Everyone should have access to accurate, unbiased information about all available methods in order to make an informed choice.1
Below is a table of different types of contraception. Please ensure that you discuss these methods with your healthcare provider to ensure that you are using the correct contraceptive method for your body.
Abstinence
The definition of abstinence is when you don’t have sex.
Abstinence can mean different things depending on who you ask. For some people, abstinence means not having any kind of sex. For other people, abstinence only means not having vaginal sex, but other sexual activities are allowed such as oral, and anal sex.
But both anal and oral sex can spread STDs, so use a condom during oral sex and anal sex.
Abstinence prevents pregnancy by keeping semen away from the vagina, so the sperm cells in semen can’t get to an egg and cause pregnancy.
Rhythm Method (natural family planning)
In order to use the rhythm method, you have to learn a lot about your menstrual cycle. You have to know when you’re ovulating and fertile, and when it’s safe for you to have sex without risking pregnancy.
The days near ovulation are your fertile days — when you’re most likely to get pregnant. So people use the rhythm method to prevent pregnancy by avoiding sex or using another birth control method (like condoms) on those “unsafe,” fertile days.
Points to consider
You need to have a regular menstrual cycle that you keep track of. Try downloading an app on your phone.
About 76-88% effective: that means 12-24 out of 100 couples who use the rhythm method will get pregnant each year
Coitus Interruptus (Withdrawal Method)
Pulling out (also known as withdrawal) is a way to prevent pregnancy by keeping semen away from the vagina. Withdrawal works best when you use another birth control method with it, like a condom.
While withdrawal can prevent pregnancy, it doesn’t protect you against STDs.
For withdrawal to work as well as possible, it must be done right every single time. Always. Your partner has to always pull out BEFORE ejaculation, and always make sure to ejaculate (cum) away from your genitals.
But pulling out can be difficult to do perfectly. So in real life, about 22 out of 100 people who use withdrawal get pregnant every year — that’s about 1 in 5.
The reality is withdrawal isn’t as effective as other types of birth control, but it’s definitely better than not using anything at all.
Lactational Amenorrhea method (Breastfeeding)
Breastfeeding isn’t just a healthy way to feed your baby. It can also be a form of birth control — but only done in a certain way.
When you exclusively breastfeed — meaning you nurse at least every 4 hours during the day and every 6 hours at night, and feed your baby only breast milk — your body naturally stops ovulating.
No ovulation means you won’t have your period, either.
Using breastfeeding as a method of birth control can be about as effective as hormonal contraceptives (like the pill), if done exclusively.
About 2 out of 100 people who use breastfeeding as birth control get pregnant in the 6 months it can be used after a baby is born.
Breastfeeding won’t prevent pregnancy if you feed your baby anything other than breast milk.
It also doesn’t work if you use a breast pump — you need to nurse your baby if you want your breastfeeding to prevent pregnancy.
Male Condom
Condoms are thin, stretchy pouches that are worn on the penis during sex. Condoms are great at preventing both pregnancy and STDs. If you follow the instructions and use them every time you have vaginal, anal, or oral sex, there’s very little chance of pregnancy, or getting or giving an STD.
Available over the counter at a pharmacy or your local Government Clinic.
Keep in mind that condoms made of lambskin or other animal membranes DO NOT protect against STDs — they only prevent pregnancy. Only synthetic condoms (latex or plastic) prevent the spread of STDs.
If you use condoms perfectly every single time you have sex, they’re 98% effective at preventing pregnancy. But people aren’t perfect, so in real life condoms are about 85% effective — that means about 15 out of 100 people who use condoms as their only birth control method will get pregnant each year.
Female Condom (internal condom)
An alternative to regular condoms. They provide pretty much the same great protection from pregnancy and STDs. What’s different about them? Instead of going on the penis, female condoms go inside your vagina for pregnancy prevention or into the vagina or anus for protection from STDs.
Available over the counter at a pharmacy or your local Government Clinic.
Female condoms may take a bit of practice to get used to. And for them to work, you have to use them correctly every single time you have sex.
If you use them perfectly every single time you have sex, female condom effectiveness is 95%. But people aren’t perfect, so in real life they’re about 79% effective — that means about 21 out of 100 people who use female condoms as their main method of birth control will get pregnant each year.
The Pill (Contraceptive Pill)
Birth control pills come in a pack, and you take 1 pill every day. The pill is safe, affordable, and effective if you always take your pill on time.
Besides preventing pregnancy, the pill has lots of other health benefits, too, which you can discuss with your healthcare provider.
You’ll start by choosing either combination birth control pill or minipills, which are only for breastfeeding moms.
When taking a combined oral contraception, you will have the choice of having your period every month or you can avoid / postpone for an event or sporting activity i.e,
Forgetting pills, losing the pack, not refilling your prescription on time — these are the main reasons why people might get pregnant when they use the pill. It’s good to plan ahead and think about the best way for you to use the pill correctly.
