Anyone want to tell me about birth control?

[garddwr]

I usually stay away from too-personal topics, but I don't know where else I could find so many women willing to share their wisdom on all kinds of topics. So here goes:

 

I know the basics of different types of birth control, but I've never done any intensive research because I've never been in a position of needing it. I'm not super fertile and I've always wanted a large family. We're not done having kids, but dh and I both feel it might be a good time to take a break--maybe an extra year or so--before TTC again. Natural spacing for me seems to be between 2 and 2.5 years between kids (I get 12-18 months free from cycles while breastfeeding, which is fabulous); we're thinking of stretching that to 3-4 years. Don't want to wait too long because we're hoping for two more and I'm not getting any younger...

 

I'd like to hear pros and cons of different options from those with experience. I would really like to minimize side effects. I will also be breastfeeding, and I know some BC is not good for that. We may just work with NFP + barrier methods, especially since I'm not super worried about an "accident" (i.e., if it happens that's fine), but I want to consider other options as well.

 

:bigear:

[LaxMom]

If it were me, from what you're saying, I would go with NFP + barrier methods. No side effects and the "oops" factor would be the same for forgetting to take a pill, kwim? That was what we chose before we decided we were done.

 

Long-term, I really liked my copper (non-hormonal) IUD, but there are risks involved there, too, and it's meant for longer term than a couple of years.

 

Obviously, you should choose the method that works for your risk/benefit wise. That's just my two cents.

[carriede]

NFP/FAM with barriers would indeed be the least invasive. I'd get a copy of Taking Charge of your Fertility if you don't already have one.

[Sisyphus]

The copper iud was fabulous for me. It hurt a bit with insertion, removal was painless, no maintenance or remembering anything, no hormones. There is no reason it must be long term, though it can stay in place for 10 years (or nearly 12 in my case...whoops). I thought it was making my periods heavier and more crampy, but they have continued to be obnoxious now that's its gone, so I think that was actually just age these last 4-5 years, not the iud after all.

 

It is expensive if insurance doesn't cover it, so maybe too expensive for keeping it just 3-4 years.

[Melissa in NC]

I have been using the Nuvoring for endometriosis. I like it because I insert it and forget it for 3 weeks. It is a constant dose of hormones which I really need. Easy, easy, easy.

[Mergath]

I'd avoid the pill and other forms of hormonal bc if you're not super worried about an oops baby. It's great for people like me, who have hormone issues, but if your hormones are normal and high effectiveness isn't too much of an issue, it's probably not going to be worth the potential side effects.

 

Condoms are good. Cheap, fairly effective, and safe. Try a few different kinds to see what your dh likes. Loss of sensitivity for the guy can be an issue, but they do make some really thin ones now that help with that.

[Prairie~Phlox]

I had a copper IUD as well and loved it.

[Alexigail]

One thing I've found really helpful in addition to the ideas you've already gotten is the cycle beads app on my phone.

[happypamama]

I would learn about taking your temperatures and observing fertility signs. If you're breastfeeding, your cycles may be very irregular, but watching your fertility signs (and using a barrier method) should help a lot. I would recommend the book Taking Charge of Your Fertility. (And also, even if breastfeeding has given you a nice break in the past, it may not every time. I've breastfed all of my kids well past a year, and we have a variety of spacings -- from 3y8m down to 25 months.)

[AngieW in Texas]

The diaphragm has worked for me for 13.5 years. I am period-free for almost 18 months after childbirth.

 

The only problem I have with the diaphragm is that I can only get the gel at Walgreen's now. Everybody else stopped carrying it.

 

You put the diaphragm in beforehand and then you don't notice it's even there. You just need to remember to take it out 6-12 hours later.

[MercyA]

Wading in cautiously here, since you asked about the pros and cons of different options from those with experience. I've personally used several different methods of birth control and have also been a guest speaker on birth control and related topics at a nursing class at a local college.

