PREVENTING PREGNANCY AND STDs

For more information about prevention of pregnancy and STDs call the "Ask Emma" line, 1-800-848-7684

Birth Control Pills

What is it?

The pill is a small tablet made of synthetic hormones which will prevent a woman from ovulating.

Where can you get it?

The pill must be prescribed by a clinician. This is important because before going on the pill the clinician must thoroughly check your medical history and give you a physical examination to make sure you would be a good candidate for the pill. After you get a prescription, you can have it filled by a pharmacist.

How do you use it?

Pills with hormones are taken for 21 days and pills without hormones, or no pills at all, are taken for 7 days. It is important to take a pill at about the same time every day. When a woman takes the pill every day, she does not ovulate, so there is no egg to be fertilized by any sperm that may enter her vagina and uterus.

How much does it cost?

Before receiving the birth control pill, the woman must have a gynecology exam. The initial exam can cost between $50-$100, and each month's supply of pills can cost between $7-$20.

Effectiveness

A woman on the pill has a 0.1%-3% chance of becoming pregnant the first year that she uses it. Of course the more consistently she uses the pill, the higher the effectiveness will be.

Pros

convenience
cramping and bleeding during the period may decrease
may have a reduced risk of developing endometrial (uterine) and ovarian cancers, ovarian cysts, endometriosis and fibrocystic breast disease.

Cons

health risks: depression, body's reduced ability to absorb vitamins B and C, blood clotting which may lead to stroke or heart attack, increased risk of developing asthma, diabetes, gall bladder disease, viral infections.
extra estrogen can help cancerous tumors grow
may worsen migraine headaches
about 40% of pill users experience some side effects
minor side effects: weight gain, nausea, high blood pressure, hair loss, vaginal infections, increased risk of STDs, water retention, headaches, oily scalp, breast tenderness.

Regular physical exercise, dietary considerations, and vitamin supplements may alleviate some minor side effects.

Condoms (Rubbers, Prophylactics)

What are they?

Condoms are made of thin latex, rubber or animal membrane and come in a variety of colors and textures. They are made to fit over a man's erect penis like a glove and catch his ejaculated semen (come) so sperm cannot enter the woman's vagina and uterus.

Where can you get them?

Condoms are sold in packages of 3 or 12 in most drug stores, supermarkets, and family planning clinics, and are often sold in bathroom vending machines.

How much do they cost?

In drug stores, most latex condoms cost between $5-$8 for a package of 12 and lambskin condoms cost about $25 for a package of 12. Birth control clinics often charge less.

How do you use them?

A condom must be rolled onto a penis while it is erect and before it has had any contact with a woman's vagina. It is also important to fold over the tip of the condom (about 1/2 inch) and hold it while putting the condom on. This allows space at the end of the penis to catch the ejaculated semen. Otherwise it is possible that the force of the ejaculation will cause the condom to burst or cause sperm to spill out of the open end of the condom and then swim up into the vagina. Some condoms have a "reservoir" tip for this purpose. Again, the tip should be removed of air and folded over or held during placement. After ejaculation and while the penis is still a little hard the penis should be removed from the vagina. The rim at the base of the condom should be held while the penis is withdrawn to prevent any semen from spilling out. The condom is then removed and thrown away.

Effectiveness

When the partner is using the condom, a woman has a 3-12% chance of becoming pregnant. If condoms are used with spermicidal foam, the chance of becoming pregnant is lowered to 2-7%. Condoms with a spermicide can also be purchased and help to reduce the chance of pregnancy. They should not be used as a substitute for the combined usage of condoms and a separate spermicide, in the form of suppository, gel, or foam.

Pros

don't need a doctor's prescription
inexpensive and easily obtained
latex condoms have been shown to decrease the risk of receiving or spreading sexually transmitted diseases, including HIV.
allows male partner to be actively involved in contraception.
relatively free of side effects.

Cons

may interrupt the spontaneity of lovemaking.
for some men condoms decrease their sensation during sex.
effectiveness depends on male partner's motivation and willingness to use consistently.
no genital contact should occur before condom is in place since pregnancy can result from an early, unexpected or unfelt release of semen from the penis.

