Getting Advice on Contraception
Fact: A woman who has intercourse without using contraception has a 90% chance of becoming pregnant in a year.
Your midwife is there to help you have your baby, but you may not realize that she is also there to help you with options on how not to have a baby, or how to decide when to have a baby. Many women who seek the care of a midwife for their pregnancy and birth decide to stay for their ongoing well-woman gynecological care. Women who go to midwives for contraceptive services like the fact that they seem to have time to talk, that they explain the exam and perform it in a gentle way, and that they treat you as a partner in the decision about a birth control method. Midwives are educated and trained in providing all of the available reversible contraceptive options. Certified nurse-midwives, or CNMs, have prescriptive privileges in all 50 states, and can help you choose and obtain an appropriate contraceptive method. In order to do so, the midwife will ask you to make an appointment for a physical exam and Pap smear, and then go over the various options for birth control with you, taking into consideration your life style and your risk factors.
For information about contraception and reproductive health on the internet, you might try the MedlinePlus contraception site from the National Library of Medicine. Another helpful site is from the Association of Reproductive Health Professionals; it includes online brochures and information, and allows you to test your “contraception IQ” with two interactive programs. A third site you might check out is the Engender Health contraception site, which provides basic information on reversible and permanent methods, and answers questions to consider when you are considering different contraceptive methods. EngenderHealth is a nonprofit organization founded in 1943, that has been working internationally for over 30 years to support and strengthen reproductive health services for women and men worldwide. Since its inception, its work has improved the health and lives of more than 100 million individuals in 90 countries. Finally, the Food and Drug Administration has an online article, entitled “Protecting Against Unintended Pregnancy: A Guide to Contraceptive Choices.”
Although it is intended for professionals in the area of family planning, Contraceptive Technology has a lot of useful information. Check their website at http://www.contraceptiveupdate.com/.
If you have had at least one child, are in a stable, monogamous relationship, and have no history of pelvic inflammatory disease, you may want to consider an intrauterine device (IUD). For more information on this form of birth control, visit the Paragard IUD site.
Emergency contraceptives (EC) are methods of preventing pregnancy after unprotected sexual intercourse. They do not protect against sexually transmitted infections. Emergency contraception can be used when a condom breaks, after a sexual assault, or any time unprotected sexual intercourse occurs. Emergency contraceptives available in the United States include emergency contraceptive pills and the copper-T intrauterine device. (Contraceptive pills packaged specifically for use as EC are Preven and Plan B; however, other pills may be used as well.) The availability of these methods are not well known to women, nor to all providers of health care. There are several sites which provide information and referrals for emergency contraception. The Emergency Contraception World Wide Web server is operated by the Office of Population Research at Princeton University and funded through generous foundation support. This server is designed to provide accurate information about emergency contraception derived from the medical literature and a directory of clinicians willing to provide emergency contraceptives. More information on EC as well as other forms of contraception is offered by Planned Parenthood of America, which is running a public awareness campaign about EC. The announcements remind viewers that “accidents happen” and, in the case of unprotected sex, it may not be too late to prevent a pregnancy.