- There are a lot of myths surrounding contraception.
- Hormonal birth control is effective at preventing pregnancy when taken correctly
- INSIDER reached out to two experts to bust some contraception myths
Birth control has always been a hot topic. Since couples have sex for a number of reasons, knowing how to prevent pregnancy safely is important for the health of all involved. Over the past few centuries, people around the world have experimented with ways to prevent pregnancy without abstaining from sex. During the 1600s, people in England used condoms that were made out of animal guts.
As times have evolved, so too has contraception. Today, there are a wide variety of family planning strategies that allow people to have healthy sex lives whilst avoiding unwanted pregnancy. There are still barrier methods such as condoms and diaphragms, but now there are also hormonal methods like the birth control pill, patch, shot, implant, and intrauterine device (IUD).
Despite medical advances and birth control becoming more accessible, unplanned pregnancies still remain fairly common. Although research shows that the rate of unintentional pregnancies in the US has declined over the past 30 years, the numbers still remain considerably high. According to The World Health Organisation, “26.5 million unintended pregnancies occur each year because of inappropriate use or method failure of their birth control.”
To find out the truth about some common contraception myths, INSIDER reached out to two experts on this subject.
MYTH: You can’t get pregnant if you have sex during your period
In general, people are their least fertile during and right after their menstrual period. This is the time of the menstrual cycle that happens prior to ovulation when a potentially fertilizable egg is released from the ovaries. As a result, some people may think this means they can have unprotected sex without having to worry about pregnancy.
However, according to Dr. Lauren Streicher, MD, clinical professor of Obstetrics and Gynecology at Northwestern University and author of Sex Rx, this isn’t a reliable approach at all.
She told INSIDER, “What happens is somebody may have some bleeding which they interpret as their period, when in fact, it might even be ovulation. Some people bleed a little bit when they ovulate. Or somebody might have bleeding that’s breakthrough bleeding, and it’s still not their period.”
Even if a person has a fairly regular cycle, there’s still a chance that their body might ovulate early, “Now if someone is like clockwork, and they have sex during their period – their true period, the chances of conception are tiny because ovulation is gonna occur 12 to 14 days later,” said Dr. Streicher. “But you have to keep in mind if someone has sex on day six of their period, and then they ovulate early … you never know.”
Dr. Streicher told INSIDER that sperm can live up to 72 hours and an egg can hang on for 48-72 hours. This means that the window where a person can get pregnant is much wider than people may believe.
MYTH: If a person douches or washes the vagina immediately after sex, pregnancy can be prevented
Dr. Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, told INSIDER, “The problem with this is those sperm are pretty fast little devils. Once ejaculation occurs, sperm can be within the uterus in 20 minutes. And the vigorous ones, the healthiest guys [sperm] tend to be up there the fastest, and those are the ones that are most likely to get you pregnant. [Cleaning the vagina] will get rid of a lot of sperm hanging around, but many will already have made their way into the uterus.”
MYTH: You can’t get pregnant if you have unprotected sex in a hot tub
“It’s not likely, but it is possible,” said Dr. Minkin. “Sperm do not like heat, it’s true … but the heat doesn’t kill everything.”
She noted that if the penis ejaculates semen into the vagina, the sperm can travel fast enough to make it safely up into the uterus, where they can impregnate a potential egg.
MYTH: You can’t get pregnant from unprotected sex your partner does not orgasm inside you
Typically when a person with male sex organs experiences an orgasm, the penis releases semen. That semen contains sperm that can travel up through the cervix and fertilize an egg.As a result, some people might believe if the person with a penis doesn’t climax during unprotected sex, then pregnancy won’t occur.
This, however, is not the case.
Dr. Streicher noted that prior to orgasm, the penis can expel pre-ejaculate. Dr. Streicher added that this pre-ejaculate can contain sperm that is very capable of conceiving a child. In other words – just because the partner with the penis didn’t ejaculate while inside the vagina if the penis entered the vaginal canal with some of that “pre-cum” on it, fertilization can still occur.
This is why the withdrawal method isn’t always a viable form of contraception.
MYTH: If you track your cycle every month, you don’t need hormonal birth control or condoms
Fertility awareness methods have been around for centuries, long before hormonal methods of contraception like the birth control pill, patch, IUD, and Nuvaring were invented. Today, there are still some people who say monitoring their fertility is still a sufficient method to prevent pregnancy. There are even smartphone apps that claim to simplify the process for couples by recording data about a person’s monthly cycle and their basal body temperature.
However, the effectiveness of these methods can be questionable. Mayo Clinic reports that 24 of every 100 couples using this approach will wind up pregnant within the first year of trying it.
Dr. Minkin said that the reason why fertility awareness isn’t the strongest approach to prevent pregnancy is that a person’s menstrual cycle length can vary from month to month and that the exact day the egg is released from the ovary can be late or early. This makes it difficult to figure out exactly when a person is ovulating.
She told INSIDER, “In general, you ovulate about 14 days before you get your next period. If you have a 28 day period, then you’re ovulating around day 14; counting the date of your period as Day 1 of your cycle…let’s say somebody’s shortest cycle is 21 days and their longest is 35. She’s probably ovulating anywhere from day 11 to day 21. You could be very cautious and say you’re not having sex from day nine to day 23 if you want to be super safe.”
Dr. Minkin added that fertility awareness apps might be great for monogamous couples who wouldn’t mind getting pregnant, but for anyone who is deliberately trying to avoid pregnancy, they definitely should not rely on this method alone.
