The Ins and Outs of Contraception

There are many different forms of contraception, most of which will be covered here. Educating yourself about the effectiveness of contraceptives will empower you to make informed decisions about your body. The method you choose will depend on your general health, lifestyle and relationship. You will need to weigh up the benefits and possible negative effects of each method and look at how these methods fit in with your current and future needs.

It is important to practice safe sex as well as protect yourself against pregnancy. Not all contraception methods provide protection against sexually transmissible infections (STIs). Barrier methods can be used in conjunction with other contraceptive methods to reduce the risk of infection.

Forms of contraception can be broken into the following categories:

Physical barriers and devices
Spermacides
Oral hormone contraceptives
Hormonal implants, devices and injectables
Sterilisation
Natural Methods
Emergency Contraception

The most effective methods in typical use are those that do not depend upon regular user action. Surgical sterilization, Depo-Provera, implants, and intrauterine devices (IUDs) all have first-year failure rates of less than one percent for perfect use and typical use. Other methods may be highly effective if used consistently and correctly, but can have typical use first-year failure rates that are considerably higher due to incorrect or ineffective usage by the user.

Physical barriers and devices
Physical barriers and devices either prevent sperm from reaching an ovum (egg) for fertilisation or prevent implantation of a fertilised egg.

Male condom – a latex (or polyurethane) sheath that covers the erect penis and prevents semen entering the vagina.

Advantages:

A highly (95–98%) effective form of contraception when used properly with motivation and cooperation from both partners
Relatively cheap and are available over the counter from supermarkets and pharmacies
Easily transportable in a wallet or pocket and can be carried by either partner
Provide a high level of protection against STIs

Disadvantages:

Do not provide complete protection against genital herpes, syphilis, chancroid, or HPV because the STIs can be transmitted across infected skin surfaces not covered by the condom
Fingernails, a ring, or anything sharp can easily cause tearing and holes in the condom
Oil based lubricants, such as Vaseline or sun tan oil, can cause a hole in a condom.
The man must pull out soon after ejaculation or the condom could fall off and spill or be left in the vagina
Some people are sensitive or allergic to latex

Female condom – a loose polyurethane sheath with a flexible ring at each end that sits in the vagina and collects semen. It can be inserted many hours before intercourse and is stronger than the male latex condom, but may take some practice with insertion and use. Female condoms are available in many pharmacies and sexual health clinics. They provide a high level of protection against STIs and have an effectiveness rate of 80–95 per cent if used properly.

Advantages:

Give women more control and a sense of freedom
A woman doesn't need to see a clinician to get it. No prescription or fitting is needed
Can be put in several hours in advance of sexual intimacy
Safe and fairly effective at preventing both pregnancy and infection
Any lubricant may be used with the female condom
Comes with its own lubricant
Can be used by individuals who are allergic or sensitive to latex
Polyurethane transmits heat well. This may make sex more fun

Disadvantages:

Its size and unattractiveness may decrease enjoyment of sex
Will not work if the man's penis slides in outside of the female condom
Can make rustling noises prior to or during intercourse
Takes practice to use it right
Can be hard to use
Not available in as many stores as the male condom and may be hard to find
About three times more expensive than male condoms

Diaphragm – a soft, shallow rubber dome that fits in the vagina, covers the cervix and stops sperm from entering the uterus. The diaphragm must stay in place for at least six hours after intercourse and is 85–95 per cent effective depending on correct use, fit and positioning. Diaphragms are fitted by a doctor or through a visit to a reproductive health clinic. Diaphragms do not provide protection against STIs.