 

I'm not comfortable using an IUD or any hormonal methods of birth control (the Pill, Ortho-Evra, Depo-Provera) because they all have the potential to prevent a 5- to 12-day-old newly created human from implanting in the womb. The primary mechanism of the Pill and other hormonal methods of birth control is to prevent ovulation, but they also thin the lining of the uterus, which serves to prevent implantation should ovulation and fertilization occur. Breakthrough ovulation can and does occur on the Pill. The primary mechanisms of the IUD (depending on the type) are to prevent fertilization and/or ovulation, but IUD's also cause inflammation in the lining of the womb, again preventing implantation should fertilization occur. This may or may not be a concern for you, but I wanted to mention it as the major "con" for me.

 

The Pill also made me nauseous; I felt like I continually had morning sickness while I was on it.

 

Honestly, NFP wasn't my favorite method of birth control ;) , but it is of course very safe and non-invasive and I found it easy to learn. I don't have any experience using it while breastfeeding, and that may be more challenging.

 

I would recommend using a barrier method.

 

Peace!

[stripe]

I was quite interested to read about a form of birth control called Ovaprene that was entering the testing stage, but it seems NOT to be nearly released, certainly not on the schedule predicted, and that is a mesh diaphragm/vaginal ring like thing with a mesh center that is spermicidal, and can stay in place for three weeks. So a non hormonal, less messy alternative -- ease of use like the vaginal ring in that wouldn't require spermicidal gel, and is not inserted prior to use but stays in place, but like the diaphragm in that it's non-hormonal. I don't know what happened with it, though.

http://www.ovatech.com/images/gray_sheet_19.pdf

[Chris in VA]

I would do my own, extensive research, IIWY. Yes, we are a great resource here, but honestly, there will be so many conflicting opinions and BC experiences are so very individual that I'm not sure we will be helpful, in the long run.

 

I'll just throw out that I'd probably just go with NFP for a year or so, and use the natural spacing offered by breast feeding.

[Laura Corin]

I used a Mirena whilst breastfeeding. It's a local output of hormones affecting the reproductive organs. I've had three now over twelve years and they have worked very well for me. I have no periods - just a little spotting occasionally.

 

Laura

[garddwr]

Thanks for all the responses. You have pretty much confirmed my instinct that NFP + barrier would be best for my situation: no un-wanted side effects or potential moral dilemmas. I have done some fertility tracking in the past when I was TTC, I've just never done it the other way around. I think I have heard the Take Charge of Your Fertility book recommended before, so I will definitely look into that.

[VeganCupcake]

I found NFP pretty difficult while breastfeeding--my basic infertile pattern looks a lot like almost-fertile cervical fluid. And I found it very difficult to get anything approximating accurate basal body temps with a frequently-waking, sometimes cosleeping baby/toddler. So while I have charted to conceive, I have found it more difficult to chart to avoid. I know it can be done, but I think it's very difficult to do with a baby or young toddler, unless s/he sleeps all night without waking you and getting you to move/get up. But it may work fine for you.

[MercyA]

Just wanted to add that if you use spermicide in conjunction with condoms, it boosts the effectiveness to 98-99%.

[Veritaserum]

For years I had moral qualms against certain kinds of birth control, but after pondering more I decided that I was ok with them after all. After our NFP baby (#5), I *really* needed a break for my sanity. I got a Mirena IUD. I ended up not liking that, so I swapped it for a Paragard. Best birth control I ever used.

 

After my sixth was born we knew we needed to be done and our family felt complete. Dh got a vasectomy. Prior to that, I used the mini pill (the one you can use while breast feeding). I had used it in the past, but it made me so sick this time! I quit after six weeks. I used the sponge after that. It's a barrier with a spermicide.

 

If dh hadn't gotten a vasectomy, I would have gotten another Paragard.

[garddwr]

 

I used to be under the false impression that intrauterine devices can cause abortions (egg can be fertilized, but can't implant), but they actually change your cervical mucus to the extent that there is basically no way egg and sperm can meet in the first place. Mirena can also prevent ovulation.

 

I have had several friends get pregnant and miscarry while using an IUD, so while they might work the way you describe most of the time, they obviously don't work all the time.

