Birth Control Methods vs. Abstinence: Pros and Cons

Introduction

Although birth control methods and abstinence are widely acknowledged and practiced, it is important to consider their respective advantages and disadvantages.

Every woman holds the right to decide whether and when she wants to become pregnant. For couples who are planning for a family, using birth control methods until they are ready helps ensure that both the mother and the newborn will be as healthy as possible. If an individual is sexually active, the only way to prevent pregnancy is to choose an effective birth control method and to use it correctly and consistently ("Birth Control: What's Right for You?").

According to the Columbia Encyclopedia, birth control can be defined as the "practice of contraception for the purpose of limiting reproduction" ("Birth Control"). Research conducted to date has not identified a single best method of birth control, as all methods have their pros and cons. Every man and woman can exercise control over when they become parents; however, making choices about birth control or contraceptive methods is not straightforward. Many factors must be considered, including overall health, frequency of sexual intercourse, number of sexual partners, desire to have children, possible side effects, and comfort level with a given method. It is also important to remember that even the most effective birth control methods can sometimes fail ("Birth Control Methods").

Abstinence, on the other hand, can be simply described as refraining from sex of any kind — vaginal, anal, or oral. When an individual decides to practice sexual abstinence, he or she has chosen not to have sex. Abstinence is considered the simplest form of birth control because it requires no device or medication. If a couple does not engage in sexual intercourse, there is no possibility of a sperm fertilizing an egg, and therefore no pregnancy. Other forms of birth control, such as condoms, rely on barriers that prevent sperm from reaching the egg, or interfere with the menstrual cycle as hormonal pills do. Abstinence requires neither a barrier nor a pill.

Birth Control Methods

Birth control methods available to males include withdrawal — the practice of the male pulling out before ejaculation — which is said to be the oldest technique for contraception. Another method is the condom, a rubber sheath used to cover the penis. Because it also provides protection against sexually transmitted diseases (STDs), the condom is the most frequently used contraceptive device ("Birth Control").

Contraceptive methods for females are more varied. The rhythm method involves abstaining from sexual intercourse around the time of ovulation. Women may also use precoital insertion of spermicidal substances — creams, foams, jellies, or suppositories — into the vagina. The diaphragm is a cup-shaped rubber device inserted before intercourse to prevent sperm from reaching the uterine cervix; it yields the best results when used together with a spermicide. Contraceptive sponges infused with spermicide are also inserted into the vagina before sexual contact and work principally by stopping the male sperm from fertilizing the female egg. Intrauterine devices (IUDs) are small objects of various shapes inserted into the uterus by a physician; their primary purpose is to create a uterine environment that is unreceptive to sperm or to a fertilized egg ("Birth Control").

The birth control pill is an oral contraceptive. Its intake "involves a hormonal method in which estrogen and progestins (progesterone-like substances) are taken cyclically for 21 or 84 days, followed by 7 days of inactive or no pills" ("Birth Control"). The elevated hormone levels in the blood suppress the production of pituitary hormones — luteinizing hormone and follicle-stimulating hormone — that normally trigger ovulation. There is also a formulation taken every day with no inactive pills, which achieves complete suppression of menstruation. A weekly contraceptive skin patch delivers estrogen and progestins transdermally. A flexible plastic ring — the vaginal ring — can be worn for a full month to slowly release estrogen and progestins through the vaginal tract ("Birth Control").

Female sterilization is often performed during a Cesarean section or shortly after childbirth, in a procedure in which the Fallopian tubes — the vessels carrying egg cells from the ovaries to the uterus — are cut or tied. In vasectomy, the male sterilization procedure, surgeons interrupt the tubes that carry sperm from the testes to the penis. In most cases, sterilization is irreversible; however, neither libido nor the capacity for sexual pleasure is lost as a consequence ("Birth Control").

The birth control shot, known by the brand name Depo-Provera, is another option. Women receive injections of the hormone progestin in the buttocks or arm every three months. The shot prevents the release of eggs from the ovaries and causes changes in the cervix that stop sperm from reaching an egg. The implantable rod — a matchstick-sized, flexible rod inserted under the skin of the upper arm — releases progestin that alters the inner lining of the uterus and the cervical mucus, preventing sperm from joining an egg. It remains effective for up to five years ("Birth Control Methods").

It is important to note that no contraceptive currently formulated is simultaneously trouble-free, highly effective, safe, and fully reversible. For instance, the diaphragm, condom, and chemical and rhythm methods all require high motivation and consistent use. The daily birth control pill frequently produces negative side effects, including nausea, headache, weight gain, and an increased tendency for blood-clot formation. While intrauterine devices require no ongoing personal effort, they are often poorly tolerated, can be expelled, and — if improperly designed — may cause uterine infection, septic abortion, or related complications ("Birth Control").

In cases where birth control is not used or fails, a doctor may prescribe several large doses of certain oral contraceptives as "morning-after" pills. The elevated hormone levels that result can inhibit the establishment of pregnancy even after intercourse has occurred ("Birth Control"). All birth control methods work best only when used correctly and consistently every time a couple has sex ("Birth Control Methods").

Side Effects and Risks of Contraception

As noted above, all birth control methods carry side effects that should not be overlooked. Side effects and risks of sterilization surgery for women include pain, bleeding, surgical complications, and ectopic pregnancy. The male sterilization procedure carries the same risks, excluding ectopic pregnancy. The implantable rod does not work reliably for obese or significantly overweight women. Other potential side effects include acne, weight gain, ovarian cysts, mood swings, depression, hair loss, headache, nausea, dizziness, breast soreness, changes in the menstrual cycle, and decreased interest in sex ("Birth Control Methods"). IUDs can sometimes cause "cramps, bleeding between periods, pelvic inflammatory disease, infertility, or a tear or hole in the uterus" ("Birth Control Methods").

The birth control shot can cause bleeding between periods, weight gain, breast tenderness, and headaches; long-term use may also lead to bone density loss. Side effects of oral contraceptives include dizziness, nausea, changes in the menstrual cycle, stroke, mood swings, weight gain, high blood pressure, blood clotting, heart attack, and vision problems. The vaginal ring can cause vaginal swelling, discharge, and irritation. When the diaphragm is used with spermicide, it can cause pain, allergic reactions, and urinary tract infections, and prolonged use raises the risk of toxic shock syndrome.

Because of these side effects, oral contraceptives, the vaginal ring, the diaphragm, the shot or injection, and IUDs should be used only under a physician's prescription. Condoms, spermicides, and emergency contraceptive pills may be purchased over the counter ("Birth Control Methods").

Conclusion

In summary, where abstinence means not having sex, birth control methods address how to have sex safely ("The ABC's of Teen" A21). Both birth control methods and sexual abstinence are useful in their own ways. However, the disadvantages and side effects of each approach should not be ignored. Practicing moderation and making informed, personal decisions remains the best policy in this regard.