MYTH: Emergency contraception is basically the same thing as an abortion
Emergency contraception, commonly called the morning after pill, is a form of hormonal contraception that a person can take after they have had unprotected sex to prevent pregnancy. Many people falsely believe that because emergency contraception is used after sex occurs, that it works as an abortion would, by destroying the embryo. This, however, is quite far from the truth.
In fact, emergency contraception is basically like a super strong version of the birth control pill in that it stops ovulation from occurring. And as long as ovulation doesn’t occur, no sperm can fertilize an egg. Dr. Minkin told INSIDER, “Any over the counter morning after pill, are hormonal contraception, and they contain progestins which are basically gonna prevent the egg from coming out.”
On the other hand, Dr. Minkin says that when a person chooses to have an abortion, they have already experienced implantation and are verifiably pregnant. This means that they did ovulate and one of their eggs was successfully fertilised during sex. When that happens, a person can acquire a prescription for Mifepristone, which terminates an existing pregnancy by suppressing the hormones the body needs to sustain it.
MYTH: The morning after pill only prevents pregnancy if taken literally the morning after sex
If a person takes the morning after pill within 72 hours of unprotected intercourse, it’s actually pretty effective at preventing pregnancy, says Dr. Minkin. There are still some risks. If a person waits too long after unprotected sex to take it, it’s possible they will still end up pregnant.
Dr. Minkin said, “If you already have ovulated [when the sex occurs], the morning after pill may not work. It’s very effective, but it’s not 100%. The statistics say approximately 7 out of 8 pregnancies will be prevented when it is used correctly … If you’ve had tha oops moment and you’re within that 72 hours, generally you’ll be fine.”
The good news is there’s still a way to prevent pregnancy from occurring if you take the morning after pill late. Dr. Minkin told INSIDER, “If you’re beyond that 72 hours, there is a prescription medication – Ella or Ulipristal, that’s approved up to five days after unprotected sex. If you call Planned Parenthood, they can help give you guidance.”
MYTH: You can’t get the morning after pill without a prescription.
For a long time, this was actually true. In the United States, it wasn’t until August of 2006 that the pill became over the counter to people over the age of 18. It would be another seven years before it became available to people of all ages, in all 50 states without a prescription.
Dr. Minkin told INSIDER, “The most important thing I try to get across [to people] is that morning after pill is [now] available over the counter … It’s available at CVS, Duane Reade, wherever [pharmacy].”
The International Consortium on Emergency Contraception reports that the morning after pill is readily available over-the-counter in 60 countries worldwide.
MYTH: You can’t get pregnant during that first week of taking birth control because the hormones are already in your body
Doctors who may encourage their patients to use supplemental contraception, like a condom, during that first week of starting hormonal birth control. However, since some pills are said to be effective immediately if taken within five days of a person’s menstrual period, it’s easy to see why they would think they don’t need to worry about using a condom.
According to Dr. Minkin, however, the reason why doctors push for people to use a backup method in the first place is because human error is always very likely. This ties directly into that statistic from the World Health Organisation that says incorrect birth control use is one of the leading causes of unwanted pregnancy.
Dr. Minkin told INSIDER, “People just starting the pill are not great at taking it on a daily basis. We tell them to make sure they have a backup method to be extra safe.”
MYTH: You can’t get pregnant if you’re breastfeeding
In order for pregnancy to occur, the person with a uterus needs to ovulate. This process happens during the part of the menstrual cycle when certain hormone levels surge and stimulate. However, when a person is breastfeeding a child, their body increases prolactin production, which inhibits those ovulation hormones. This is why many people believe they can’t get pregnant while they’re nursing a baby.
According to Dr. Streicher, however, ovulation can resume at any time. She told INSIDER, “It is true that fertility is diminished, but it is not considered to be reliable birth control.” This is because many people can’t tell when their cycle begins until they have experienced that first post-delivery menstrual period. Dr. Streicher said, “By the time they [the breastfeeding mother] has a period, that means they have already ovulated.”
She also added that a lot of people may end up tandem nursing, or breastfeeding two children of different ages because they can get pregnant shortly after giving birth.
She said, “Essentially, when someone delivers, what we tell a breastfeeding mum is if another pregnancy would be acceptable to you, then you don’t bother with contraception. But if another pregnancy would not be acceptable to you, then you do need to use contraception.”
MYTH: IUDs aren’t worth it for preventing pregnancy because they can cause infection
Although IUDs (intrauterine devices) have risen in popularity, some people fear that having the device implanted in their uterus for years puts them at risk for infection. Dr. Minkin said that the risk for developing infections because of an IUD is actually quite low. The only exception would be during those first few weeks when its newly in place.
She told INSIDER, “There is an increased risk of pelvic infection during those first few (2-3) weeks of having the IUD inserted, due to the manipulation of the uterus… once you get beyond that, there is no increased risk of the infection.” In fact, the IUD may even be helpful in preventing some pelvic infections, according to Dr. Minkin.
She said, “The great thing about the IUD is the progestin in it can make the cervical mucus hostile to sperm, and generally the way bacteria makes it up into the uterus is by riding on the backs on the sperm. So, if you make the environment hostile to sperm, you also make it hostile to the bacteria who are riding in.”
Dr. Minkin added, “I encourage everybody to use a condom, there is still that risk [of STD infection] if it’s not a monogamous situation. The IUD does not protect you from getting gonorrhea or chlamydia in your cervix.”
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