Female Condom

What is it?

The female condom is a six inch polyurethane sheath that lines the vagina. It needs lubrication before it is inserted into the vagina. One end of the condom is open and consists of an outer ring which hangs out about one inch from the vaginal opening. The condom does not require a prescription and it may be used only once.

How much does it cost?

Each condom costs about $2.50 and are sold in packets of three, including a tube of lubricant and instructions.

Where can you get it?

The female condom is available at drug stores, and women's clinics.

How do you use it?

The ring at the closed end of the condom is squeezed and inserted into the vagina. The end of the ring at the open mouth of the sheath extends an inch beyond the vaginal opening. The penis is inserted inside the condom. During intercourse the condom lines the vagina while the outer part lies flat against the labia (this prevents skin to skin contact, providing protection for STDs.)

Effectiveness

5-21% chance of becoming pregnant. Effectiveness is increased when used with spermicide. The female condom should not be used with the male condom, since both products will not stay in place together.

Pros

rarely breaks
can be inserted before intercourse, so does not interrupt spontaneity
protects against sexually transmitted diseases
relatively free of side effects

Cons

some women have difficulty inserting the condom
reports of the condom slipping out of place during intercourse
complaints that outer ring rubs against clitoris or labia and inhibits enjoyment; however, some women say the rubbing enhances their enjoyment of sex
expensive compared to the male condom

Cervical Cap and Spermicide

What is it?

The cervical cap is a thimble-shaped rubber cap that fits snugly over the cervix. It blocks sperm from entering the cervical opening. Because cervices are different sizes, the rubber cap comes in four different sizes (from 22 millimeters to 31 millimeters.)

Where can you get it?

The cap must be fitted by a trained practitioner, which would include women's health clinics, family planning clinics and private physicians. Once the practitioner has determined the proper size of the cap, a prescription is written and can be filled by the practitioner or pharmacy.

How much does it cost?

The full gynecological exam costs approximately between $25-$60. The fitting of the cap costs between $18-$20. (The initial fitting can be $70-$130.) The cervical cap itself costs between $30-$35. Family planning or birth control clinics may charge less for their services than private gynecologists.

How do you use it?

The cap can be inserted up to forty hours before intercourse. However, FDA regulations state that it should not be left in longer than 48 hours. It is recommended that the woman use a small amount of spermicidal jelly or cream inside the cap. The cap should only be filled about one-third full so as to not inhibit the suction of the cap. It is important not to get any jelly on the outer rim of the cap. When the cap is ready, the woman inserts the open end first into her vagina until the outer ring is covering the cervix. The cap forms an airtight seal over the cervix.

Effectiveness?

A woman using the cervical cap has a 9%-18% chance of becoming pregnant. The effectiveness of the cervical cap depends mainly on proper and consistent use.

Pros

cap is inexpensive
very effective
can be inserted long before intercourse and left in place for 48 hours
does not interfere with lovemaking
provides some protection against gonorrhea and chlamydia
small size can be very comfortable

Cons

cap only comes in four sizes, does not fit all women
if left in place for a long time, the woman is more susceptible to vaginal infections and unpleasant odor
partner could feel discomfort if his penis hits the rim of the cap during intercourse
some women have difficulty inserting or removing the cap
does not provide enough protection against all sexually transmitted diseases

IUD (Intrauterine Device)

What is it?

Two types of IUDs are available in the U.S. The CuT 380A (Paragard) is a plastic T-shaped device wrapped with fine copper wire. It is approved for up to 10 years of use. The Progesterone T (Progestacert System) is a plastic T-shaped device which contains a reservoir of the hormone progesterone, which is released at a steady rate. The Progestacert IUD must be replaced every year. Both types have a plastic string at the end which extends a couple of inches into the vagina.

IUDs are inserted into the uterus by a doctor or other trained clinician.

No one knows exactly how the IUD works. Some studies suggest that the IUD seems to cause a reaction in the lining of the uterus which prevents a fertilized egg from implanting in the uterus. Other studies have found some evidence that the IUD may actually prevent fertilization from happening, either by speeding up the egg's passage through the fallopian tube or by interfering with the passage of sperm from the vagina to the fallopian tube.

