Your Post‑Baby Birth Control Options
Let’s say you’ve had all the kids you plan to have, but you’re not done having all the sex you plan to have. How much do you really know about your birth control options?
Most couples considering a decade or two of monogamous intercourse without the possibility of unintended pregnancies don’t really know where to turn. They’re sick of stocking up on the contraception options that tend to be popular with younger sexually active people – such as condoms or diaphragms or sponges – that also require some amount of active preparation. By their mid-30’s, many women are also getting wary of being on hormonal birth control because of the possible health impact of being on synthetic hormones for too long. Couples who don’t want to risk having another kid want something that feels more permanent… but somehow not too permanent.
So where do you turn when you don’t want to be worrying about having supplies on hand, but you also don’t want to be popping hormones?
We did an informal survey, and almost everyone we asked – men and women – assumed vasectomies were the best way to achieve this type of long-term, “low-maintenance” birth control. And, it’s worth noting, almost all of the men we informally surveyed are terrified of the procedure.
The facts on vasectomies are simple: they will not impact virility or sexual desire or prowess, and contrary to popular belief, they are reversible. The process involves tying or sealing the vas deferens so that sperm cannot reach and fertilize an egg. It can be done in a doctor’s office and involves less than a day of recovery time. This does not impact a man’s ability to orgasm or ejaculate.
If you change your mind and decide to try to have another baby, the procedure to reverse the vasectomy can be done in a 2-4 hour surgery (usually with anesthesia). Success rates depend on a variety of factors, but for the most part, if the reversal is done within ten years of the vasectomy, overall post-surgery pregnancy rates are over 50%.
Pros: reversible, very safe, highly effective, easy procedure/recovery, no maintenance, no hormones
Cons: low acceptance rates because of stigma, reversal success not guaranteed
Tubal Ligation (a.k.a., getting your “tubes tied”)
Tubal ligation is the surgical process of getting your fallopian tubes sealed off (or tied) to prevent sperm from ever being able to meet an egg. The process is a relatively minor surgery, usually done with a small cut in the abdomen, which takes half an hour to complete and only a few days of rest to recover from.
This is the most permanent form of female birth control (reversing it is complicated and not commonly successful). Because of its relative permanence, this is not a recommended method for women who are unsure of their desire to have more children in the future.
However, even if you are 100% sure you want a low-maintenance and permanent form of birth control, there are a few factors to consider. Some women still do get pregnant after tubal ligations (though the rates are very low, less that 2% over ten years). And because of that, the rates of ectopic pregnancies — where a fertilized egg implants along the fallopian tube — are higher.
Pros: no maintenance, no hormones, safe
Cons: permanent/low reversal success rates, not 100% effective, some recovery time
Intra-Uterine Device (IUD)
Surprisingly, in our little informal survey, IUD’s were the most frequently misunderstood of the semi-permanent birth control options. IUDs are small T-shaped objects that are inserted into the uterus and prevent a sterilized egg from implanting on the walls of the uterus. They take a few minutes to insert at a doctor’s office and can be removed at any time.
There are two types: those with hormones, which last 3-5 years, and those without (made of copper), which last ten years. Women who are at high risk of breast cancer are usually advised not to use the progesterone (hormonal) IUDs. Women who opt for the non-hormonal IUD, also called a copper-T, should note that they can cause heavier and longer periods.
Finally, of note: Copper T’s got a bad rap in the 70’s, when it was believed that they increased women’s risk of deadly infection. But that has since been disproven, and IUDs are considered among the safest and most effective methods of birth control available.
Pros: reversible, no surgery/recovery, highly effective, painless, hassle-free, inexpensive, minimal maintenance, non-hormonal options, very safe
Cons: heavier periods (with copper version)