There are so many birth control choices. I don’t even know where to begin. My boyfriend says it’s up to me. I’m happy using condoms, but I don’t always have them when I need them. Besides, he doesn’t like them at all. I know that the birth control pill is the most effective method, but I’m not good at remembering to take them and they cost too much. Maybe I don’t need to worry about birth control because I haven’t got pregnant yet. I probably can’t get pregnant anyway.
- Age of less than 30 years old.
- Frequent intercourse.
- Lifestyle (e.g., street involvement) or sexual patterns that make correct and consistent use of birth control difficult.
- Known use of alcohol and/or other substances.
- Previous contraceptive failure.
For more information on pregnancy, click here.
According to the 2009/2010 Canadian Community Health Survey, 66% of youth aged 15-24 had sexual intercourse at least one time (Rotermann, 2012).
Whereas in a 2010 Edmonton study of street-involved youth, 98.5% of youth ages 15-24, had sexual intercourse at least once (Alberta Health Services, 2011).
Abstinence means different things to different people. It is often referred to as being 100% safe; meaning that it completely eliminates the risk of unintended pregnancy and sexually transmitted infections (STIs). This is only true if abstinence is interpreted to mean no intimate sexual contact with another person, such as contact with vaginal or seminal fluid, any contact with the anal or genital area or intimate skin to skin contact. Pregnancy can occur without intercourse if sperm is ejaculated near the entrance of the vagina. Abstinence may not be seen as an option for all youth given their life circumstances.
Withdrawal (“pulling out”) is when the penis is pulled out of the vagina before ejaculation. With typical use, this is about 73% effective at preventing pregnancy. This method is not recommended if unintended pregnancy would be a problem and emergency contraception should be considered.
Some methods of birth control are combined hormonal contraception which means they contain both estrogen and progesterone. The way the combined hormones work is by preventing ovulation. If a person does not release an egg, they cannot get pregnant.
Examples of combined hormonal birth control methods include the birth control pill, the contraceptive patch and the vaginal ring.
Some hormonal methods contain only one hormone called progesterone. This type of contraception is often referred to as progesterone only hormonal contraception.
The way that progesterone only contraception works is that progesterone thickens the cervical mucus to help prevent sperm from getting into the uterus, changing the lining of the uterus which helps prevent a fertilized egg (embryo) from implanting, and it changes the movement of the ovum (egg) inside the fallopian tube to help prevent the egg and sperm from meeting. Progesterone only contraception may or may not prevent ovulation.
Examples of progesterone only contraception include Depo-Provera injections (“the shot”), progesterone only pills (“mini pill”), Mirena and Jaydess IUD.
Barrier methods are methods that work by blocking sperm from getting inside the uterus. Examples of barrier methods of birth control are diaphragms and male and female condoms. For added protection some barrier methods are intended for use with a spermicide.
Spermicidal methods are products that are inserted into the vagina or contraceptive device (e.g., diaphragm) prior to insertion into the vagina that help to kill sperm. The active ingredient for spermicidal products in Canada is nonoxynol-9 (N-9). Spermicidal products can come in several forms like foam, film, suppositories and creams.
Other methods of birth control include the Copper IUD, vasectomy, and tubal ligation. Vasectomy and tubal ligation are sometimes referred to as sterilization and are not reversible.
The ECP works best if taken within first 24 hours but can be used up to 5 days. Levonorgestrel ECPs can be bought at a pharmacy without a prescription, or found at many family doctors, walk in clinics or Alberta Health Services Sexual and Reproductive Health Clinics. For information on community resources, click here. A newer type of ECP, ulipristal acetate is also available by prescription. The Copper IUD needs to be inserted into the uterus by a trained health care professional. Youth should be encouraged to call their local clinic to see if this if offered.
A person should do a pregnancy test if their period does not come within three weeks of using EC, or if the period is much lighter than normal. For more information on ECPs, click here.
Other methods require a prescription (e.g., birth control pill, patch, ring, IUD). Some methods require insertion or fitting by a healthcare provider (e.g., IUD and diaphragms).
|Natural Family Planning||Abstinence||Excellent Protection|
|Fertility Awareness-Based Methods||No Protection|
|Hormonal||Birth Control Pill||No Protection|
|Depo Provera||No Protection|
|Emergency Contraception Pills||No Protection|
|Evra Patch||No Protection|
|Hormonal IUD||No Protection|
|Vaginal Contraceptive Ring||No Protection|
|Barrier||Male Condom (latex or polyurethane)||Good Protection|
|Female Condom||Good Protection|
|Diaphragm with Spermicidal Jelly||No Protection|
|Spermicidal||Foam and Jelly||No Protection|
|The Sponge||No Protection|
|Vaginal Contraceptive Film||No Protection|
|Other||Copper IUD||No Protection|
|Tubal Ligation||No Protection|
For information on STIs, click here.
- What matters most is correct and consistent use of the birth control method. Often this is based on age and where one is in their life (e.g., taking a pill everyday may be hard for those with unstable living conditions).
- No method is 100% effective at preventing pregnancy.
- Dual protection or the use of two methods (e.g., hormonal contraception and a condom) at the same time dramatically lowers the risk of unintended pregnancy and STIs.
- Methods of birth control that protect a person for a long time and do not require daily or coital adherence tend to be associated with lower pregnancy rates. Long acting methods of birth control include IUDs and the birth control injection.
- Emergency contraception (EC) provides a last chance to prevent pregnancy after unprotected sex.
Alberta Health Services. (2011). E-SYS. Enhanced street youth surveillance Edmonton site results (1999-2010). Edmonton AB: Communicable Disease Control, Alberta Health Services.
Elliot, A. (2013). Meeting the health care needs of street-involved youth. Paediatrics and Child Health, 18(6), 317-321.
Hatcher, R.A., et al. (2011). Contraceptive Technology (20th Ed.). Ardent Media: New York.
Lokanc-Diluzio, W. (2014). A mixed methods study of service provider capacity development to protect and promote the sexual and reproductive health of street-involved youth: An evaluation of two training approaches. (Doctoral dissertation). Available from http://hdl.handle.net/11023/1507
Smith, A., Stewart, D., Poon, C., Peled, M., Saewyc, E., and McCreary Centre Society. (2015). Our communities, our youth: The health of homeless and street-involved youth in BC. Vancouver, BC: McCreary Centre Society.
Rotermann, M. (2012). Sexual behaviour and condom use of 15- to 24-year-olds in 2003 and 2009/2010. Health Reports, 23(1).