal contraceptive methods unrelated to coitus and requiring user involvement (oral contraceptives, progestin injection, transdermal patch, vaginal ring)
> 10% with coitus-related methods requiring user involvement (eg, condoms, diaphragms, fertility awareness methods, spermicides, withdrawal)
Pregnancy rates tend to be higher during the first year of use and decrease in subsequent years as users become more familiar with the contraceptive method they have chosen. Also, as women age, fertility declines. For fertile couples trying to conceive, the pregnancy rate is about 85% after 1 year if no contraceptive method is used.
Despite the higher pregnancy rate associated with condom use, experts recommend that condoms always be worn during intercourse because condoms (primarily latex and synthetic condoms) protect against sexually transmitted diseases (STDs). Most importantly, they help protect against HIV. For most effective contraception, other birth control methods should be used with condoms.
If contraception fails, emergency contraception Emergency Contraception Commonly used emergency contraception (EC) regimens include Insertion of a copper-bearing T380A IUD within 5 days of unprotected intercourse Levonorgestrel 0.75 mg orally in 2 doses 12 hours... read more may help prevent an unintended pregnancy. Emergency contraception should not be used as a regular form of contraception.