If you do not want to get pregnant, you had better be on birth control (contraceptives) and use condoms as well. In this way you can have sex with your partner without use of a condom and not get pregnant. There are a lot of contraceptives. The ones which are best for you, depends on your circumstances. If you have had sex without a contraceptive, you can decide taking the morning-after pill.

Contraceptives do not protect you from STIs. To protect you from STIs you must use condoms.

For free personal advice contact a nurse with P&G292

Personal circumstances

There are a lot of different contraceptives. They differ in the way they are to be taken and in possible side effects. To decide what is best for you, you can answer the following questions for yourself:

  • Have you taken contraceptives before?
  • Are you for or against taking hormones?
  • Do you smoke? Do you want to stop? Can you stop? Hormones combined with smoking can be bad.
  • Can you remember taking a pill every day or do you prefer not having to think about contraceptives for some time?
  • Do you mind taking oral contraceptives or do you prefer putting something on the skin of into your vagina?
  • Do you insist on having your menstrual period or don’t you want to bleed every month?
  • Are you afraid of  bodily changes?
  • Will you have a child wish in the near future?

Different types of contraceptives

The following 8 types of contraceptives are safe to use.

Not safe when you are a sex worker are:

  • Using sperm-killing creams or tablets;
  • ‘Coitus interruptus’ (removal of the penis from the vagina before he comes, before ejaculation);
  • Calendar method or temperature method.)

Safe are:

Contraceptive Pill

Daily intake. The hormones of the Pill prevent pregnancy because they prevent the egg to ripen. Every month you take the pill for 21 days, then stop taking it for 7 days. In those 7 days you will have your period.

When you stop taking the Pill altogether, you can get pregnant again soon.

Positive aspect:

  • Your period can be delayed when you continue taking the Pill.

Negative aspect:

  • You must not forget. If you do, you can get pregnant.

Birth control ring

The birth control ring (Nuvaring®) is a flexible plastic ring with hormones. You insert it into the vagina once a month. It must be removed after three weeks. The following week you have your period. When you stop inserting it you can soon get pregnant.

Positive aspects:

  • You can forget about birth control for three weeks a month.
  • You can delay your period if you skip the ring-free week.

Negative aspects:

  • The ring may slip from the vagina when you often have sex, which is the case with sex workers.
  • You can only buy three rings at a time at the chemist’s.

Birth control patch

A birth control patch is a thin 4.5 by 4.5 cm strip. Each week a new one must be applied. After three weeks you stop the application for one week. You have a bleeding then. After you have stopped altogether, you can get pregnant quickly again.

Positive aspects:

  • You can forget about birth control for a week at the time.
  • You can delay your period when you skip the patch-free week.

Negative aspects:

  • The patch is clearly visible.
  • It is less reliable with women weighing over 90 kilos.

Injection

This contraceptive injection contains hormones. The injection is given by a nurse every 12 weeks. When you stop. your period will return and you can become pregnant again. This may take some time. Sometimes it will take over a year.

Positive aspect:

  • You do not have to remember taking contraceptives for a few months.

Negative aspects:

  • Irregular bleeding is common. It may stop altogether.
  • If you experience side-effects, it will take some time before the hormones go from the body after you have stopped the injections.

Coil

The coil is made from plastic or copper and it sits inside the womb. It is inserted by a doctor. It can stay in your womb for 5 years. Once removed you can get pregnant quickly. There are copper ones and ones with hormones.

Positive aspects:

  • You do not have to remember for five years
  • With a copper coil: no hormones, your cycle is not affected.
  • With a hormone coil : your bleedings are lighter or disappear altogether.

Negative aspects:

  • With a copper coil: your periods can be heavier the first few months.
  • With a hormone coil: irregular bleedings are common.

Implant

The contraceptive implant (Implanon®) is a small flexible tube with hormones. It is inserted by a doctor under the skin of your upper arm. It can sit there for three years. After removal you can get pregnant again soon.

Positive aspects:

  • You do not have to remember for three years.
  • Your bleedings are lighter or they disappear.

Negative aspect:

  • Irregular bleedings are common.

Sterilization

With female sterilization the tubes between the womb and the ovary are cut or blocked. It is done by a gynecologist. It is permanent, so you must be convinced that you do not want any (more) children.

Positive aspect:

  • You can forget about birth control altogether.

Negative aspect:

  • It is permanent. To get it undone is a complicated operation which isn’t always successful.

Condom

Condoms are the only contraceptives that protect against pregnancy, HIV and most STIs. You put on a condom before you have sexual intercourse. Read more about how to use a condom.

What are your options?

At P&G292 a nurse can help you to choose a birth control method that is the most effective for you. When you have decided the nurse can get you a prescription at the Area Health Authority (GGD). Some methods are put in by a doctor; this can be your family doctor or a doctor with GGD.

The cost of contraceptives are compensated by your health insurance if you are under 21 years of age. If you are over 21, the costs may be (partly) compensated when you have an additional health insurance. For more information on the costs, ask the nurse for an up-to-date pricelist.

Tip:

If you do not use any birth control methods, have a morning-after pill with you at any time, to be used in case of emergency.

More information on birth control methods:

www.anticoncepie-online.nl

www.sense.info/voorbehoedmiddelen

Morning-after pill

If you have failed using a contraceptive or something went wrong (you forgot to take a pill or a condom broke) you can take the morning-after pill. It is also called the emergency pill. It is one pill only. The morning-after pill delays ovulation (the release of an egg). It prevents pregnancy.

When do you take the morning-after pill?

Take the pill as soon as possible after unprotected sex. Then there is a very small chance of getting pregnant (80% on average). You can take it up to 72 hours (three days) after having unsafe sex. If you had sex longer ago, taking the morning-after pill is useless. Nowadays you can buy ellaOne® without prescription, which you can take till five days (120 hrs) after unprotected sex.

What happens after you have taken the morning-after pill?

After you have taken the morning-after pill your bleeding can be too soon, in time or one week too late maximum. Even when you have taken the morning-after pill, there is a small chance of becoming pregnant. Take a pregnancy test if you have not started your period.

Where do you buy the morning-after pill?

You can buy the morning-after pill without prescription at the chemist’s. The cost will be compensated by your health insurance when you are younger than 21. You will need a doctor’s prescription for it.

Too late for the morning-after pill?

There is also the possibility of having a doctor insert a copper-coated coil contraceptive. This will make the womb less likely to accept an egg, so it prevents pregnancy.

Questions

If you have questions about the morning-after pill or if you have not started your period after you have taken this pill, contact the P&G292 nurse.