Advantages:

Gives a woman fairly good control over contraception
When used perfectly, only six women in 100 become pregnant the first year using a diaphragm
It can be put in up to several hours in advance of sexual intercourse
No hormones and no side effects
The penis can remain inside the vagina after ejaculation

Disadvantages:

Must be fitted by a clinician
You must wash your hands with soap and water before putting a diaphragm in
Inserting the diaphragm may interrupt sex
A woman has to take it with her on vacations or trips
A diaphragm increases a woman's risk for urinary tract infections
It is difficult for some women to insert a diaphragm properly even after being taught
If left in too long, it slightly increases a woman's risk for a very serious infection called toxic shock syndrome. Don't leave a diaphragm in for more than 24 hours after intercourse.
It may slip out of place during sex. If you change who is on top, you may want to check to see that the diaphragm is still covering the cervix.
After putting it in, a woman should check to be sure it is covering the opening of the cervix
A new fitting may be necessary after having a baby, abortion or miscarriage, or gaining 15 pounds
It is not recommended that you use a diaphragm during menstruation

Cervical cap – a soft, rubber dome-shaped cap with a flexible rim that fits over the cervix and prevents sperm coming in contact with an egg. Cervical caps are similar to diaphragms in use and fitting methods, but may be more difficult to use. Cervical caps do not provide protection against STIs. The effectiveness of cervical caps ranges from about 75–91 per cent, depending on the number of children the women has previously had.

Advantages:

Small and easy to carry
May be put in up to one hour before sex
It will work continuously for 48 hours
It does not matter how many times a couple has sex as long as you leave it in at least six to eight hours after the last time you have sex
Your partner doesn't have to know you are using it

Disadvantages:

Must be fitted by a clinician
You must wash your hands with soap and water before putting in the cap
It may interrupt sex
A woman has to take it with her on vacations or trips
It increases a woman's risk for inflammation of the surface of the cervix
It is difficult for some women to insert a cervical cap properly even after being taught
If left in too long, increases slightly a woman's risk for a very serious infection called toxic shock syndrome. Don't leave your cervical cap in for more than 48 hours.
It may accidentally be placed onto the cervix improperly or may slip out of place during sex
After putting it in, a woman must check to be sure it is covering the cervix
New fitting may be necessary after a baby, abortion, miscarriage, or gaining 15 pounds
Latex may cause irritation or a woman may be allergic to it
A woman should have a new cap each year
You need fresh spermicidal cream or jelly each time you use your cap
It is not recommended that you use a cervical cap during menstruation

Contraceptive Sponge – acts as a barrier to prevent semen from entering the cervix. The sponge is more effective with women who have never given birth than with women who have. With typical use of the sponge, about 16 percent of women will experience pregnancy within one year. With consistent and correct use of the sponge, about nine percent of women will experience pregnancy within one year.

Advantages:

Easy to use, relatively inexpensive, and available without prescription
Because you may insert the sponge when your sex partner is not present, they offer a good measure of contraceptive privacy
The sponge offers continuous protection for up to 24 hours after insertion, no matter how many times you have sex
Because vaginal barrier methods, including the sponge, protect the cervix, they may help in preventing some sexually transmitted infections, including gonorrhea, chlamydia, and trichomoniasis

Disadvantages:

For each act of sex, you need a fresh, unopened sponge and clean water
You need to wash your hands with soap and water before you insert the sponge
The sponge must be inserted into the vagina and up against the cervix prior to the penis entering the vagina
Some women find it difficult to place the sponge correctly
Some women have difficulty removing the sponge
If left within the vagina for more than 30 hours, the sponge slightly increases your risk for a very serious infection called toxic shock syndrome. Don’t leave your sponge in for more than 30 hours.
The sponge may accidentally be placed onto the cervix improperly or may slip out of place during sex.
Sponges must be stored in a clean, cool, dark place—not in the glove compartment of a car or in a purse

Intrauterine device (IUD) – a small device inserted into the uterus that is toxic to sperm, restricts egg movement and makes it difficult for an embryo to be implanted in the uterus. Copper IUDs are the most common non-hormonal IUD. Hormonal IUDs are discussed in “Hormonal implants, devices and injectables”.

