Before increasing their family, they should take into consideration whether God would be glorified or dishonored by their bringing children into the world. They should seek to glorify God by their union from the first, and during every year of their married life.Testimonies for the Church 2:380
You already know the importance of premarital checkups for you and your fiancé, now let’s talk about the best method of birth control for you and your lifestyle. When choosing the best method for your family planning, consider three points:
- The woman’s choice and the couple’s choice – it should be a method that you and your husband agree on. Above all, your physical and emotional health must be preserved, so don’t force yourself to use a method just to please your husband.
- The method – evaluate the advantages and disadvantages of each method and consider which is most effective for you.
- Individual and situational factors – your age, financial situation, if there’s a health clinic/hospital near your home, what services and methods they offer, whether your goal is to prevent pregnancy or get pregnant, if you already have a child, if you are breastfeeding, and other things that are specific to your reality.
Factors to consider
Below is a list of specific characteristics that must be considered when it comes to contraceptives:
● Effectiveness – there are two effectiveness rates: A) that of regular use, when the woman uses the method as she can, daily, sometimes forgetting or using it incorrectly; and B) that of strict adherence, use without fail. To calculate the effectiveness rate, researchers count how many women become pregnant in the first year when using the method regularly and those using it without fail. Then they calculate how effective the method is in each situation.
● Side effects – the famous side effects. Hormonal methods tend to bring a wider range of side effects, so it’s important to choose carefully.
● Acceptability – this refers to how much you trust the method and your motivation for using it correctly. Psychological, cultural, and religious factors can influence your decision.
● Availability – it’s important to know if the method is available and accessible where you live, whether it’s affordable and available nearby. It’s important to have everything necessary to comply with the steps to guarantee maximum efficacy.
● Ease of use – choose a method that is easy to use correctly. For example: if you are unable to take the pill at the same time every day, then it’s better to use another method.
● Reversibility – each method has a defined period of time that it is active and functional in the body. Some lose their effectiveness immediately after a pause in use and others take longer to leave the body. Others are irreversible. Take this into consideration when choosing the one that best suits your family planning.
● Protection against STIs (sexually transmitted infections) – in accordance with Biblical teachings, we believe that sexual intercourse should happen only within a marriage. This already provides a protective factor against STIs. However, it’s still possible that one, or both, individuals in a marriage are infected without knowing it. So it’s important that a couple know how to use contraceptive methods to protect one another.
Birth control methods
BEHAVIORAL BIRTH CONTROL METHODS: These methods rely on behavioral modification. Throughout the menstrual cycle, changes occur in a woman’s body. Through observation and self-knowledge, it’s possible to identify the fertile and non-fertile periods. The benefits of behavioral birth control are self-knowledge, communication between the couple, and respect for the natural functioning of the female body. Anyone can use these methods. The failure rate in the first year is 0.5 to 9% if strictly followed and 20% if followed regularly.²
● Ogino-Knaus Method (Rhythm, Calendar, or Table Method) – You will keep track of every day of your menstruation cycle (through an app, a notebook, a calendar…) and identify fertile, risky, and non-fertile days, according to the length of your cycle. Keep track for at least six months to increase accuracy before trusting this method alone.
● Basal body temperature method – Body temperature fluctuates with each phase of the cycle, so you will take your temperature every morning and record it. As the variations appear, you will identify what phase of the cycle you are in.
● Cervical mucous or Billings ovulation method – The vagina produces natural mucous that changes according to the menstrual cycle. In the Billings method, you observe the characteristics of your mucous (color, odor, viscosity) and the sensation it produces to identify the fertile period.
● Sympto-thermal method – This method uses the basal temperature and cervical mucous methods together. You will also need to observe the physical and psychological symptoms that appear at each phase of the cycle.
● Necklace method – This method uses a bead necklace to keep track of your cycle days. It isn’t recommended for women with a cycle of less than 27 or greater than 31 days.
BARRIER METHODS: These rely on mechanical or chemical obstacles to prevent the passage of sperm. Depending on the method, it can cause vaginal irritation or allergic reactions. The failure rate ranges from 1.6% with correct usage to 21% if used incorrectly.²
● Male condom – the well-known condom, which prevents the semen from contacting the vagina. It’s considered the simplest to use and the most effective against the transmission of infections.
● Female condom – not as famous, the female condom is inserted into the vagina before intercourse and has the same function as the male condom. Note: NEVER use the female and male condoms together. The friction between the two materials can cause disruption and consequent failure of both.
● Diaphragm – a flexible ring that covers the cervix, preventing the passage of sperm. There are several sizes, and a doctor will be able to tell you which one is right for you. It lasts for three years and can be removed and sanitized after sexual intercourse.