[MercyA]

I used to be under the false impression that intrauterine devices can cause abortions (egg can be fertilized, but can't implant), but they actually change your cervical mucus to the extent that there is basically no way egg and sperm can meet in the first place.

 

Estimated post-fertilization losses attributable to the IUD, per year, for various types:

 

Inert IUD--0.72 to 1.97 losses per year

Copper-380 IUD (Paraguard)--0.19 to 1.04 losses per year

Levonorgestrel-20 IUD (Minera)--0.19 to 1.82 losses per year

 

"These estimates indicate that, although prefertilization effects are more prominent for the copper IUD, both prefertilization and postfertilization mechanisms of action contribute significantly to the effectiveness of all types of intrauterine devices."

 

Source: Mechanisms of action of intrauterine devices: Update and estimation of postfertilization effects by Joseph B. Stanford, MD, MSPH, and Rafael T. Mikolajczyk, MD. American Journal of Obstetrics and Gynecology, 2002;187:1699-708.

[LucyStoner]

NFP + barrier during fertile periods is what we use. Because many forms of hormonal BC costs me my sex drive and creates other problems, NFP is what we use. That said, it is not easy or especially reliable while breastfeeding. I think I would prefer an IUD while breastfeeding.

 

Lots of women miscarry when not using an IUD or hormonal BC in any form, stating that a miscarriage while on BC is because of the BC is not accurate. I have an almost 10 year old to defy that- conceived on the pill and born 9 months later. There are also IUD babies born every year.

[Veritaserum]

 

 

I have had several friends get pregnant and miscarry while using an IUD, so while they might work the way you describe most of the time, they obviously don't work all the time.

 

NO birth control works all the time. See my NFP baby. :) What each couple has to decide is which method will be the most effective with the fewest number of cons or side effects.

[garddwr]

NFP + barrier during fertile periods is what we use. Because many forms of hormonal BC costs me my sex drive and creates other problems, NFP is what we use. That said, it is not easy or especially reliable while breastfeeding. I think I would prefer an IUD while breastfeeding.

 

Lots of women miscarry when not using an IUD or hormonal BC in any form, stating that a miscarriage while on BC is because of the BC is not accurate. I have an almost 10 year old to defy that- conceived on the pill and born 9 months later. There are also IUD babies born every year.

 

A previous poster stated that the IUD functioned in such a way as to make it impossible for egg and sperm to meet. That is the claim we were responding to. If a miscarriage occurs, the egg and sperm obviously met. If a baby is conceived and carried to term the egg and sperm also obviously met.

 

ETA: sorry if I am misunderstanding your argument. I have a tantruming toddler I'm trying to deal with so I'm sure my brain is not fully engaged. From my experience through my friends when conception occurs with an IUD miscarriage is much more likely than if it had occurred without the IUD. If that is true then many miscarriages would have to be attributed directly to the effects of the IUD.

[LucyStoner]

 

 

A previous poster stated that the IUD functioned in such a way as to make it impossible for egg and sperm to meet. That is the claim we were responding to. If a miscarriage occurs, the egg and sperm obviously met. If a baby is conceived and carried to term the egg and sperm also obviously met.

 

That no BC is 100% effective goes without saying. However I frequently hear that miscarriages are caused by BC or that various forms of birth control are abortifacients and that is simply not true. I have had recurrent miscarriages while TTC. Miscarriages are not rare. A very significant number of pregnancies, both planned and unplanned, end spontaneously. Some of these are pregnancies that are the result of BC failures and it is impossible to say for sure if there would or would not have been a mc if the BC was not used.

[Karen in CO]

NO birth control works all the time. See my NFP baby. :) What each couple has to decide is which method will be the most effective with the fewest number of cons or side effects.

 

My OB has told me more than once that 99% is 99% for a reason. With all three of my kids as surprises from 3 different bc methods, I will now always recommend NFP for people who aren't done having kids yet. It has fewer side effects. :D

[MercyA]

That no BC is 100% effective goes without saying. However I frequently hear that miscarriages are caused by BC or that various forms of birth control are abortifacients and that is simply not true. I have had recurrent miscarriages while TTC. Miscarriages are not rare. A very significant number of pregnancies, both planned and unplanned, end spontaneously. Some of these are pregnancies that are the result of BC failures and it is impossible to say for sure if there would or would not have been a mc if the BC was not used.