Advantages:

The second most effective reversible method, rivaling surgical sterilization in preventing pregnancy
Effective for at least 10 years
Provides a very effective (98–99.5%) form of contraception
Prevents ectopic pregnancies
Far more readily reversible than tubal sterilization or vasectomy
Protects against endometrial cancer
Very low cost over time
Convenient, safe and private

Disadvantages:

There may be cramping, pain or spotting after insertion
The number of bleeding days is slightly higher than normal and you could have somewhat increased menstrual cramping
No protection against sexually transmitted infections
High initial cost of insertion
Must be inserted by a doctor, nurse practitioner, nurse midwife or physician's assistant
A small percentage of women are allergic to copper

Spermacides
Spermacides are designed to kill sperm before the enter the cervix. Among typical couples who initiate use of vaginal spermicide, 29 percent of women will experience an accidental pregnancy in the first year. If vaginal spermicide is used consistently and correctly, about 18 percent of women will become pregnant. They are best used in conjuction with a barrier method.

Contraceptive film – a two inch by two inch thin sheet with a chemical (nonoxynol-9) that kills sperm. It is placed on or near the cervix (the opening of the womb). It dissolves in seconds.

Advantages:

Simple to use
It is not messy; there is no discharge. It is virtually undetectable and discreet. You can't tell it is there.
Can be brought at most drug stores; no prescription is needed
A woman does not need her partner's help
Film may be used alone or with a diaphragm or a condom
It reduces the risk of getting some sexually transmitted diseases

Disadvantages:

It must be inserted no longer than one hour before sex
Inserting it may interrupt sex
A woman must use a new film each time she has intercourse
The film must make contact with the cervix in order to be effective
A woman must wash hands with soap and water before putting the contraceptive film in. She must also dry hands carefully to keep the film from sticking to her fingers.
Some people may be sensitive to film or find it causes irritation
It is not as effective as some other contraceptives
Contraceptive film does not adequately protect from the HIV/AIDS virus or other STIs
Frequent use of nonoxynol-9 can cause irritation which may increase susceptibility to HIV and other STIs

Contraceptive foam – a foam placed into the woman's vagina using an applicator. It kills or destroys sperm and blocks the man's fluids from entering the cervical canal. Foam stops sperm from getting to the egg.

Advantages:

Gives the woman control over use of a contraceptive
Available over the counter without a visit to a clinician
Can be put into the vagina up to 20 minutes before sexual intercourse, but it is also effective immediately
Safe, has no hormones and is immediately reversible
The man's penis can remain inside the vagina after ejaculation

Disadvantages:

Can be irritating to the vagina, and some people feel that it is messy
May not be protective against HIV/AIDS
Some women do not like placing an applicator up into the vagina
The taste of foam is unpleasant
The container carrying the foam is large and some may find it embarrassing to carry around

Contraceptive suppositories – inserted deep into the vagina before sexual intercourse. The suppository melts, releasing spermicide. The spermicide prevents sperm from moving toward the egg and also protects the cervix.

Advantages:

Inexpensive and available without prescription
Can be used by any woman who wants to use them
Remain effective for about one hour after insertion

Disadvantages:

Some brands of spermicide may irritate the penis or vagina
Cannot safely be used many times in one day
A new suppository must be inserted deep into the vagina prior to each act of sex
If not used exactly as directed, the suppository may not form a good barrier over the cervix
Can be messy

Oral hormone contraceptives
Oral contraceptives provide hormonal contraception for women in the form of a daily pill that is available by prescription. Hormonal contraceptives are a highly effective (94–99%) form of contraception, if used correctly. They may produce side effects and don’t protect against STIs. There are two types of oral contraceptives – the combined pill and the mini-pill.

Combined pill – made up of the synthetic forms of the hormones oestrogen and progesterone. The combined pill prevents ovulation, thickens cervical mucus to make it harder for sperm to enter the uterus and changes the lining of the uterus to make it less suitable to receive a fertilised egg. There are many types of combined pills with different dose and hormone combinations. Among typical couples who initiate use of combined pills about eight percent of women will experience an accidental pregnancy in the first year. But if pills are used consistently and correctly, just three in 1,000 women will become pregnant.

