Myth Youcan’tget pregnant ifyoustand upafteryou have intercourse. Or if your partner ejaculates outside you. Or if you douche with Coca-Cola right after intercourse.

Fact None of these methods will keep you from getting pregnant.

Safe, legal contraception has given women control over their lives as never before. If you have grown up since the 1960s, in an era when contraception has been largely a matter of personal choice, you may not realize that this freedom is relatively new and was won only after years of struggle.

Margaret Sanger, an obstetrical nurse, saddened by the physical and social consequences of unwanted pregnancies, botched illegal abortions, and widespread sexually transmitted disease, started her crusade for birth control in the early 1900s. Defying existing laws against distributing information about birth control, she was reviled for her work, arrested, and put in a workhouse for a month. Popular opinion was strongly opposed to letting women have access to contraception.

Eventually Sanger and her allies prevailed. In the mid-i930s the government was legally prevented from seizing contraceptives that were sold across state lines. In 1965 in Griswold v. Connecticut, the Supreme Court declared unconstitutional a state law that made it illegal for physicians to give out contraceptive information. In that landmark decision, the court developed the notion of a “zone of privacy” where individual citizens were protected from government intrusion, a concept that has been the basis of many subsequent reproductive decisions.

Choosing A Contraceptive

Contraception is something you should think about carefully. It should not be a decision left to your sexual partner, to a frantic last-minute trip to the drugstore, or, even worse, to superstition and luck. Finding the right contraceptive is a personal choice. A contraceptive that is fine for someone else can be absolutely wrong for you, and a contraceptive that is right for you when you are 20 years old may no longer suit your needs when you are 40.

Unfortunately, there is no perfect contraceptive — one that would never fail, would be so easy to use you would not have to think about it, and would have no unpleasant side effects or negative health consequences. But we have come a long way in the thirty-plus years since birth control became legal in this country. Many kinds of contraceptives are available. Some are safer than others, some are less bother, some are more affordable.

So how do you choose? The first guideline is your level of personal comfort. If a contraceptive method makes you physically or emotionally uncomfortable, you probably will not use it faithfully each and every time you have intercourse. If birth control pills upset your stomach or depress you, or if you feel that spermicidal foams or jellies are messy and unaesthetic, choose a different contraceptive.

A second guideline is your reaction to contraceptive failure. How would you feel if you did become pregnant by accident, even though you were using your contraception conscientiously? If you have already had several children and do not want to get pregnant again, no matter what, you will want a different contraceptive from the woman who would like to have a child maybe next year or the year after. While making the right choice balances personal, emotional, and (sometimes) religious factors, there are a couple of ground rules that every heterosexually active woman should follow.

Some contraceptive methods protect you against both pregnancy and disease; most protect only against pregnancy. The combination of a condom and contraceptive foam is probably the best all-around double-duty prevention against sexually transmitted diseases and also against pregnancy.

Two Absolutely Basic Ground Rules for Protecting Yourself Against Pregnancy and Sexually Transmitted Diseases

Rule 1: If you do not wish to get pregnant, you must use some kind of contraception every timeyou have intercourse.

Rule 2: If both you and your sexual partner are not entirely and permanently monogamous, you must protect yourself against disease as well as against pregnancy. Many women have learned that a relationship they thought was mutually monogamous was only monogamous on their side.

What are the chances of getting pregnant if you have intercourse without using contraception?

You may believe that the likelihood of becoming pregnant from a single act of unprotected intercourse is close to 100 percent, but that is not true. On the other hand, many women have learned to their dismay or surprise that the percentage is not zero, either. If you have unprotected intercourse once right around the time of ovulation, your chances of getting pregnant are about 10 percent, to the best of our statistical knowledge. That rate will drop to the range of 2-3 percent if the unprotected intercourse occurs a day or two after your period.

You can become pregnant early in your cycle because sperm can remain potent for a day or two, maybe even longer, after ejaculation and because you may ovulate earlier than usual. If you have a twenty-eight-day cycle, you will probably ovulate on the fourteenth day after the beginning of your menstrual period, but you cannot rely on being perfectly regular each and every cycle of your life. Since ovulation is more variable at the beginning and end of your reproductive life, young women — teenagers, in particular — are at increased risk of getting pregnant. Women older than 40, whose fertility is declining, may also ovulate unpredictably, though they may also ovulate less frequently than younger women.

Your chances of getting pregnant during any one complete menstrual cycle if you have unprotected intercourse every other night all month are about 15-20 percent. On a longer-term basis, about 80-85 percent of couples will become pregnant after a year of unprotected intercourse every other night, and 90 percent will be pregnant after two years.

Contraceptive Reliability

Reversible Contraceptives

Basically, there are three kinds of reversible contraceptives: (1) barrier types, which keep sperm out of the upper reproductive tract where fertilization can take place, (2) hormonal contraceptives, which interfere with ovulation or deny sperm access to the egg, and (3) nonbarrier mechanical devices, which inhibit fertilization or implantation.

Given these three approaches, you have several either/or choices. To begin with one of life’s basic natural divisions, there are contraceptives for men and contraceptives for women. Then there are long-term and “per-need” contraceptives. Of the long-term contraceptives, the ones you do not need to think about each time you have intercourse, some (birth control pills or intrauterine devices, Depo-Provera, Norplant) are reversible. Of the short-term or per-need contraceptives, most provide a barrier that prevents sperm from meeting egg; some of these barriers are physical (condoms) and others are chemical (spermicidal jellies and creams). Also in the short-term category are “before” and “after” contraceptives, those you take to prevent conception and those you take when you and your partner have “made a mistake.”

Barrier Methods

Hormonal Contraception

Nonbarrier Methods

Morning-After Contraception

Permanent Contraception

Natural Birth Control

Levonorgestrel

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