Contraception and Pregnancy

If someone with a uterus and someone with a penis are sexually active, there is a risk for pregnancy. To reduce the risk for pregnancy, contraception (or birth control) can be used. Birth control use is common among college students: according to the 2018 ACHA-NCHA survey [pdf], 52.7% of students reported using some method of contraception the last time they had vaginal sex.

The most common forms are:

  • The pill (55% reported using)
  • External condoms (61.6% reported using)
  • Withdrawal (30% reported using) Note: just because withdrawal is commonly used, that doesn’t mean it’s effective. It’s only about 78% effective and requires lots of dedication and skill to practice it effectively. 

There are many types of contraception available and they fall into two categories: hormonal and non-hormonal. When determining the effectiveness of contraception, people should consider how well it works with perfect use and with typical use. Perfect use means that someone uses the birth control exactly as it was intended to be used. Sometimes this can be hard, though!

There could be several reasons that birth control might not be used exactly as intended. For example, some people might forget to take their birth control or may not use a condom every time. That’s what you’ll see “typical use” reported on the chart. This means that this is how most people use the method. As you’re deciding what type of birth control is right for you, you’ll want to think about the effectiveness with typical use, as well as other factors, such as how often you must take it, whether it provides STI protection, and how much it costs.

contraception

 

Hormonal Birth Control

Birth Control

How to Use

Effectiveness

Prescription Needed

Protects Against STIs

Monthly oral contraceptive (the Pill)

Take 1 pill at the same time each day.  A period occurs every 28 days.

99% effective with perfect use; 91% effective with typical use.

Yes

No

Extended-regimen oral contraceptive (also known as the Pill)

Take 1 pill at the same time each day for 3 months.  A period occurs every 3 months.

99% effective with perfect use; 91% effective with typical use.

Yes

No

Patch

Apply to skin and change weekly.  A period occurs every 28 days.

99% effective with perfect use; 91% effective with typical use.

Yes

No

Ring

Insert into the vagina and leave in for 21 days.  A period occurs every 28 days.

Over 99% effective with perfect use; 91% effective with typical use.

Yes

No

Implant

Inserted in arm for up to 5 years.

Over 99% effective.

 Yes. The device is implanted in a health care provider’s office or clinic.

No

Injection (The shot)

Get injections every 3 months.

Over 99% effective with perfect use; 94% effective with typical use.

Yes. Injections given in health care provider’s office or clinic.

No

Hormonal Intrauterine Device (IUD)

Inserted in the uterus for 3-7 years, depending on the brand.  May alter periods.

Over 99% effective.

Yes. IUD inserted in health care provider’s office or clinic.

No

 

Non-Hormonal Birth Control

Birth Control

How to Use

Effectiveness

Prescription Needed

Protects Against STIs

Spermicide

Apply every time before sex.

82% effective with perfect use; 71% effective with typical use.

No

No

Diaphragm

Insert every time before sex.

94% effective with perfect use; 88% effective with typical use.

Yes

No

External condom

Put on every time before sex.

98% effective with perfect use; 85% effective with typical use.

 

No

 

Yes

Internal condom

Insert every time before sex.

95% effective with perfect use; 79% effective with typical use.

No

Yes

Non-hormonal Intrauterine Device (Paragard)

Inserted in the uterus for up to 10 years.

Over 99% effective.

Yes. IUD inserted in health care professional’s office or clinic.

No

Female or male sterilization

No action required after surgery (follow clinician’s instructions).

Nearly 100% effective if done as directed.

No. Performed surgically.

No

Withdrawal

Pull the penis out of the vagina before ejaculation.

Up to 96% effective with perfect use; 73% effective with imperfect use.

No

No

 

Emergency Contraception

Emergency contraception (also known as “the morning after pill”) can be used to prevent pregnancy after unprotected sex. In the 2018 ACHA-NCHA survey [pdf], 14.8% of college students reported that they or their partner used emergency contraception in the last year. There are several options available:

  • Get the non-hormonal IUD inserted within five days after unprotected sex. This is the most effective option and requires a visit to a health care provider.
  • Take a pill within five days after unprotected sex. There are two types available:
    • One type of pill (ella®) requires a prescription, but it is the most effective emergency contraception pill option.
    • Another type of pill has several brand names available and is available over-the-counter. These pills are most effective if taken within three days of unprotected sex, but could be taken up to five days after. They are most effective if taken as soon as possible after unprotected sex.

Emergency contraception (EC) is not as effective as birth control that’s taken regularly, such as the hormonal methods listed above. If you find that you take EC often, you might consider using a regular form of birth control to reduce the risk for pregnancy.

In the United States, EC is available without a prescription for people of any age. Male-identified people can purchase the pill for their partners. Depending on where you get it, EC could range in price from free to $65. Check with your health center to see if they offer a reduced price for emergency contraception. Because EC is most effective if taken as soon as possible after unprotected sex, it’s a good idea to purchase it ahead of time, even if you don’t need it. You never know when you might need to take it.

Pregnancy

Pregnancy is possible, even when taking birth control. If you or your partner gets pregnant, you are not alone! Unintended pregnancies happen, and you have options for what you can do next.

You could decide to keep the baby. Your college or university might have programs available for parents in college. Check with your health center or student affairs office for more information. There might also be scholarships or public support available to help cover tuition or other necessities, like food or utilities.

You could decide to put the baby up for adoption. Your health center or county health department may have resources available for how to do this. The U.S. Department of Health and Human Services has resources available on adoption, including how to determine if this is the right decision for you.

You could have an abortion, depending on how far along the pregnancy is and what state you live in. Some states allow for health insurance companies to pay for abortions, while other states require they be paid for out of pocket. The Guttmacher Institute provides up-to-date information on abortion laws by state.