Advantages:

Very effective when used consistently and correctly
Decrease a woman's risk for cancer of the ovaries and cancer of the lining of the uterus (endometrial cancer)
Lower a woman's chances of having benign breast masses
Significantly decrease a woman's menstrual cramps and pain
Reduce menstrual blood loss and anemia
Reduce PMS symptoms
Can reduce prevalence of acne by up to two-thirds
Some clinicians will provide pills without a pelvic exam
Suppress endometriosis

Disadvantages:

A woman must remember to take the pill at the same time every day
Inconsistent use greatly diminishes the effectiveness of the contraception
Nausea and/or spotting are the two problems women may have the first month
Missed periods or very light periods
Tend to make periods very short and scanty
A woman may see no blood at all. Most women like this when they understand it is to be expected.
Some women experience headaches, depression or decreased enjoyment of sex
Serious complications such as blood clots are rare, but do occur
Can be quite expensive and usually require a prescription
Use is associated with a statistically higher risk of developing cervical dysplasia. Pills users with dysplasia who also have HPV (human papillomavirus) have a three- to four-fold higher risk of developing cervical cancer.
Pill users who smoke or have hypertension are at significantly higher risk of suffering a stroke, compared to other pill users. Pill users who smoke are also at significantly higher risk of a heart attack, compared to pill users who do not smoke and to other women.
Do not protect from HIV/AIDS or other STIs.
Not recommended for breastfeeding mothers due to the reduced supply of breastmilk and risk of hormones passing through to the baby

Mini-pill – contains only the synthetic form of progesterone. It makes the cervical mucus thicker, which prevents sperm from entering the uterus. This pill must be taken every day at the same time. The mini-pill is suitable for women for whom oestrogen is not recommended, such as breastfeeding mothers. Among typical couples who initiate the use of progestogen-only pills about eight percent of women will experience accidental pregnancy in the first year. But if these pills are used consistently and correctly, just three in 1000 women will become pregnant.

Advantages:

Do not have oestrogen related side effects and can be taken by women who have had side effects or complications using oestrogen-containing pills
The amount of the progestogen in minipills is less than in combined pills
Nursing mothers can take progestogen-only pills (preferably after the baby is six weeks old)
Cause scanty menstrual flow and less anemia.
Reduce menstrual cramps, pain, headaches, mood swings, and breast tenderness.
Are associated with reduced risk of endometrial cancer, ovarian cancer, and pelvic inflammatory disease (PID).
Can help manage the pain associated with endometriosis

Disadvantages:

Menstrual irregularity is the big problem with minipills. While the amount of blood lost is less, bleeding may be at irregular intervals and there may be spotting between periods.
Tend to make periods very short and scanty. A woman may go several months with no bleeding at all, and some women do not like this.
A woman must remember to take a pill at the same time every single day
Some women using minipills gain weight or complain of feeling bloated
Some women using minipills experience increased symptoms of depression
Do not protect from HIV/AIDS or other STIs

Hormonal implants, devices and injectables
Hormonal contraceptives for women are also available as implants, devices and injectables. As for oral hormonal methods, these are highly effective if used correctly, but may produce side effects and don’t protect against STIs. Male injectable contraceptives are currently being trialled.

Implanon – a hormone implant inserted under the skin at the inner side of the upper arm. It contains etonogestrel, a progesterone-like hormone that prevents ovulation and hinders sperm from entering the cervix (by changing cervical mucus). Implanon lasts for three years, is close to 100 per cent effective and is suitable for women who can’t tolerate synthetic oestrogens. The device is inserted by a doctor under local anaesthetic.

Advantages:

Very effective and long lasting. In a study, no pregnancies occurred among the first 70,000 cycles of Implanon users.
There is nothing to do on a daily basis or at the time of intercourse
Women lose less blood during menstruation. They also have less cramping, headaches, and breast tenderness.
Depression and premenstrual symptoms may improve

Disadvantages:

Implants are quite likely to cause irregular periods in some women. As time goes on a woman's periods may become more regular.
You may gain weight, lose hair, develop headaches or note darkening of the skin over your implants
May cause some arm discomfort
Depression and premenstrual symptoms may become worse
A woman may have trouble finding a clinician who will remove her implants
Can cause problems if not inserted correctly
Do not protect from HIV/AIDS or other STIs.

