We saw this happen last November, when the Trump administration made changes to the Affordable Care Act (ACA). Under the ACA, all health insurance plans had previously been required to provide full coverage for all forms of birth control, but now exemptions are allowed based on religious and moral beliefs. Regardless of your views, here’s information on the available birth control options to help plan for the upcoming years if you don’t have health insurance or think you may lose it.
The pill
- What is it? Also called oral contraceptives, the pill is the most popular form of hormonal birth control. One pack contains a three- or four-week schedule of pills with varying strengths of estrogen and progestin.
- Effectiveness: 91%
- Pros:
- Most affordable hormonal birth control, even without insurance
- Unnoticeable and won’t get in the way of spontaneity
- Can be used to regulate or control periods
- Side effects vary between brands, so if one doesn’t work you can try another
- You have to remember to take it every day
- Choosing from over 200 brands can be confusing at first
- Pills with estrogen are not suitable for breastfeeding women
The patch
- What is it? The contraceptive patch sticks to your skin and releases estrogen and progestin hormones into your body.
- Effectiveness: 91%
- Pros:
- Only needs to be replaced once a week for three consecutive weeks
- Unnoticeable and won’t get in the way of spontaneity
- Can help regulate periods and clear up acne
- There’s only one brand available, so it can be expensive
- Requires backup birth control if placed after the first 24 hours of your period
- May peel off if not applied properly
- Less effective for women over 198 lbs.
- Not suitable for breastfeeding women
The ring
- What is it? The contraceptive ring is a small, flexible ring that releases progestin into your body. It needs to be inserted into the vagina in order to work.
- Effectiveness: 91%
- Pros:
- Only needs to be replaced once a month
- Unnoticeable and won’t get in the way of spontaneity
- Periods usually become lighter and shorter after the first few months and may stop altogether if used continuously
- Can help clear up acne
- There’s only one brand available, so it may be expensive
- You have to be comfortable inserting it and taking it out
- Requires backup birth control if inserted after the first 24 hours of your period
- May fall out (rare, but it happens)
- Some people may feel it during sex (but you can take it out for a maximum of three hours within 24 hours)
- Not suitable for breastfeeding women
The shot
- What is it? The “Depo” shot is a progestin injection that has to be taken every three months.
- Effectiveness: 94%
- Pros:
- Available as an affordable generic
- Only needs to be administered once every three months
- Unnoticeable and won’t get in the way of spontaneity
- Periods usually become lighter and shorter after the first few months and may stop altogether
- Safe to use while breastfeeding
- Not for people who are afraid of needles
- Requires an appointment every three months unless you do it yourself at home (may cost up to $150/visit)
- Common side effects include heavy bleeding and weight gain in the first six to 12 months
- Fertility may take up to nine months from your last dose to return
The IUD
- What is it? Short for intrauterine device, the IUD is a small T-shaped device that needs to be professionally inserted into the uterus. Plastic IUDs contain progestin that is released over time, while non-hormonal copper IUDs are toxic to sperm.
- Effectiveness: 99.2%-99.8%
- Pros:
- Can last five to 12 years (depending on the brand)
- Unnoticeable and won’t get in the way of spontaneity
- Periods usually become lighter and shorter after the first few months and may stop altogether.
- Safe to use while breastfeeding
- Fertility returns immediately after removal (copper IUDs only)
- Requires an appointment for insertion or removal (may cost up to $300/visit)
- Not recommended for women with frequent infections
- Irregular bleeding can occur in the first three to six months
- Some people may feel the strings during sex at first
- Can potentially tear through the uterine wall
- Fertility may take up to four to six months to return after removal (plastic IUDs only)
The implant
- What is it? The implant is a short plastic rod that goes under the skin of your upper arm and releases progestin over time.
- Effectiveness: 99.95% (it’s the only birth control method where effectiveness in typical, everyday use is the same as “perfect use”)
- Pros:
- Lasts up to four years
- Unnoticeable and won’t get in the way of spontaneity
- Periods usually become lighter and shorter after the first few months and may stop altogether
- Safe to use while breastfeeding
- Fertility returns almost immediately after removal
- Requires an appointment for insertion or removal (may cost up to $300/visit)
- May cause irregular bleeding in the first three to six months
- You need to be comfortable with the insertion and removal process and the idea of having an implant that you can feel in your arm
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