 

The study I cited above estimated post-fertilization losses that were *specifically attributable* to IUD's. The authors of the study of course accounted for natural miscarriages and many other factors when doing their research and calculations.

 

Obviously no one can tell for sure whether or not a specific loss was directly caused by birth control, although researchers can make educated estimates of how often it occurs. The point is simply that some methods of birth control can indeed prevent implantation, and that is a concern for some.

[SarahW]

The study I cited above estimated post-fertilization losses that were *specifically attributable* to IUD's. The authors of the study of course accounted for natural miscarriages and many other factors when doing their research and calculations.

 

Obviously no one can tell for sure whether or not a specific loss was directly caused by birth control, although researchers can make educated estimates of how often it occurs. The point is simply that some methods of birth control can indeed prevent implantation, and that is a concern for some.

 

 

I don't mean to be argumentative, or take this off course, but even if that is true, it means nothing to me.

 

When DH and I decided to have baby #2 I had already been off BC for quite a few years. We were sort of in the mind of "oops if we do, oh well if we don't" during that time. But then we started actually trying and --- nothing. I got a copy of TCOYF out of the library and charted, and as it turns out I ovulate late, and from some quick calculations the reason why I wasn't getting pregnant was because my luteal phase was under 14 days, sometimes by a lot. Well, I did get a month where timing worked out and my luteal phase didn't put the kabosh on things (I suspect it had something to do with the complete elimination of soy in my diet, ymmv) and now I'm 3 months pregnant.

 

How many fertilized eggs did my body expel over the years because of my short luteal phase? I have no idea, but I'm guessing at least a few. Does this make God a murderer? No, I don't think it does. Which is why I don't think a fertilized egg before implantation has a soul. I'm not making this up, this is old Catholic teaching, and it is the only thing that makes sense to me in the light of biological reality.

[MercyA]

I'm not trying to be argumentative either, but I did want to respond to a few of your comments.

 

I don't mean to be argumentative, or take this off course, but even if that is true, it means nothing to me.

 

I did say that this is a "concern for some." I recognize that not everyone is bothered by this.

 

How many fertilized eggs did my body expel over the years because of my short luteal phase? I have no idea, but I'm guessing at least a few. Does this make God a murderer?

 

Of course not; nor is He a murderer when a baby is miscarried at 8 weeks gestational age, or at 8 months, or when a child dies after birth.

 

Which is why I don't think a fertilized egg before implantation has a soul. I'm not making this up, this is old Catholic teaching, and it is the only thing that makes sense to me in the light of biological reality.

 

Well, I'm not Catholic ;) , and I didn't say anything about souls. I don't claim to know when the soul comes into existence, but it makes sense to me that it would not be dependent on one's age, size, level of development, or degree of dependence.

 

Regardless, I personally don't want to potentially cause the end of a human life by preventing his or her implantation. When it comes to anyone's life, I'd much rather err on the side of caution.

 

Congratulations on your pregnancy! :) (And very interesting, about the soy!)

[SarahW]

MercyA, I'm really not trying to argue, but a few times on this thread you made any sort of non-barrier form of BC into a moral issue because of the fact that you believe they often cause fertilized eggs to be expelled. You apparently believe this is causing the end of human life, because otherwise it would not be a moral issue.

 

My point is that a woman's body will, in fact, sometimes expel a fertilized egg before implantation even without any BC method (which is what I think kijipt was also saying). If God thought this was causing the end of human life, something completely sacred, why does he allow a woman's body to work this way?

 

Therefore, if you say BC expelling fertilized eggs makes them morally wrong, then you are also saying that God made women's bodies to be immoral.

 

And I'm not Catholic either. Just saying that the idea that personhood starts at conception has not always been the mainstream Christian teaching.