Depo Provera – a long-acting (12 to 14 weeks) injectable contraceptive containing the hormone progestogen. It prevents ovulation, makes the cervical mucus impenetrable to sperm and causes changes in the lining of the uterus to make it unsuitable for a fertilised egg to implant. It is highly effective (failure rate of 0.01%) and is sometimes used to treat women with menstrual problems.

Advantages:

Nothing needs to be taken daily or at the time of sexual intercourse
Injectables are extremely effective
Women lose less blood during menstruation when they are using injectables and have less menstrual cramps
Privacy is a major advantage: no one has to know a woman is using this method
Nursing mothers can receive injections; it is best to receive after the baby is six weeks old
It is okay for a woman to start another contraceptive method if it is less than 13 weeks since the last shot
Injectables may lead to improvement in PMS (premenstrual symptoms), depression or symptoms from endometriosis

Disadvantages:

Injections can lead to very irregular periods
Some women gain weight
A woman has to return every three months for her injection
Depression and premenstrual symptoms may become worse
Do not protect you from HIV infection or other STIs
It may be a number of months before a woman's periods return to normal after her last shot
May cause bone loss, especially in smokers
Some women are allergic to injectables

Mirena IUD and LNG-IUS – a small T-shaped device that releases small amounts of a progesterone-like hormone into the uterus. It increases the thickness of the cervical mucus, making it difficult for sperm to enter the cervix. It also thins the lining of the uterus to prevent fertilised eggs from implanting.

Advantages:

The most effective reversible method, rivaling surgical sterilization in preventing pregnancy. It is close to 100 per cent effective.
Prevents ectopic pregnancies and pelvic inflammatory disease, decreases menstrual cramping and dramatically decreases menstrual blood loss.
May be left in place for up to five or seven years, depending on the exact type of device.
Safe, inexpensive over time, and provides extremely effective long-term contraception from a single decision

Disadvantages:

Often changes the menstrual cycle. A woman has more bleeding days than normal for the first few months and less than normal after six to eight months.
Provides no protection against sexually transmitted infections.
High initial cost of insertion

Contraceptive Ring – known as NuvaRing, it is a small, flexible device that a woman inserts into her vagina once a month. She leaves it in place for three weeks and takes it out for the remaining week of her menstrual cycle. The ring releases combined hormones (oestrogen and progestogen) to protect against pregnancy. Although no studies have yet been published, experts believe that the ring will be as effective as the combined pill: out of 100 typical couples who rely on the ring for contraception, eight percent of women may accidentally get pregnant. Among women who use the ring perfectly, fewer than one percent should get pregnant.

Advantages:

Must be inserted only once each month
Means you don’t have to do anything at the time of sexual intercourse
Can be placed anywhere in the vagina
Does not require fitting
Frequently causes more regular, lighter, and shorter periods
Is quickly reversible
Helps prevent menstrual cramping and premenstrual symptoms as well as headaches and depression
May protect against medical problems such as ectopic pregnancy, pelvic inflammatory disease (PID), cysts, and cancer of the ovaries and of the uterus)
May enhance sex because you don’t have to worry about pregnancy

Disadvantages:

You must remember to keep the ring in place for three weeks and then to remove it three weeks to the day after you inserted it
You must remember to insert a new ring on the same day one week after you removed the old ring
You must wash your hands with soap and water prior to inserting the ring
Could slip out: if it does, you must replace it within three hours
You must wrap the ring in foil and throw it in the trash. It must not be flushed.
May cause increased spotting, breast tenderness, nausea and vomiting and mood swings for the first three months of use
May cause vaginal irritation or infection and increased vaginal discharge
As with other forms of combined hormonal contraception, the ring slightly increases your risk of blood clots, especially if you are 35 or older and smoke
Does not provide any protection from STIs, including HIV

