After baby arrives, it’s time to think about contraception. Family Planning New Zealand (familyplanning.org.nz) shares info on your options – talk to your LMC or GP about what’s right for you.
BARRIERS
1. Male condom
What is it?
A thin rubber barrier. Best used with lubricant (water based)
How does it work?
Fits over erect penis and catches sperm when the man ejaculates.
Chance of getting pregnant
- Typically 15% but 2% if used perfectly every time
- DO NOT USE oil-based lubricant or some anti-thrush creams
Health concerns
None known
Advantages
- Easy to use, easy to carry
- Used only when needed
- Helps protect against STIs
- Available from Family Planning clinics and other healthcare providers
- Can buy from pubs, clubs, pharmacies and many shops
- Cheaper on prescription
Disadvantages
- Some people are allergic to rubber
- Must be put on when penis is erect and before sexual intercourse
- Some people say it reduces sexual feeling
- Can slip off or break
2. Female condom
What is it?
A thin polyurethane barrier
How does it work?
Goes into the vagina and prevents sperm entering the woman’s body
Chance of getting pregnant
Typically 21% but 5% if used perfectly
Health concerns
None known
Advantages
- Helps protect against STIs
- Women can use it
- Easy to use
Disadvantages
- Relatively expensive
- Can be noisy
- Can get them from the internet
- Need to insert every time
Hormonal contraception
3. Combined pill
What is it?
Pill made of two hormones, oestrogen and progestogen
How does it work?
Stops ovaries from releasing an egg each month
Chance of getting pregnant
Typically 8% but less that 1% if used perfectly
Health concerns
- Very small chance of blood clots, heart attacks and strokes. More likely in women over 35 who smoke, are obese or have a family history of the above conditions
- Very slight increased risk of cervical cancer
Advantages
- Simple and easy to take
- Doesn’t interfere with sexual intercourse
- Periods usually regular, shorter, lighter and less painful
- Less chance of cancer of lining of the womb or ovaries
- Can be taken up to menopause if a health non-smoker
Disadvantages
- Should not be used by women over 35 who smoke
- Must remember to take it daily
- May have irregular bleeding
4. Progestogen-only pill
What is it?
Pill made of one hormone – progestogen
How does it work?
By thickening mucus in cervix and may stop ovaries from releasing an egg each month
Chance of getting pregnant
Typically 8% but less than 1% if used perfectly
Health concerns
No serious risk
Advantages
- Doesn’t interfere with sexual intercourse
- Can be used at any age
- Can be used by breastfeeding women
- Useful for women who can’t take combine pill
Disadvantages
May have irregular bleeding
5. Vaginal ring
What is it?
NuvaRing contains two hormones, oestrogen and progestogen. Sits inside vagina
How does it work?
Stops ovaries from releasing an egg each month
Chance of getting pregnant
Typically 8% but less than 1% if used perfectly
Health concerns
Very small chance of blood clots, heart attacks and strokes. More likely in women over 35 who smoke, are obese or have a family history of the above conditions.
Advantages
- Lasts for 3-4 weeks
- Useful for those who forget pills
Disadvantages
Should not be used by women over 35 who smoke
6. Depo Provera
What is it?
An injection of progestogen
How does it work?
Stops ovaries from releasing an egg each month
Chance of getting pregnant
Typically 3% but less than 1% if next injection given on time
Health concerns
No serious concerns
Advantages
- One injection lasts 12 weeks
- Doesn’t interfere with sexual intercourse
- Usually no periods
- Useful for women who can’t take combined pill
Disadvantages
- Irregular bleeding, no periods or occasional heavy bleeding
- Periods and fertility take an average of 6 months to return after stopping the injection
Long-acting reversible contraception
7. Implant
What is it?
Progestogen is released from 1 or 2 implanted under the skin of the arm
How does it work?
By thickening mucus in the cervix and may stop ovaries from releasing an egg each month
Chance of getting pregnant
Less than 1%
Health concerns
Very small chance of pelvic infection when IUD put in
Advantages
- Can stay in place for 5 years or more – fit and forget
- Useful for women who can’t take combined pill
- Useful for those who forget pills or injection appointments
Disadvantages
Irregular bleeding often gets better with time and can be controlled with medication
8. Intra-uterine device (IUD)
What is it?
Put inside the womb. Copper IUD or progestogen releasing Mirena (IUS)
How does it work?
Stops sperm reaching an egg
Chance of getting pregnant
IUD and Mirena – less that 1%
Health concerns
Very small chance of pelvic infection when IUD put in
Advantages
- Can stay in place for 5 years or more – fit and forget
- Doesn’t interfere with sexual intercourse
- IUS – lighter periods or no period at all, – suitable for women with heavy periods
Disadvantages
- Needs to be inserted by an experienced doctor or nurse
- IUD may cause heavier periods or cramping
- IUS may cause irregular bleeding in the first few months
Other methods
9. Fertility Awareness
What is it?
Women checks body temperature, cervical mucus and periods. These body signs show when you are more likely to get pregnant
Chance of getting pregnant
Typically 25% but can be 3% if used perfectly
Health concerns
None
Advantages
- After learning method, no further costs of visits to health professionals required
- Helps you understand how your body works
Disadvantages
- Expert instruction needed to learn method
- No sexual intercourse during fertile time
- Must chart temperature and cervical mucus daily
- Body signs can be difficult to recognise and may vary
10. Emergency contraception
What is it?
Emergency Contraceptive Pills (ECP) or copper IUD used after unprotected sexual intercourse
How does it work?
Delays ovulation or stops sperm reaching an egg
Chance of getting pregnant
- ECP – 2% for women of average weight, 6% if overweight
- IUD – less than 1%
Health concerns
- ECP – none known
- IUD – risk of pelvic infection of STI present
Advantages
- Reduces chance of pregnancy after unprotected sexual intercourse
- ECP – can be used up to 72 hours after unprotected sexual intercourse
- Can have ECP at home for future use
- Can be used if other method fails, eg broken condom or missed pill
- Can buy from pharmacies
Disadvantages
- ECP should be started within 72 hours of unprotected sexual intercourse
- ECP may not be effective for heavier women
- IUD needs to be fitted by an experienced doctor or nurse and can be uncomfortable
Permanent Contraception
11. Vasectomy and tubal ligation
What is it?
Permanent contraception. An operation
How does it work?
- Vasectomy – male tubes cut to stop sperm getting to the penis
- Tubal ligation – clips put on female tubes to stop the egg getting to the uterus
Chance of getting pregnant
Less than 1%
Health concerns
- Vasectomy – rare possibility of long-term scrotal pain
- Tubal ligation – very slight risk from reaction to anaesthetic or damage to internal organs
Advantages
- Once only
- Permanent
Disadvantages
- Not easily reversible
- Requires an operation
- May have short term side effects, eg pain, bruising
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