 

If you want to err on the side of caution, fine. Please do. But I get all sorts of nervous when people imply that people who choose hormonal BC are going to "be surprised to find they have a lot more kids when they get to heaven." I know that's not what you said, but I have actually read that in real life. And as a woman who has had a short luteal phase, it makes me a little snippy.

[PachiSusan]

MercyA, I'm really not trying to argue, but a few times on this thread you made any sort of non-barrier form of BC into a moral issue because of the fact that you believe they often cause fertilized eggs to be expelled. You apparently believe this is causing the end of human life, because otherwise it would not be a moral issue.

 

My point is that a woman's body will, in fact, sometimes expel a fertilized egg before implantation even without any BC method (which is what I think kijipt was also saying). If God thought this was causing the end of human life, something completely sacred, why does he allow a woman's body to work this way?

 

Therefore, if you say BC expelling fertilized eggs makes them morally wrong, then you are also saying that God made women's bodies to be immoral.

 

And I'm not Catholic either. Just saying that the idea that personhood starts at conception has not always been the mainstream Christian teaching.

 

If you want to err on the side of caution, fine. Please do. But I get all sorts of nervous when people imply that people who choose hormonal BC are going to "be surprised to find they have a lot more kids when they get to heaven." I know that's not what you said, but I have actually read that in real life. And as a woman who has had a short luteal phase, it makes me a little snippy.

 

It is not a "belief" that hormonal birth control changes a woman's body and can expel a fertilized egg - it is a fact that one of the mechanisms of hormonal birth control is to expel n embryo if conception occurs.

 

It is a "belief" that it ends a life because that has not been proven OR disproven where life begins.

 

I'm not sure how to address the bolded...but when an embryo is expelled due to natural processes it is TOTALLY different. In one instance, there is either something wrong with the embryo or the mother that causes such an early spontaneous abortion (miscarriage) In the other, one is purposely taking something that can cause an otherwise completely viable product of conception to abort. Do you really want to compare the two??? One is active commission, one is natural.

 

As a woman who has a very short luteal phase myself, learning the facts about hormonal birth control doesn't make me snippy - having to avoid sex for longer periods than other women does makes me snippy. ;)

 

ETA: Modified hopefully to make more sense.

[MercyA]

Peace, Sarah. I'm sorry you feel snippy. The OP asked for input on the pros and cons of various methods of birth control, and I shared my personal input, which I think she appreciated. I have tried to as pleasant and diplomatic as possible while still being open and honest about my beliefs.

 

I believe that preventing implantation does end a human life (see a few quotes from embryology textbooks, below), and yes, the loss of any human life is a moral issue to me.

 

Yes, God allows zygotes to be expelled. He also allows babies of *all* ages to be miscarried, and allows already born humans of all ages to die. I fail to see how that makes their lives any less sacred, and of course those natural deaths do not make their mothers' bodies immoral. The issue for me is causation. I don't want to *cause* the ending of a life by my actions. I'm sorry you are so offended by my point of view. It was not my purpose to cause offense.

 

I hope I never base my beliefs simply on mainstream teaching of any kind. Believe it or not, I've arrived at my conclusions on my own. ;)

 

"Although life is a continuous process, fertilization (which, incidentally, is not a 'moment') is a critical landmark because, under ordinary circumstances, a new genetically distinct human organism is formed when the chromosomes of the male and female pronuclei blend in the oocyte."

Ronan O'Rahilly and Fabiola Müller, Human Embryology and Teratology, 3rd edition. New York: Wiley-Liss, 2001. p. 8.

 

"Human development begins at fertilization, the process during which a male gamete or sperm (spermatozoo development) unites with a female gamete or oocyte (ovum) to form a single cell called a zygote. This highly specialized, totipotent cell marked the beginning of each of us as a unique individual."

Keith L. Moore, The Developing Human: Clinically Oriented Embryology, 7th edition. Philadelphia, PA: Saunders, 2003. pp. 16.

 

"[The zygote], formed by the union of an oocyte and a sperm, is the beginning of a new human being."

Keith L. Moore, Before We Are Born: Essentials of Embryology, 7th edition. Philadelphia, PA: Saunders, 2008. p. 2.