Contraceptive patch – a lightweight, thin, flexible, beige-colored patch. It has three layers: the outer, protective, polyester layer; the medicated, adhesive layer; and a protective liner which is removed prior to applying the patch. The patch can be applied to the skin of the buttock, abdomen, upper torso (but not the breasts), or the outside of the upper arm. Each patch lasts seven days. Women replace the patch each week for three weeks, then have a seven-day patch-free week, during which time they begin their menstrual bleeding. During a year of typical use, eight women will experience pregnancy; with perfect use, only three in 1,000 women will experience pregnancy.

Advantages:

Used properly and consistently, the patch is highly effective at preventing unintended pregnancy
Easy to use, since it needs to be applied only once a week
The user can easily verify that her patch is still in place
It is rapidly reversible, should you decide that you wish to conceive a child
Because the hormonal mechanisms of action are similar to that of birth control pills, experts believe the patch may provide many of the same advantages and non-contraceptive health benefits of contraceptive pills, although hard data about long-term health benefits may not be available for decades.

Disadvantages:

Women must remember to change the patch once a week for three weeks and then to resume the patch after seven patch-free days
Difficult to hide and thus offers less privacy than many other contraceptive methods
Expensive
When removed, it must be wrapped and placed in a garbage can (not flushed)
Must be stored carefully in a clean, cool, dark place—not in a purse or the glove compartment of a car
If a patch becomes dislodged and cannot be firmly reattached with ten seconds of continuous pressure, then it must be removed and replaced
Women who use the patch are vulnerable to the same health issues that arise with birth control pills, including increased risk of heart attack and stroke. Women who smoke should not use the patch.
Can cause skin irritation, redness, or rash
Can cause breast tenderness, vaginal spotting, and/or temporary interruption of menses for the first two cycles of use
Less effective in preventing pregnancy among women who weigh more than 198 pounds
Provides no protection against sexually transmitted diseases

Sterilisation
Female sterilisation – blocks the Fallopian tubes, preventing an egg from passing down the tube and being fertilised. Tubal ligation (having your tubes tied) or Essure micro-inserts are the two common surgical methods used. Both are permanent surgical procedures that require referral to a specialist. Female sterilisation methods have a very low failure rate (0.2%) but do not provide protection against STIs.

Vasectomy (male sterilisation) – involves cutting the sperm ducts in the testes to prevent sperm entering the semen. Vasectomy is a highly effective, permanent surgical procedure that requires referral to a specialist. Vasectomy doesn’t protect against STIs.

Advantages:

Low failure rate
A permanent solution

Disadvantages:

Does not provide protection against STIs
Non-reversible should you change your mind

Natural & Behavioural Methods

Abstinence – the avoidance of sexual contact or intercourse.

Advantages:

Free and available to all
100% effective method of preventing sexually transmitted infections (STIs) and unwanted pregnancy
Can be started at any time in one's life
May encourage people to build relationships in other ways
May be the course of action which you feel is right for you and makes you feel good about yourself

Disadvantages:

If you're counting on abstinence, and change your mind in the heat of the moment, you might not have birth control handy. Some people would like to be prepared and have a condom and spermicide available in case they change their mind. Others feel that having a contraceptive ready and available might tempt them.
Some people find not having sex too frustrating

Outercourse – alternatives to sexual intercourse, usually referring to types of sexual intimacy which do not involve oral, vaginal, or anal sex. This may include:

Holding hands
Hugs
Kisses
Petting above the belt
Petting below the belt
Mutual masturbation

Outercourse does take some discipline. Both partners must be committed to this method or else these forms of sexual intimacy can lead to sexual intercourse. It works better if there has been communication in advance. Decide in advance what sexual activities you will say "yes" to and discuss these with your partner. Tell your partner, very clearly and in advance, not at the last minute, what activities you will not do. At the same time learn more about the methods of birth control and safer sex so that you will be ready if you change your mind.

