By today’s estimates, it takes more than $450,000 to raise a child from birth to legal maturity, including four years at a public university. That’s not even counting the psychological impact of creating and being responsible for someone for the next two or three decades.
Without any type of contraception, 85 percent of women having unprotected vaginal sex will become pregnant within a year.
For anyone who is sexually active and within their reproductively capable years, statistics like these keep birth control on the active radar screen.
The idea of birth control is nothing new. The history of contraception encompasses miscarriage-inducing herbs, infanticide, primitive barrier methods and even cast iron chastity belts. Thankfully, today’s methods are largely safe, easy to use and effective.
"Selecting a contraceptive is a really individual thing. Lots of factors figure into the decision," said Margaret Trout, RN, Interim Assistant Director of PSU’s Center for Student Health and Counseling (SHAC),
When choosing a method of birth control, there are several key considerations. Will it fit into your lifestyle? How convenient is it? Is it effective? Is it safe? Can you afford it? Can you reverse it later? Will it protect you against sexually transmitted diseases (STDs)?
Many contraceptives – for example, condoms and spermicides – can be obtained without prescription from the local pharmacy or grocery store. For birth control requiring medical examination or prescription, the personal physician or nurse practitioner is always a good choice. Planned Parenthood is an excellent source for counseling and for all types of contraceptive devices. The SHAC at Portland State is a valuable resource for students seeking birth control, particularly those on a budget.
Finally, it’s important to note that an effective contraceptive isn’t necessarily also effective at preventing STDs. For example, a woman taking birth control pills should still insist that her male partner wear a condom for protection against STDs. A physician or health agency (such as Planned Parenthood) is the best resource for coordination this sort of information and planning, as is SHAC.
Here is a rundown of a few of the most common and safe ways to protect yourself from STDs and unwanted pregnancy.
The barrier methods are all reasonably inexpensive, and when used properly are highly effective. Some are available over the counter; others require prescription.
Perhaps the most common and well-known form of birth control is the male latex condom. They are easy to obtain, often free, and easy to use. The drawback is that condoms are not 100 percent effective at preventing pregnancy. However, they are one of the most effective means of protecting yourself from STDs. Non-latex condoms are also available for people with latex allergies.
Female barrier methods include diaphragms, caps, shields and female condoms.
These are soft latex or silicone barriers that fit inside of the vagina and cover the cervix, preventing sperm from entering the uterus and encountering an egg.
Female barriers are always used with spermicidal cream or jelly. Male condoms are also much more effective if used with spermicides.
The contraceptive sponge, placed deep within the woman’s vagina, combines a barrier with a spermicide. When used with another male or female barrier method, it is quite effective.
Pills, shots and patches
To date, all hormone-regulating contraceptives are for females’ use only. The most common of these is the oral contraceptive, or birth control pill.
There are two main types of oral contraceptive available. One type works by thickening the cervical mucus to prevent the sperm from passing into the uterus. The other type has the same mucus-thickening effect but also prevents the ovary from releasing its monthly egg (a part of the normal menstrual cycle).
Oral contraceptives are highly effective against pregnancy when used as directed. However they can cause side effects, and because of their relationship to strokes, blood clots and migraines cannot be used by all women. They also require a prescription and can be expensive over time.
While the basic student health insurance doesn’t cover prescription medications, SHAC offers birth control pills to students for as little as $7 per month.
"We sell our prescriptions cheaply, because we get good price through our state contract. If students are purchasing contraceptives, we’re much cheaper than Fred Meyer," Trout said.
Other types of hormone-related contraception are administered through trans-dermal patch, under-skin inserts, vaginal ring or long-lasting intramuscular injection. These vary greatly in effectiveness and level of protection, and their use is best discussed with a health care provider.
Most of these are available through the PSU SHAC, including Depo-Provera and versions of the patch, the ring, and the inserts.
In case of emergency…
Another kind of hormone-regulating method is emergency contraception, also known as "the morning-after pill."
The morning-after pill consists of a large dose of hormones (estrogen and/or progestin) that prevents pregnancy after an act of unprotected intercourse or sexual assault. The medication can be provided by physician, health clinic or emergency room.
SHAC provides its own PSU version of the morning-after pill, known as "Plan B."
"I don’t think we have enough advertisement for Plan B. If more of the female students knew about it, it would be great," Trout said. "If we do a student’s annual exam, and they tell us they’re using condoms as their primary type of birth control, we’ll offer them a prescription of Plan B to keep on hand."
SHAC sells Plan B for $9.50 per use, about half of what it’s sold for elsewhere.
According to Trout, Plan B works best when students have it on hand at home, to take immediately following an episode of unprotected sex.
"It’s most effective when taken right away. It’s even still somewhat effective if taken within 72 hours," Trout said.
In some states, the State Board of Pharmacy has achieved legislation allowing pharmacists to dispense the morning-after pill. While this hasn’t happened in Oregon, pharmacies in Washington may dispense morning-after medication without a prescription.
The intrauterine device, or IUD, is a small flexible plastic device that it placed within the uterus. IUDs available in the United States are also impregnated with either copper or hormones and are designed to stay in place for up to five years.
Although their mechanism of action is unknown, IUDs work by preventing fertilization and/or by preventing the fertilized egg from implanting in the uterine lining. The additional copper or hormone substrates have additional anti-pregnancy action.
"We’ve been carrying IUDs at SHAC for about a year. The IUD works out to be pretty cheap if you keep it in for the full five years," Trout said.
Copper IUDs are also an effective means of emergency pregnancy protection if placed immediately after an act of unprotected intercourse.