When it comes to birth control, many people want to just set it and forget it. It’s there, it does its job, who wants to think about it, right?
But bungling birth control is all too common. To make sure you can count on your contraceptive, here are the potential pitfalls.
You’re not using it
It’s no secret that birth control is a touchy subject. Political and religious leaders fight about it endlessly, and it’s all tangled up in personal choices about sex.
But the bottom line is if you’re sexually active, and now isn’t a great time to start a family, you should select a type of birth control that works for you.
Missing three or more combination birth control pills (the most commonly used type, which contain both estrogen and progestin) means all bets are off until you’ve taken the pills again for seven days straight—so you need to use backup birth control during that week.
If you miss even one or two of the first pills of a pack, it also means you need seven days of backup birth control (such as condoms).
Progestin-only pills need to be taken at the same time each day, with backup contraception needed for 48 hours if you get off-schedule by more than three hours.
You’re on the wrong pill
People call it “the pill,” but there are a bunch of different types, with some more effective than others. If you’re breastfeeding or have heart disease, migraines, or other reasons you can’t take estrogen, it may make sense to be on a progestin-only pill (or “mini-pill”), but a combination pill provides more pregnancy protection.
“Choosing between birth control pills is more of an art than a science,” says Dr. Edelman. Talk to your doctor about balancing the highest level of efficacy with your other needs and concerns.
You pick the wrong condoms
Condoms that are too small can break, and there is some evidence that polyurethane condoms may break more frequently than latex ones.
Latex, polyurethane, and lambskin condoms all protect against pregnancy, but lambskin condoms may not protect against HIV. So unless a latex allergy is an issue, lambskin condoms may not be your best option.
You skip backup
If you get a contraceptive implant (Implanon) or start taking a combination pill within five days after your period starts, you don’t need backup birth control, but if you start any other time during your cycle, you need condoms or another birth control method for the first seven days.
For progestin-only pills, you need backup for the first 48 hours of use. Whatever type you choose, check with your doctor to find out if you need backup until it starts working.
You don’t have an emergency plan
If a condom breaks or slips off, an IUD insertion or emergency contraception (also called the “morning-after pill”) can help prevent unwanted pregnancy.
People 17 and older don’t need a prescription to buy emergency contraception products, called Plan B One-Step and Next Choice, at drugstores.
But the pills must be taken within 72 hours (up to 3 days) of unprotected sex, according to the manufacturers, and the sooner the better. (Experts, including Planned Parenthood, say emergency contraception will work if taken within 120 hours, or up to 5 days, but again—sooner is better.) It’s a good idea to have them on hand, just in case.
You rely on spermicide alone
Studies show that spermicide can make other methods of contraception, including condoms and the pill, even more effective. But on its own, spermicide offers very low protection from pregnancy.
You use condoms incorrectly
Condoms need to be used correctly to work. (They’re 98% effective if you do it right, only 83% if you don’t).
Use one before any genital contact, not just before intercourse or climax as even a few drops of pre-ejaculatory fluid can cause pregnancy.
To prevent breakage, squeeze the tip of the condom to get the air out before putting it on. Check which way the condom unrolls before touching it to the penis, and if you make a mistake, throw it away in case there’s already semen on the tip.
It’s common knowledge that smoking while taking birth control pills ups the risk of blood clots, heart disease, and stroke—though the risk may be higher with some types of pills than others.
Can’t quit, no matter how hard you try? Don’t give up, since serial quitters are more likely to successfully kick the habit.
In the meantime, talk to your doctor to find the safest birth control for you.
You don’t use condoms
Condoms can help protect you from sexually transmitted diseases such as HIV, unlike hormonal birth control.
Diaphragms and cervical caps may provide a small amount of STD protection, but are much less effective than condoms.