Advantages:

Needs no supplies and is free
Fun: for some it's more fun than sexual intercourse
No worry about pregnancy
No fluid is exchanged, providing protection against sexually transmitted infections
Can increase emotional closeness between individuals

Disadvantages:

For some partners, the desire to have intercourse can cause stress
This method may have either partner thinking, "Is this going to go farther than I want?" This concern may decrease enjoyment
Touching your partner's genitals or anal area during masturbation could possibly result in transmitting STIs. You may want to use some method of protection, such as latex gloves.

Withdrawal – also known as Coitus Interruptus, the “Pulling Out” method or affectionately for us Aussies as “getting off at Redfern”. When the man senses that he is about to come, he pulls his penis out of the vagina. He ejaculates outside of the vagina. This takes a lot of discipline! If the woman has not had an orgasm, the man can stimulate her in other ways after withdrawal. It works best if the couple has agreed to use this method in advance. Among typical couples who initiate use of withdrawal, about 27 percent of women will experience an accidental pregnancy in the first year. If withdrawal is used consistently and correctly, about 4 percent of women will become pregnant. Use in combination with spermicides for increased effectiveness.

Advantages:

Always an option
Definitely better than no method at all
No fluid or much less fluid is deposited in the woman's vagina. This means that there is somewhat less chance of infection spreading from a man to a woman.
It has no medical complications, no hormones, no supplies, and is free.

Disadvantages:

The big problem is the desire to keep thrusting when it is time for a man to pull out
The concern of whether the male will withdraw in time may decrease both partners' enjoyment of intercourse
Provides poor to no protection against STIs, including HIV
A low risk of semen being present in the pre-ejaculate fluid

Fertility awareness – a means of understanding a woman's reproductive cycle by observing and writing down fertility signs. These signs determine whether or not she can become pregnant on a given day. A woman is actually fertile during only about a fourth of her cycle.
The three primary fertility signs are a woman's temperature when she first wakes up, her cervical fluid (the fluid at the mouth of a woman's womb) and the position of her cervix. The fertility awareness method permits a woman to use this information so that she may abstain from intercourse when she is most fertile. The failure rate among women who use this method perfectly is two to three percent; while the failure rate among most women who use this method is 13 to 20 percent.
Before ovulation, waking temperatures remain low, cervical fluid looks similar to raw egg white, becomes wet and then dry and the cervix rises and becomes softer and open. After ovulation, Waking temperatures rise for 12 to 16 days.
Cervical fluid quickly dries up after ovulation.
Cervix quickly drops and becomes firm and closed after ovulation

Advantages:

Helps a woman track and improve PMS (premenstrual syndrome) symptoms
Empowers women with practical knowledge
Helps a woman know when during her cycle to have sex to become pregnant or to avoid pregnancy, depending on her goal
Useful in conjunction with other contraceptive methods, such as barrier contraceptives and withdrawal

Disadvantages:

Provides no protection against sexually transmitted infection
Involves daily charting of fertility signs
Requires discipline for a number of days in the cycle if a woman chooses to avoid sex rather than use a barrier contraceptive during her fertile days
As a contraceptive, this method is unforgiving of improper use. If a woman has sex when this method tells her to abstain, she is very likely to become pregnant.
Abstinence is required at the time in a woman's cycle when her sexual urge is usually at its peak

Statistical methods – such as the Rhythm Method and Standard Days Method are dissimilar from observational fertility awareness methods, in that they do not involve the observation or recording of bodily cues of fertility. Instead, statistical methods estimate the likelihood of fertility based on the length of past menstrual cycles. Statistical methods are much less accurate than fertility awareness methods, and are considered by many fertility awareness teachers to have been obsolete for at least 20 years.

Advantages:

Helps a woman know when during her cycle to have sex to become pregnant or to avoid pregnancy, depending on her goal

Disadvantages:

Provides no protection against sexually transmitted infection
Highly unreliable when periods are irregular
Requires discipline for a number of days in the cycle if a woman chooses to avoid sex rather than use a barrier contraceptive during her fertile days
As a contraceptive, this method is unforgiving of improper use. If a woman has sex when this method tells her to abstain, she is very likely to become pregnant.
Abstinence is required at the time in a woman's cycle when her sexual urge is usually at its peak.