Interactions between the pill and certain medicines or supplements can cause contraception failure. Please discuss with your healthcare provider.
The most common side effects are spotting or bleeding between periods (this is more common with progestin-only pills), sore breasts, nausea, or headaches. But these usually go away after 2 or 3 months, and they don’t happen to everyone who takes the pill.
The pill is really good at preventing pregnancy, but it won’t protect you from sexually transmitted infections.
If you use it perfectly, the pill is 99% effective. But people aren’t perfect and it’s easy to forget or miss pills — so in reality the pill is about 91% effective. That means about 9 out of 100 pill users get pregnant each year.
The main thing that makes the pill not work is not taking it every day. But other things, like vomiting or having diarrhea for more than 48 hours (2 days) may lower how well the pill prevents pregnancy.
Implant
The birth control implant is a tiny, thin rod about the size of a matchstick. The implant releases hormones into your body that prevent you from getting pregnant. A nurse or doctor inserts the implant into your arm and that’s it — you’re protected from pregnancy for up to 5 years.
It’s safe to use the implant while you’re breastfeeding.
Prescription needed from your doctor for this type of birth control or available at your local government clinic.
Like all medicines, there can be side effects with the implant. But many people adjust to the implant with no problems. Negative side effects usually go away after a few months, once your body gets used to your implant.
The most common side effect is irregular bleeding (aka spotting), especially in the first 6-12 months. But most people on the implant get lighter periods, or their periods stop altogether while they have the implant. Other possible side effects that aren’t as common include headaches, breast pain, and nausea. There may also be temporary pain, bruising, or an infection on your arm where you got the implant.
Does not protect you against STD’s or HIV.
The implant is one of the best birth control methods out there — it’s more than 99% effective.
The Shot
The shot is an injection you get once every 3 months. It’s a safe, convenient, and private birth control method that works really well if you always get it on time.
Prescription needed from your doctor for this type of birth control or available at your local government clinic.
The shot is really good at preventing pregnancy, but it won’t protect you from sexually transmitted infections
You have to go to a doctor’s office or health center every 3 months for your injection. Or you may be able to get a supply of shots at the health center to bring home and give yourself every 3 months. Either way, the shot only works if you get it on time, so it’s important to stay on schedule.
The Diaphragm
A diaphragm is a shallow, bendable cup that you put inside your vagina. It covers your cervix during sex to prevent pregnancy.
The diaphragm is a barrier that covers your cervix, stopping sperm from joining an egg.
Adding spermicide to your diaphragm before you put it in your vagina makes it much more effective. Spermicide has chemicals that stop sperm from moving so they can’t get to an egg. The diaphragm keeps the spermicide in place, near your cervix.
Available over the counter at the pharmacy.
In order for your diaphragm to work as well as possible, you have to use it correctly every time you have vaginal sex
Some people have trouble inserting the diaphragm, and it can take practice to get comfortable doing using.
Diaphragms come in different sizes, and so do our bodies. Changes in your body over time can mess up the fit of your diaphragm. You might have to get refitted for a new size after you’re pregnant or if you gain or lose weight.
Diaphragms can get moved out of place if there’s a lot of hard thrusting going on.
Also, diaphragms won’t work as well if you don’t stay on top of the spermicide situation.
You have to make sure you put your diaphragm-with-spermicide in before you start having sex, and leave it in for 6 hours after sex.
Remember it does not protect you against STD’s or HIV.
If you use your diaphragm perfectly every single time you have sex, it’s 94% effective. But nobody’s perfect, so in real life diaphragms are about 88% effective — that means about 12 out of 100 people who use a diaphragm will get pregnant each year.
Birth Control Ring
The birth control ring is a safe and convenient birth control method that works really well if you always use it correctly. You wear the small, flexible ring inside your vagina, and it prevents pregnancy by releasing hormones into your body.
Prescription needed from your doctor for this type of birth control.
Forgetting to refill your prescription or not putting a new ring in on time — is the main reason why people might get pregnant when they’re using the ring.
Like with all medicines, the birth control ring can have some side effects. But most usually go away after 2 or 3 months.
Ring is really good at preventing pregnancy, but it won’t protect you from sexually transmitted infections.
If you use it perfectly, the Birth Control Ring is 99% effective. But people aren’t perfect and it can be easy to make a mistake — so in reality the ring is about 91% effective. That means about 9 out of 10 ring users will not get pregnant each year.
The Patch
Transdermal contraceptive patch is a safe and convenient birth control method that works really well if you always use it correctly. You wear the patch on certain parts of your body, and it releases hormones through your skin that prevent pregnancy.
Prescription needed from your doctor for this type of birth control.
To get the patch’s full birth control powers, you have to use it correctly. Making a mistake — like forgetting to refill your prescription or not putting on a new patch on time — is the main reason why people might get pregnant when they’re using the patch.
The most common side effects are spotting or bleeding between periods, sore breasts, nausea, or headaches. But these usually go away after 2 or 3 months
The patch is really good at preventing pregnancy, but it won’t protect you from sexually transmitted infections.
