You’re in a sexual relationship – maybe it’s longstanding, maybe it’s new – but between you and your partner, who’s responsible for birth control? The short answer: You both are.
The World Health Organization says the ability to choose whether to have children and when is a human right. This is true for people of all genders. Having a baby, if you’re not ready, can put the brakes on your education and career. Yet for many people, getting birth control isn’t simple. You may be worried about whether it will cause side effects, what kinds there are to choose from, and how to find it.
Here are ideas on how to be proactive and how not to make assumptions.
Who’s Responsible for Using Birth Control?
When you're the one who can get pregnant, you may feel like all of the pressure is on you to keep that from happening. This isn’t the case. Yes, you can take birth control pills or choose other forms of contraception, but your partner also has options.
You may find out that your partner has preferences about contraception that match yours, or they may differ. Talk through the options to find something that both of you agree on.
When you're not clear who's responsible for birth control, it can put stress on your relationship. Although there are many more types available now than there were decades ago, most of the responsibility to obtain contraception, and to use it, continues to fall on women. Some of this imbalance relates to the fact that in most cases, women are the ones who actually become pregnant and give birth. However, much of it relates to outdated gender roles that assume women are the ones who take care of children.
Where to Start If You’re New to Sex
Before having sex, make sure you and your partner are ready to talk openly about birth control. Together, you can learn about your options and decide what’s best for you.
If you're a minor thinking about becoming sexually active, know that laws vary about whether you’ll have to get your parent or guardian’s permission for birth control. But in all U.S. states, even if you’re under 18, you have the right to privacy when speaking with your doctor about your options for contraception. To know what’s available in your area, check with your doctor. Local clinics, such as Planned Parenthood, can provide resources, too. And if you’ve recently had unprotected sex and are worried about pregnancy, there are no age requirements for buying emergency contraceptive pills. These can be bought at drugstores, pharmacies, and many large chain stores without a prescription. But these should not be used as a regular option.
You’ve Been With Your Partner for Years: Now What?
Birth control is not about the past, it’s about your future. It’s never too late to think ahead about your options. Both you and your partner can ask your doctor for ideas on what’s the best fit for your relationship. If one of you is allergic to latex condoms, for instance, you’ll likely want to choose a different form of contraception. Birth control pills could be a good choice if you’re having sex regularly but don’t want to make a long-term decision. Intrauterine devices (IUDs) also are temporary but last for several years. And if you know you don’t want to become pregnant in the future, sterilization (tubal ligation, also known as having your tubes tied) and vasectomy could offer peace of mind.
What Are Your Options?
The key here is to be proactive. In the short term, you can take steps ahead of sex to prevent unplanned pregnancies. Some work better than others. Some require using them on a schedule, while others need only to be used during the sexual encounter.
If you’re a woman, you have an array of options to choose from:
- Hormonal methods like birth control pills and patches. These are quite effective (91%-94%), though they can cause side effects such as changes in period symptoms, headaches, and nausea.
- Barrier methods like internal condoms (female condoms), diaphragms, and spermicide/gel. These are less effective (72%-88%) and only used while you have sex. But they have the advantage of causing milder side effects, most often irritation or allergic reactions.
- Sterilization (tubal ligation). This procedure is more than 99% effective and permanent. As with any surgery, there’s the risk of bleeding and infection.
- Birth control implants and IUDs. These, too, are very good at preventing pregnancy (greater than 99% effective) and are reversible. On the downside, they can cause menstrual changes, cramping, and other side effects.
- Lactational amenorrhea method (LAM). If you’ve had a baby, continuing to breastfeed after giving birth is 98% protective within the first 6 months.
If you’re a man, you have two main options:
- Condoms. These must be used correctly each time you have vaginal intercourse in order to work well (82% effective) but can cause allergies or irritated skin in both partners. Notably, they also protect against sexually transmitted infections like HIV.
- Vasectomy. This surgery is more than 99% effective and is permanent.
You can work as a team with your partner using other strategies such as fertility awareness methods (also known as natural family planning or the rhythm method; 76% effective) and withdrawal (pull-out method, 78% effective). In discussing your options, you may decide it’s best not have any sex right now (abstinence) or not have vaginal sex in particular.
What About Emergency Contraception?
Although this shouldn’t be your main form of contraception, sometimes accidents happen. You may not have used your usual method of birth control during sex for some reason, or it may not have worked as it should. Don’t panic if the condom broke, you forgot to take your oral contraceptive that day, or you or your partner didn’t pull out in time. These are all less scary scenarios since you’ve already opened the door to talking with your partner. Now, the two of you can come up with a plan you agree on.
It’s important to move quickly. Know that pregnancy doesn’t happen immediately after sex. Sperm can live for days inside a woman’s body, waiting to encounter an egg. So during this time there are still safe, accessible ways to prevent pregnancy. These don’t cause any long-term side effects or affect your ability to get pregnant later on. However, they can be expensive, so you should discuss cost concerns.
One possibility is a copper IUD, which can prevent pregnancy if it's inserted within 5 days of having sex. You'll need to see a health care provider to get one. A less effective but perhaps simpler option is an emergency contraception pill (known as the morning-after pill). It isn’t an abortion pill since no pregnancy has occured. There are two kinds:
- Ulpristal acetate (UPA)-based pills, which need a prescription and should be taken as soon as possible in the first 5 days after unprotected sex.
- Levonorgestrel (LNG)-based pills, which can be bought over the counter without a prescription and are meant to be taken within 3 days after sex.