Lactational Amenorrhea Method – a method of exploiting the natural period of infertility after the birth of a child. As long as the nursing mother is exclusively breastfeeding (nursing frequently day and night with no supplemental feedings), the baby is younger than 6 months of age, and the mother has not started having periods, she is more than 98% protected against pregnancy. This period of exclusive nursing means not only no supplemental feedings of water or formula, but also little or no pacifier use. All of the baby's sucking needs are met at the breast, which means demand feedings around the clock. As long as the mother has had no vaginal bleeding after 56 days postpartum, and the baby receives no supplemental feeds, she has only about a 2% chance of becoming pregnant.

Fertility is most effectively suppressed when the baby goes no longer than four hours during the day and six hours at night between feedings. The pattern of breastfeeding is a key factor, but the mother's own body chemistry also has an influence.

Advantages:

Highly effective for nursing mothers provided breastfeeding occurs exclusively
Free and readily available
Nourishes baby and improves bondin while providing contraception
Excellent health benefits for mother and baby
Comparable to the contraceptive pill for effectiveness

Disadvantages:

Not able to be used by women who are not breastfeeding
Unreliable once the baby is six months old
Unreliable once feeds stretch past four hourly during the day or six hourly at night
Unreliable once menstruation has returned

Emergency Contraception
Sometimes it’s necessary to prevent pregnancy after sex rather than before: for example when a pill is forgotten, a condom breaks or in the case of rape. Emergency contraception is a hormonal method of contraception that prevents or delays ovulation in that cycle or stops a fertilised egg from implanting in the uterus.

There are different types of emergency (‘morning after’) pills available. The most commonly used form – two tablets of progestogen hormone – can be prescribed by a doctor or is available over the counter at many pharmacies (in Australia at least). These pills must be started within 72 hours of unprotected sex. Copper intrauterine devices may also be used as emergency contraception. For this use, they must be inserted within five days of the birth control failure or unprotected intercourse.

Advantages:

A good back-up method in case of emergency

Disadvantages:

Not a method to solely rely upon
Causes more stress than preventative methods
Ethical and moral issues may impede the availability of the morning after pill

Misconceptions
Modern misconceptions and urban legends have given rise to a great deal of false claims:

The suggestion that douching immediately following intercourse works as a contraceptive is untrue. While it may seem like a sensible idea to try to wash the ejaculate out of the vagina, it is not likely to be effective. Due to the nature of the fluids and the structure of the female reproductive tract – if anything, douching spreads semen further towards the uterus. Some slight spermicidal effect may occur if the douche solution is particularly acidic, but overall it is not scientifically observed to be a reliably effective method.
The suggestion to shake a bottle of Coca-Cola and insert it into the vagina after ejaculation is not a form of birth control, it does not prevent pregnancy, and doing this can also promote candidiasis (yeast infections).
It is a myth that a female cannot become pregnant as a result of the first time she engages in sexual intercourse.
While women are usually less fertile for the first few days of menstruation,it is a myth that a woman cannot get pregnant if she has sex during her period.
Having sex in a hot tub does not prevent pregnancy, but may contribute to vaginal infections.
Although some sex positions may encourage pregnancy, no sexual positions prevent pregnancy. Having sex while standing up or with a woman on top will not keep the sperm from entering the uterus. The force of ejaculation, the contractions of the uterus caused by prostaglandinsin the semen, as well as ability of sperm to swim overrides gravity.
Sneezing after sex is also completely ineffective.
Urinating after sex does not prevent pregnancy and is not a form of birth control, although it is often advised anyway to help prevent urinary tract infections.
Toothpaste cannot be used as an effective contraceptive

Information sourced from:
www.advocatesforyouth.org . . .
www.betterhealth.vic.gov.au . . .
en.wikipedia.org . . .
www.storknet.com . . .