Where can you it?

An IUD must be inserted by a doctor or other trained clinician. It can be done at a doctor's office or a clinic.

How much does it cost?

Depending on where you go to have the IUD inserted and which type of IUD you will be using, the average cost is between $175 - $300. In general, private practice gynecologists will probably charge more than family planning clinics.

How do you use it?

Once you've had the IUD inserted, the only thing you need to do is check the string once a month to be sure the IUD is in place. The Progestacert IUD has to be replaced every year. The Paragard IUD has to be replaced every 8 to 10 years.

Effectiveness

When the IUD has been inserted correctly and is in place during intercourse, a woman using the IUD has a 0.17% - 2% chance of becoming pregnant.
If a pregnancy occurs when an IUD is in place, the rate of spontaneous abortion
(miscarriage) is 25-50%.

A small percent of IUD users will spontaneously expel the IUD, and need to have it replaced.

Pros

Convenient to use. Once it's inserted all you need do is check the string once a month. Allows spontaneity in lovemaking.
Cost per year of use is less than some other methods.
Women who are unable to use other hormonal methods of birth control can use the IUD.
Progesterone-releasing IUDs may decrease menstrual flow and cramping.

Cons

Some women experience heavier menstrual bleeding and cramping while using the IUD.
Pelvic Inflammatory Disease (PID) is a serious infection of the uterus and fallopian tubes, which may cause infertility or sterility. The greatest risk of PID associated with IUD use is at the time of insertion. Most healthcare providers require that women be tested for sexually transmitted diseases before having an IUD inserted. Women who have more than one sexual partner or whose partner has other sexual partners are at greater risk of developing PID while using an IUD.
Uterine perforation (puncture of the uterus by the IUD) occurs in about 1 out of 1000 IUD users.

Chemical Spermicides

What are they?

Chemical spermicides are available as either foam, gel, or suppositories. They contain a sperm killing chemical, most often Nonoxynol-9. They are inserted into the vagina near the cervix (the lower third of the uterus that extends into the vagina). They work by acting as a barrier into the cervix and also by killing any sperm before they have a chance to swim through the cervical opening into the uterus.

Where can you get them?

Most drug stores and women's clinics carry a variety of brands of foam, gel, and suppositories to choose from.

How much do they cost?

A medium size can of foam costs between $10-$12. A package of 10 suppositories costs between $7-$10. Spermicidal gel costs between $7-$10 for a package of six. However, birth control and family planning clinics sell spermicides and condoms at reduced rates.

How do you use them?

Foam must be inserted not more than 15 minutes before intercourse. To insert the foam, first shake the can of spermicide, fill the applicator with foam, gently insert the applicator into the vagina as far back as it can go, then push the plunger to release the foam into the vagina. A suppository should be placed against the cervix at least 10 minutes before intercourse. It will be effective for about 2 hours, but a second tablet must be used if intercourse is repeated. Gel is inserted with an applicator in the same manner as foam.

Effectiveness

We do not recommend using chemical suppositories alone to prevent pregnancy. They are much more effective when used with the condom. However, spermicides are more effective than using nothing at all. Women using this method alone will have a 6-21% chance of becoming pregnant the first year of use. When used with the condom, the chance of becoming pregnant is lowered to 2-7%.

Pros

You don't need a doctor's prescription. Inexpensive and easily obtained. Spermicides containing Nonoxynol-9 have been shown to kill a number of organisms that cause sexually transmitted diseases, including gonorrhea, chlamydia, trichomoniasis, herpes, and HIV. It is important to note that spermicides only protect the area that they cover, which in many cases will exclude external genitalia and sometimes the vagina.

Cons

Some women think chemical suppositories are messy or that they interrupt the spontaneity of lovemaking. Not very effect if used alone. Must be inserted prior to each act of intercourse. May irritate vaginal walls or penis.

Vaginal Contraceptive Film

What is it?

The vaginal contraceptive film is a thin square of translucent material composed of nonoxynol-9, polyvinyl alcohol and glycerine. The film is inserted into the vagina and covers the cervix so that sperm cannot enter the cervical canal.