● Vaginal Sponge – disc-shaped, soft, made of foam, with a handle for removal. It comes with spermicide, must be wet before use, and can remain in the vagina for up to thirty hours. Its action is like that of the diaphragm, but the effectiveness is greater in women who have given birth at least once, compared to women who have never given birth.
● Spermicide – chemical substances that, introduced into the vagina, serve as ‘sperm poison’. It can come in gel, foam, cream, or suppository form. It’s the method that can cause the most irritation and hurt the genital mucosa, so it should be used with care.
HORMONAL METHODS: These chemically alter the menstrual cycle. Side effects include nausea, vomiting, bleeding, spotting, missed periods, weight gain, headache, dizziness, breast tenderness, mood swings, decreased libido, vaginal dryness, acne breakouts, and others. If you have diabetes, obesity, hypertension, or a predisposition to the development of cardiovascular diseases, there is a risk of thrombotic or cardiovascular events. The failure rate varies from 0.1% to 9% with correct use and the effectiveness reaches 99.5%.²
● Birth Control Pills – prevent ovulation and hinder the passage of sperm. There are three types of pills:
1) Monophasic pill: composed of estrogen and progesterone. At the end of each pack, there is a 7-day break to allow menstruation.
2) Minipill: contains only progesterone and must be taken continuously. Indicated for women who are breastfeeding.
3) Multiphasic pill: the hormones are combined in different dosages during each phase of the cycle, and the chart has different colors to indicate the right days to take each pill.
● Injections – have the same substances and the same action as pills. There are two types:
1) Monthly: a dose of hormones equivalent to one month. Must be administered monthly to be effective.
2) Quarterly: applied every three months, it has a greater amount of hormones and takes longer to leave the woman’s body.
● Morning-after pill – an emergency contraceptive pill. It works by preventing or delaying ovulation and delaying sperm. But its effectiveness depends on how much time has passed since sexual intercourse: the longer the interval between intercourse and the pill, the less effective it is. It should only be taken once a year, and it cannot be used as a routine contraceptive method because the hormonal dosage is too high and can cause many side effects.
● Contraceptive patch – composed of two hormones, it’s a square patch that must be applied to the skin and changed after seven days, for three weeks. Then there is a week-long pause to allow menstruation.
● Contraceptive implant – a thin plastic rod with etonogestrel, which is inserted into the skin. It acts by slowly releasing the hormone into the body. It’s active for three years and has an effectiveness rate of 99.5%.²
● Hormonal vaginal contraceptive ring – a flexible silicone ring that must be inserted into the vagina, it releases hormone for three weeks, preventing pregnancy. After that time, it must be discarded.
● Intrauterine Device (IUD) – a T-shaped plastic object that is placed inside the uterus to prevent fertilization. There are two types:
1) Copper IUD: works without hormones, rather is coated with copper and can stay in the body for up to ten years. It acts by leaving the vaginal environment hostile for sperm and has few side effects.
2) LNG IUD: releases progestin, which prevents ovulation and the passage of sperm. Can stay in the body for up to five years.
SURGICAL METHODS – This is when, through surgery, the woman or the man performs a procedure that prevents fertility. They are usually not contraindicated, but there are prerequisites to be eligible, including age and number of live children. The risks range from absolutely none to the normal risks that accompany surgery. They can be reversible or irreversible, depending on the time and the way the procedure is performed.
● Tubal ligation – a woman’s tubes are cut and tied, cauterized, or closed with clips or rings, preventing the sperm from reaching the egg. Although common, in some countries it cannot be performed at childbirth, as 60 days are required between the surgery request and surgery procedure. You will need to find out from your doctor the exact process in your location.
● Vasectomy – the man’s vas deferens are cut and tied or stapled, preventing sperm from leaving the scrotum. Only local anesthesia is necessary, and recovery is fast.
This is a summary of the methods of birth control out there. Take time to consider which method is best for you and your health at this stage of your life. Consider your future plans, talk with your husband and your health care provider. And don’t forget, “The best method for a person to use is the one that makes them comfortable and best adapts to their way of life and their health.”¹
¹Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Direitos sexuais, direitos reprodutivos e métodos anticoncepcionais / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas. – Brasília: Ministério da Saúde, 2009.
²BRASIL, Ministério da Saúde. Secretaria de Políticas de Saúde. Área Técnica de Saúde da Mulher. Assistência em Planejamento Familiar: Manual Técnico/Secretaria de Políticas de Saúde, Área Técnica de Saúde da Mulher – 4a edição – Brasília: Ministério da Saúde, 2002.
⁴WHITE, ELLEN. Testimonies for the Church 2:380. Mountain View, CA: Pacific Press Publishing Association, 1868.