How To Prevent an Unplanned Pregnancy

Methods to prevent an unplanned pregnancy include emergency contraception and barrier methods like condoms, diaphragms, and hormonal birth control. There is still a possibility you could get pregnant if any methods are used incorrectly. For example, your pregnancy risk rises when a condom breaks or is put on incorrectly.

Preventative measures vary based on whether you're trying to prevent pregnancy before, during, or after sexual activity. Read on to learn how to prevent pregnancy and other considerations as you choose your preventative measures.

Before or During Sex

You have a few options that can help prevent unplanned pregnancy before and during sex. You might consider using barrier methods, hormonal birth control, or other methods.

Barrier Methods

When a person correctly uses a barrier method during sex, they're using something to physically block sperm from getting to an egg to reduce the likelihood of a pregnancy. Birth control options that fall under barrier methods include:

• Cervical cap and diaphragm: These are silicone cup products for vaginal insertion. They fit over the cervix—used with spermicide gels or creams—to block sperm from getting into a person's uterus.
• Condoms: There are two types of condoms people can use during sex. Male, or external, condoms are placed over the penis, while female, or internal, condoms are inserted inside the vagina. Of note, internal condoms can only be inserted beforehand within eight hours of sex.
• Sponge with spermicide: This is a method where a person uses a disk-like foam device with spermicide as a cover over the cervix.
  

Hormonal Birth Control

Like barrier methods, hormonal birth control can be helpful in reducing the risk of an unplanned pregnancy when used appropriately. Options include:

• Combined or progestin-only birth control pills
• An implant or an intrauterine device (IUD), which can only be placed by a healthcare provider
• Injections, which a healthcare provider administers every three months
• Patches
• Vaginal rings

Most hormonal birth control methods require a prescription. There's only one FDA-approved, over-the-counter hormonal birth control option available—a progestin-only pill called norgestrel (Opill).

In most cases, hormonal birth control will need to be started before having sex. The exception is emergency contraception, which is used following sex.

Other Methods

Beyond abstinence, or complete avoidance of sex, other pregnancy prevention measures exist that do not fall into the categories above. They include fertility awareness or natural family planning, lactational amenorrhea method (LAM), or withdrawal:

• Fertility awareness: This entails learning about and understanding the menstrual cycle and signs that you're about to release or have released an egg—known as ovulation. You use the knowledge for planning sexual activity to prevent or promote pregnancy.
• LAM: This is a short-term pregnancy-prevention method, where a person breastfeeds for six months to avoid having periods or spotting. However, as a person who breastfeeds begins to give their baby nutrition from other sources, their body will produce less milk and will begin to ovulate again.
• Withdrawal: Withdrawal involves a person with a penis removing their penis from a partner's vagina and ejaculating—or releasing semen—in a different area not close to the partner's genitals.

After Sex

Emergency contraception does not guarantee you will not become pregnant, but it can reduce your risk. Emergency contraception within five days after sex can prevent more than 95% of pregnancies. That means about 5% or less of the time, you still have a chance of getting pregnant.

There are two types of emergency contraception to consider: emergency contraceptive pills and IUDs that contain copper. Here is a breakdown of three options: Plan B, ella, and Paragard.

Plan B

Also known as a morning-after pill, Plan B is one of the first hormonal products that the Food and Drug Administration approved for emergency contraception. 

A progestin-only pill, Plan B can prevent ovulation and fertilization if you take the pill within three days of unprotected sex. Plan B can also prevent an embryo from implanting in the uterus by changing the tissue that lines the inside of the uterus. The sooner you take Plan B, the better.

Anyone can buy Plan B and its generic counterparts over the counter, so you do not need a prescription, but you may have to ask the pharmacist. Plan B costs between $20 and $50.

Side effects of Plan B include:

• Abdominal pain
• Changes to your next menstrual cycle
• Dizziness or headaches
• Fatigue
• Nausea or vomiting
• Tender breasts
  

You will need to take another pill to ensure its effectiveness if you vomit within two hours of taking Plan B.

ella

Like Plan B, ella (or ellaOne) has FDA approval as an emergency contraceptive. ella works the same way as Plan B, except it's effective if you take it as many as five days after having unprotected sex. The side effects of ella include nausea, tiredness, headache, and dizziness.

While Plan B is progestin-only, ella is ulipristal acetate. The medication creates an anti-progesterone effect inside the body, suppressing ovulation and preventing the tissue lining inside the uterus from thickening. Ovulation and thick uterine tissue are necessary for pregnancy to occur.

Paragard

Another type of emergency contraception is Paragard, a hormone-free, copper IUD. Copper-bearing IUDs are one of the most effective types of emergency contraception.

A healthcare provider must insert Paragard within five days after having unprotected sex. Paragard works because of one key component: copper. Copper IUDs help prevent the sperm from reaching and fertilizing the egg and an embryo from implanting in the uterus.

Unlike the two emergency contraceptive pills, Paragard is effective at preventing pregnancy for up to 10 years if it remains in the proper place. In addition, the cost of Paragard will vary depending on whether you have insurance or not. Insurance may cover it, but you'll have to check with the insurance company first.

Side effects include having heavier periods, cramping, and bleeding between periods. Those side effects usually go away after the first few months.

Other Considerations

There are some other things to consider when you're trying to prevent an unplanned pregnancy. These other considerations include not douching, getting tested for a sexually transmitted infection (STI), and monitoring your menstrual cycle.

Avoid Douching

The one thing you shouldn't do after unprotected sex is douching. Douching alters the normal balance of yeast and bacteria in the reproductive tract.

Douching can increase the risk of other reproductive system infections and vaginal irritation or dryness. It may also make it hard to get pregnant or create complications during pregnancy.

Get Tested for Sexually Transmitted Infections

Receiving regular tests for STIs—including gonorrhea, chlamydia, syphilis, human immunodeficiency virus (HIV), and hepatitis B and C virus—is essential if you are sexually active. It's a good idea to receive a test within a couple of weeks of unprotected sex. 

Of note, you will need to get retested in another six months to ensure your HIV and hepatitis test results are negative. Some tests for those viruses take a couple of weeks to six months to detect the viruses in your body.

You can take a course of post-exposure prophylaxis (PEP) within 72 hours of exposure if you think you've been exposed to HIV. Generally, healthcare providers reserve PEP for high-risk scenarios.

Monitor Your Menstrual Cycle

You will want to monitor your menstrual cycle after having condomless sex. Remember that a morning-after pill can cause spotting and alter the flow of your period. That can make it hard to tell if you are pregnant, so if your period is over a week late, take a pregnancy test.

A Quick Review

You can help prevent an unplanned pregnancy before, during, and after sex with different options. For example, you might consider using birth control, condoms, or both beforehand or use emergency contraception if you've had condomless sex.

There are other things to keep in mind while trying to prevent pregnancy. You'll want to ensure you don't douche, get tested for STIs as appropriate, and monitor your menstrual cycle.