Where is it available?

Drug stores and women's clinics. No prescription is needed.

How much does it cost?

$9-11 for a package of 12.

How do you use it?

First, remove the film from the package making sure that your fingers are dry. Next, fold the film in half and place it over the long finger. The woman should then insert the film deep into her vagina so that it covers her cervix. The film should be inserted at least 5 minutes before intercourse, however 15 minutes is recommended. It is not necessary to remove the film because it disperses into the vagina and cervical canal on its own. It is effective for up to an hour after intercourse and another contraceptive film must be inserted with repeated intercourse. It is strongly recommended that the vaginal contraceptive film be used with a male condom.

How does it work?

Once the film is placed on the cervix, it begins to dissolve in the vaginal fluids and changes into a gel-like substance. It forms a barrier over the cervix so that the sperm cannot pass. The nonoxynol-9 is a spermicide and it deactivates the sperm.
We do not recommend using the film alone to prevent pregnancy.

Effectiveness

The chance of getting pregnant using the film alone is 10-18%. It is very effective when used with a condom, diaphragm, or cervical cap, with a 2-7% chance of becoming pregnant.

Pros

when used with a condom, is highly effective
less messy than cream or jelly
helps prevent gonorrhea and chlamydia

Cons

does not provide complete protection against sexually transmitted diseases, including HIV
may have difficulty with insertion
may be sensitive to it, causing vaginal irritation
more expensive than most other forms of nonoxynol-9 spermicide

Diaphragm and Spermicide

What is it?

The diaphragm is a small, shallow rubber cup which when inserted correctly into the vagina holds spermicide (sperm-killing cream or jelly) against the cervix (the lower third of the uterus that extends into the vagina). The diaphragm prevents sperm from getting near the cervix and up into the uterus (womb). Sperm that get past the diaphragm are killed by the spermicide.

Where can you get it?

Diaphragms, like shoes, come in different sizes. Experienced health care workers are able to determine the best size by a simple examination of the vagina and cervix. Once you are fit for a diaphragm, you will either be given a diaphragm, or a prescription to be filled by a pharmacist.

How much does it cost?

A diaphragm costs between $10-$25. Depending upon where you go to get fitted, the examination and fitting could cost from $45-$80.In general, Family planning or birth control clinics charge less for their services than private gynecologists. The spermicidal cream or jelly used with the diaphragm is available in drug stores and costs about $10-$15 for a large tube.

How do you use it?

Spermicidal cream or jelly is inserted in the dome of the diaphragm. It is then placed into the vagina as far back as it can go so that one edge of the rim is at the back of the vagina, past the cervix, and the other edge is behind the pubic bone. The diaphragm must be put in place before intercourse and left in place 6-8 hours after intercourse for the spermicide to be effective. The spermicide is effective up to 24 hours at a time in the diaphragm, so the diaphragm may be inserted up to 16-18 hours before intercourse. Once in place, the diaphragm can rarely be felt by the woman, or by her partner during intercourse.

Effectiveness

The diaphragm has a failure rate of 6-18%. Most likely the 6% failure rate exists because the diaphragm moves around a bit with frequent insertions of the penis when the woman is on top during intercourse. The 18% failure rate is dependent on factors such as: age, frequency of intercourse and proper and consistent use.

Pros

the diaphragm does not have health risks.
the chance of getting gonorrhea if exposed to it is reduced because the spermicide tends to kill the bacteria.
when used during menstruation, the diaphragm can hold menstrual flow.

Cons

you need to be motivated to use it, as it must be in place during each act of intercourse.
to use the diaphragm you must feel comfortable touching your genitals.
some people feel putting in the diaphragm interrupts the spontaneity of lovemaking.

Natural Birth Control for Women

What is it?