 

ETA: Having said my piece, I really need to bow out for the night. Let's try not to get this thread locked down (speaking to myself here, too). Peace to all.

[goldberry]

Mercy, you really kind of rock for your kind and thoughtful manner of speaking!

 

To other posters, in her first post she very clearly stated, "this may or may not be a concern to you" but here is some info. She was being absolutely non-accusational against the OP or any other posters.

 

FTR, I personally am a long term hormonal BC user. I did not take offense to any of Mercy's comments.

[Veritaserum]

Mercy, you really kind of rock for your kind and thoughtful manner of speaking!

 

To other posters, in her first post she very clearly stated, "this may or may not be a concern to you" but here is some info. She was being absolutely non-accusational against the OP or any other posters.

 

FTR, I personally am a long term hormonal BC user. I did not take offense to any of Mercy's comments.

 

I'm not comfortable using an IUD or any hormonal methods of birth control (the Pill, Ortho-Evra, Depo-Provera) because they all have the potential to prevent a 5- to 12-day-old newly created human from implanting in the womb.

 

I think some readers who use/used IUD and hormonal BC may have found the bolded phrasing to be inflammatory....

[MercyA]

Thank you, coloradoperkins. You made my night. :)

[Sisyphus]

I can see where some might consider the language used inflammatory, but as an iud using person, I personally did not. Because I don't think a 5 to 12 day old blastocyst is a newly formed human, so? No problem. Others do think that, ergo they don't have a copper iud. The op asked for opinions, and a variety of people are giving them, as she wanted. Nothing to get upset about, I haven't seen any outright falsehoods used, just the regular ol opinion based reasons- shouldn't that be expected?

 

I would hate for anyone to feel restricted from sharing their views on a thread like this, they are their views after all!

[JumpyTheFrog]

I used to believe that hormonal birth control pills caused miscarriages and thus were incompatible with a pro-life view. However, the more I read about it, the more it sounds like this theory was never more than speculation by doctors decades ago. At the time, they didn't have enough evidence to know about rates of breakthrough ovulation and how the uterine lining might change,

 

This article to makes the important point that if hormone levels are high enough to allow ovulation, they are also high enough that the uterine lining would be normal and a fertilize egg would implant normally. The months where the lining is abnormally thin, the hormone levels are too low to allow ovulation to begin with. Therefore, it is very, very unlikely that hormonal pills cause miscarriages that wouldn't have otherwise occurred.

 

(I don't know if it might be different for IUDs, since they are a physical irritant to the uterus.)

[mommaduck]

diaphragm

[PachiSusan]

I used to believe that hormonal birth control pills caused miscarriages and thus were incompatible with a pro-life view. However, the more I read about it, the more it sounds like this theory was never more than speculation by doctors decades ago. At the time, they didn't have enough evidence to know about rates of breakthrough ovulation and how the uterine lining might change,

 

This article to makes the important point that if hormone levels are high enough to allow ovulation, they are also high enough that the uterine lining would be normal and a fertilize egg would implant normally. The months where the lining is abnormally thin, the hormone levels are too low to allow ovulation to begin with. Therefore, it is very, very unlikely that hormonal pills cause miscarriages that wouldn't have otherwise occurred.

 

(I don't know if it might be different for IUDs, since they are a physical irritant to the uterus.)

 

That information is not entirely accurate.

 

If one does a lot of research on this topic, one will find that the newer less hormone pills actually allow MORE breakthrough ovulation than ever before. The high hormone pills of the 60's? Likely it never happened. I had infertility for 3 years. TTC causes you to research until you're nauseated, and then research more.

 

I don't have a problem with anyone using any method of birth control they wish. For me, I have done my research and I know what I am comfortable with and what I am not comfortable with.

 

I do not think that the decision should be made lightly, and I do believe that all the information should be presented to each woman that wants to use the pill so that the decision is completely an informed one.

 

About 10 years ago, I was challenged to read the insert to the BC pack. I was shocked at how much information is right there if one only reads it. All 3 actions of the pill are right there in the insert. You don't HAVE to research any more than that. The producers of the pill know how the pill works, and then tell you in the insert.