If you use it perfectly, the patch is 99% effective. But people aren’t perfect, and it can be easy to make a mistake — so in reality, the patch is about 91% effective. That means about 9 out of 10 patch users will not get pregnant each year.
Inter Uterine Device (IUD)
An IUD is a tiny device that’s put into your uterus to prevent pregnancy. It’s long-term and reversible.
Hormonal IUDs usually make your periods much lighter and less crampy.
The Copper IUD can be used as emergency contraception.
An IUD is a tiny device that’s put into your uterus to prevent pregnancy. It’s long-term and reversible.
Hormonal IUDs usually make your periods much lighter and less crampy.
The Copper IUD can be used as emergency contraception.
If you get it put in within 120 hours (5 days) after unprotected sex, it’s more than 99.9% effective. It’s actually the most effective way to prevent pregnancy after sex.
Prescription needed from your doctor for this type of birth control or the copper IUD is available at your local government clinic. While IUDs are one of the best ways to prevent pregnancy, they don’t protect you from STD’s or HIV.
The process of getting your IUD placed can be painful for some people. It usually feels like strong period cramps.
IUDs are one of the best birth control methods out there — more than 99% effective. That means fewer than 1 out of 100 people who use an IUD will get pregnant each year.
Spermicides
Spermicide is a kind of birth control that has chemicals that stop sperm from reaching an egg. You put it in your vagina before sex to prevent pregnancy.
It prevents pregnancy two ways: blocking the entrance to the cervix so sperm can’t get to your egg, and stopping sperm from moving well enough to swim to your egg.
Available over the counter at the pharmacy.
Spermicide, may irritate sensitive genital tissues, especially if you use it several times a day. That irritation increases your risk for HIV and other STDs because it gives infections an easy pathway into your body. And some people are allergic to spermicide.
Like all birth control methods, spermicide is most effective when you use it correctly every single time you have vaginal sex. Be sure to read the directions that come with your type of spermicide and use it every time you have sex, or it won’t work as well.
When it comes to the numbers, 18 out of 100 people who use spermicide will become pregnant each year, even if they always use it correctly. And using spermicide perfectly is hard, so in reality about 28 out of 100 people who use spermicide become pregnant every year.
Sterilisation (getting your tubes tied)
Sterilisation is a surgical procedure that PERMANENTLY closes or blocks your fallopian tubes.
After a tubal ligation, sperm can’t get to an egg and cause pregnancy.
You still get your period after tubal ligation — you just can’t get pregnant.
Discuss with your doctor or local Government Clinic as surgery will be required.
Tubal ligation won’t protect you or your partners from sexually transmitted infections.
One of the most effective kinds of birth control. It’s permanent and more than 99% effective at preventing pregnancy.
If you want to prevent a pregnancy in any of the following situations, Emergency Contraception (The Morning After Pill) is recommended:
- After sexual intercourse where no contraception was used;
- After sexual intercourse during which a condom broke, was displaced, slipped or was improperly removed;
- If vomiting occurred within 1 hour of taking your regular contraceptive pill;
- In the case of sexual assault (rape).
Emergency Contraception (The Morning After Pill)
The best kind of emergency contraception for you depends on a few factors — when you had sex, your weight, whether you’re breastfeeding.
The Morning After Pill is available in a two tablet and single tablet pack. The tablets contain Levonorgestrel and work best when you take it within 72 hours after unprotected sex.
Since the morning-after pill works better the sooner you take it, it’s a good idea to buy it BEFORE you need it.
Available over the counter at a pharmacy or your local Government Clinic.
After you take the morning-after pill, it’s totally normal for your next period to be different from what you’re used to. It may come earlier or later, and be heavier, lighter, or more spotty. Or it may be the same as it normally is.
You may get an upset stomach, feel lightheaded or dizzy, or have tender breasts for a short while when you take the morning-after pill.
If you have underlying medical history and you are unable to use The Pill, you won’t be able to take The Morning After Pill.
Emergency Contraception (EC) is intended for emergency use only and should not replace regular contraception.
EC can lower your chance of getting pregnant by 75-89% if you take it within 72 hours after unprotected sex.
But the longer you wait to take it, the less effective it is.
If you throw up within 2 hours of taking the pill, it won’t work and you’ll need to take it again.
For more detailed information please see www.morningafter.co.za
Reference: 1. National Contraception Clinical Guidelines, A companion to the National Contraception and Fertility Planning Policy and Service Delivery Guidelines, Department of Health, December 2012. 2. Birth Control, Planned Parenthood (https://www.plannedparenthood.org/learn/birth-control) accessed 04 July 2020. 3. Birth Control, They Mayo Clinic (https://www.mayoclinic.org/healthy-lifestyle/birth-control/basics/birth-control-basics/hlv-20049454) accessed 04 July 2020
Understanding Oral Contraception
Endometriosis Facts
Emergency Contraceptives
Empowered Menopause