A woman can learn to identify the physical changes that accompany the different phases of the menstrual cycle. By observing the mucus secretions that are produced in the cervical os (the small passageway into the uterus) a woman can learn to distinguish between mucus that is fertile (clear, stretchy) and mucus that is non-fertile (opaque, non-stretchy). Fertile mucus creates a very good environment for sperm, Sperm can live up to 5 1/2 days in fertile mucus and only 1-2 hours in non-fertile mucus. There are fairly regular patterns for each woman's production of cervical mucus. By closely watching mucus changes for several months a woman can tell when she is ovulating and when the fertile times of her cycle are. She should then either abstain from penis/vagina contact or use a barrier method of birth control during her fertile times. Also, a woman's basal body temperature (resting temperature) rises about 0.5 degrees just after ovulation. By regularly taking her basal body temperature (BBT) with a special thermometer, she can confirm ovulation.

Where can you get information?

If you are interested in using these methods of natural birth control, we recommend taking a class on natural birth control to become more experienced at determining fertility. Consultations and information booklets are available at the Emma Goldman Clinic for Women in Iowa City. Some family planning agencies have information and/or classes on natural birth control.

How much does it cost?

Classes or instruction on natural birth control costs between $10-25. A basal body thermometer costs around $7 and is available at most pharmacies, birth control clinics and family planning agencies.

Effectiveness

Effectiveness depends primarily on the motivation and discipline of the user. Unfortunately, there have been few studies on using both BBT and mucus observation together. When used correctly the mucus observation method has a failure rate of 3% and the BBT method has a failure rate of 2% during the first year of use. Because this type of birth control method requires a lot of effort on the part of the woman, there is a higher chance of failure. In a study conducted by the World Health Organization clinical trials determined that the failure rate during typical use of mucus observations is 86.4%.

Pros

completely safe and very inexpensive
by monitoring BBT and cervical mucus secretions a woman can become more aware of her cyclical patterns and how her body works. With this information she becomes a more intelligent participant in her own health care.

Cons

requires a high degree of motivation.
some women may find that it is too complicated and time consuming. Several months of practice are necessary before relying on BBT and mucus observation for contraception.
fevers, douching, spermicides, semen and lubrications interfere with accurate determination of fertility.

Tubal Ligation (Female Sterilization)

What is it?

Tubal ligation is the blocking of the fallopian tubes so that an egg, released from the ovary during ovulation, is prevented from passing into the uterus.

Where can you get it done?

Tubal ligation must be done by a doctor or clinician in a hospital or office.

How much does it cost?

A tubal ligation costs between $950-$1500, including procedure, anesthesia, and lab fees, in a doctor's office. It can cost as much as $3500 if done in a hospital under general anesthetic.

How is it done?

In order to prevent the egg from passing down the fallopian tubes into the uterus, the fallopian tubes must be blocked. A doctor can block the tubes several different ways. They can be clipped closed with bands or rings. They can be cut and tied closed or they can be burned with an electric needle. Once the tubes are burned, scar tissue forms which blocks them. A surgical cut must be made in either the abdomen just above the pubic hair, in the belly button and lower abdomen, or in the back wall of the vagina. The procedure can be done using a local anesthetic to numb the area, or a general anesthetic so the woman is unconscious during the operation.

Effectiveness

Effectiveness varies somewhat depending on which method is used. In general, a woman having a tubal ligation has a less than 1% (0.04%) chance of becoming pregnant. If a woman does become pregnant it is usually because the tubes have grown back together.

Pros

not including hysterectomy or vasectomy, tubal ligation is the most effective method of birth control
although the cost for tubal ligation is quite high, it is a one-time cost

Cons

is considered permanent and irreversible.
not all women are good candidates for a tubal ligation. Risks of the surgical procedure include: hemorrhage (excessive bleeding), infection, chronic pelvic pain and puncture of another organ during surgery
some side effects associated with tubal ligation include: longer and heavier periods, cramping with periods, premature menopause in young women and an increased incidence of hysterectomy (removal of the uterus, tubes and sometimes one or both ovaries) to control excessive bleeding.

Vasectomy (Male Sterilization)

What is it?

A vasectomy is a quick and easy surgical procedure in which the tubes that carry sperm from a man's testicles (balls) to the penis are cut and tied or burned so that no sperm are released during ejaculation (orgasm, coming). The tubes which are cut are called the vas deferens. Once the operation is completed there is still some sperm left in the vas deferens and the seminal vesicles (sperm storage areas) which must be emptied before a man can rely on his vasectomy for contraception. It generally takes 6-20 ejaculations to clear out the sperm from these tubes. A trained clinician or doctor is able to look at semen under a microscope and determine how many sperm are still in the semen. This is called a sperm count. Because sperm is only about 10% of a man's ejaculate there will not be a noticeable difference in the amount of semen. Also, hormone levels, sex drive and the ability to achieve and maintain an erection are not affected by vasectomy.

Where can you get it done?

Because a vasectomy is considered a surgical procedure, it must be done by a doctor, generally a urologist, or clinician. However, it is not necessary that it be done in a hospital; it can be done in a doctor's office under local anesthetic.

How much does it cost?

A vasectomy can cost anywhere from $400-$550 when done in a doctor's office. Some physicians will send the results to a pathological lab for analysis, at an additional cost. It can cost as much as $1800 when done in a hospital.

Effectiveness

The chance of a woman becoming pregnant if her partner has had a vasectomy is less than 1%. When failure does occur it is most often because the cut ends of the tubes have grown together again. In rare cases the tubes are not tied or clipped tight enough which allows the sperm to leak through the open ends.

Pros

one of the most effective methods of birth control and is very simple, relatively inexpensive and safe.
no known long term side effects associated with a vasectomy
complication rate is low (2-4%) and most complications of the procedure are minor and short term.

Cons

considered irreversible at this time.
men experience minor swelling, bruising and pain of the area during and shortly after the procedure.
complications are rare, but include blood clotting in scrotal area, infection, scar tissue forming, inflammation and tenderness.
about 1/2 - 1/3 of all vasectomized men develop antibodies to sperm in the blood which stops sperm activity. The importance of this phenomenon is unknown at this time.

Dental Dams

What is it?

Dams are six-inch square pieces of synthetic latex rubber. They can be used to prevent the spread of HIV during oral sex.

Where can you get it?

Medical supply stores and some women's clinics sell latex dams. Latex glove:
1. Cut off the four fingers, but leave the thumb intact.
2. Cut along the pinky side of the glove.
3. Rinse the talcum off and follow the same procedure used for the dental dam.

Effectiveness

Dental Dams have been strongly recommended for safer sex, however they have not been clinically tested. This means that there is no clinical evidence that the dental dam provides an adequate barrier for HIV transmission.

Pros

safer oral sex
easy to use

Cons

cost - each dam can cost between .25-$1.00
difficult to find
some say they taste and smell bad
thickness can reduce physical sensation
not clinically tested for HIV transmission

Norplant

What is it?

Norplant is a hormonal contraceptive implant that is inserted into the fleshy part of a woman's upper arm, just under the skin, by a trained practitioner. It consists of six match-size flexible rubber capsules, each containing the synthetic progestin levonorgestrel. The hormone is slowly released by the capsules until they are removed. It is designed to last 5 years and it can be removed at any time.

Where can you get it?

Norplant is available at clinics, hospitals and some private practitioners. In general, a family planning clinic or birth control clinic charges less than a private gynecologist.

How much does it cost?

Norplant costs approximately $500-600. As yet this price has not been reduced to serve low income populations. Medicaid (Title 19) pays for Norplant but most private insurance companies do not.

How does it work

No one completely understands how Norplant prevents pregnancy. It most likely inhibits ovulation (so eggs are not released by the ovaries) and thickens the cervical mucus (which stops sperm activity.)

Effectiveness

Norplant is extremely effective. It starts working within 24 hours after insertion and lasts for up to 5 years. The overall pregnancy rate is .09%. Effectiveness can be decreased if the woman is taking a prescription drug, therefore she should consult her physician about any medications that she takes while using Norplant.

Pros

is extremely easy to use once it has been placed by a practitioner
the woman does not need to worry about it for five years
it does not affect the spontaneity of intercourse
Norplant can be removed at any time and fertility returns immediately after removal
decreased menstrual bleeding is also an advantage for many women
Norplant does not contain estrogen so it is safer than birth control pills for older women and smokers.

Cons

the most common problem associated with Norplant is irregular bleeding and excessive bleeding during menstruation.
other side effects include: headaches, acne, weight changes and breast tenderness
use of Norplant increases the risk of functional ovarian cysts.
Norplant is also costly and does not provide protection against STDs.

RU-486

What is it?

RU-486 is a drug, taken in pill form that has proven to be an effective method of early abortion. RU-486 blocks the action of progesterone (the hormone that is responsible for growth of the fetus) thus causing the lining of the uterus to shed. This results in termination of the pregnancy.

Where can you get it?

RU-486 has been clinically tested in a number of locations throughout the United States. It will be available at women's clinics or through private physicians pending FDA approval.

How much does it cost?

The cost is comparable to the cost of a surgical abortion, usually around $300-$400.

How do you use it?

The woman must have a confirmed pregnancy through a positive pregnancy test. Once the pregnancy is established the pill can be taken in a clinic under supervision of a health care provider (dosages may vary with the weight of the woman). Two days later the woman must return to the clinic for a dosage of prostaglandin, which is administered either as a suppository or injection. This drug causes the uterus to contract, thus expelling the contents completely.

Effectiveness

When used in the first two months of pregnancy and with prostaglandin, it causes a complete abortion 96% of the time. This is virtually the same as a surgical abortion which has an effectiveness rate of 97%.

Pros

private, easily accessible way to have an abortion
can be administered by many types of physicians, therefore women might have greater access to abortion services
might be able to avoid confrontations with anti-abortion groups that harass abortion clinic clients
surgical risks of vacuum aspiration abortions are avoided

Cons

must be taken during the first two months
side effects: vomiting, diarrhea, abdominal cramps
hemorrhaging can occur
if RU-486 is not successful, surgical abortion would be necessary, carrying surgical risks
new, there has not been extensive research as to potential long-term effects

Morning After Treatment (MAT)

What is it?

The "Morning After Treatment" (MAT) is a series of high doses of synthetic estrogens and progesterones that must be started within 72 hours after unprotected intercourse.

Where can you get it?

MAT is available at family planning clinics and private gynecologists.

How much does it cost?

Approximately $15-$50 depending on the clinic.

How do you use it?

A pregnancy test is done and upon a negative result two doses of Ethinyl Estradiol are given twelve hours apart. A total of eight pills are administered.

How does it work?

The dosages of hormones given within 72 hours after unprotected intercourse changes the lining of the uterus so that the fertilized egg will not be allowed to implant. Or if taken early enough it can destroy the zygote, which is formed by the joining of the egg and sperm.

Effectiveness

Published studies indicate this method to be 92 - 98% effective in preventing pregnancy.

Pros

a "second chance" at birth control if your method fails or no birth control was used.
safe and effective
risks are uncommon in young, non-smoking, healthy women.

Cons

Risks include: heart attack or stroke, liver disorders, gall bladder disorders and high blood pressure.
Side effects include nausea in 33-50% of MAT users (anti-nausea medicine is often given along with the MAT pills), headaches, breast tenderness and irregular bleeding.
Must be taken within 72 hours of unprotected intercourse.

Depo Provera

What is it?

Depo Miedroxy Progesterone Acetate (DMPA) is a contraceptive administered by injection into the muscle at the back of the arm or in the buttocks. Depo Provera is produced in the form of tiny crystals suspended in a water-based solution. During a 90 day time period, the drug is released from the crystals into the bloodstream. Each shot contains 150 milligram dosage.

Where can you get it?

The shot can be administered by a physician or by a trained professional at a woman's health clinic. The woman must return to her clinic or physician every three months for a repeat injection.

How does it work?

Depo Provera acts to create an inhospitable cervical and uterine environment for sperm survival and implantation (by changing the mucus and uterine lining) and to a certain extent inhibits ovulation.

How much does it cost?

The cost of each Depo Provera injection ranges from $30-$45, and the initial injection must be accompanied by a gynecology exam, costing between $50-$125. In general, a family planning clinic or women's health clinic charges less for their services than a private gynecologist.

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