Nearly all women use some form of birth control during their lifetime, and almost two-thirds are currently using it at any point in time. But while there are many different types of birth control available, the effectiveness of each type can vary dramatically, ranging from more than 99 percent for the birth control implant Nexplanon to only about 72 percent for spermicide.[1]
If you're not currently trying to get pregnant, here's what you need to know about the effectiveness of some of the most common types of birth control.
Can you get pregnant on the pill?
Oral contraceptives — a pill taken daily that contains two hormones, estrogen and progesterone — are 99.7 percent effective with perfect use. This means that fewer than one out of 100 women who take the pill become pregnant in a year.
But with typical use, the effectiveness of the pill drops down to 91 percent. There are a few reasons for this: If you forget and skip a day, especially with one of the newer, lower-dose pills, your hormone levels may not remain at consistent enough levels to prevent you from getting pregnant. One type of pill, the progestin-only pill known as the mini-pill (commonly used among breastfeeding moms), needs to be taken within the same three-hour window every day to remain effective.[2]
While it's rare for medications to interfere with the pill, the antibiotic rifampin, the antifungal drug griseofulvin, the herb St. John's Wort and some epilepsy drugs and antiviral medications can make the pill less effective. The pill has also been shown to be less effective in women who are overweight or obese, in which case your doctor may recommend a higher-dose option.[3]
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Can you get pregnant if you have an IUD?
Intrauterine devices (IUDs) are one of the best birth control methods out there as they're 99 percent effective. These small pieces of T-shaped plastic — about the size of a quarter — are placed inside your uterus to prevent pregnancy.
In the rare event an IUD fails, it's usually because it falls out of place (something called IUD expulsion). This sometimes causes symptoms like heavy bleeding, cramping or vaginal discharge.
Can you get pregnant if you have an implant?
The birth control implant (known by the brand name Nexplanon) is a flexible plastic rod about the size of a matchstick that is placed under the skin of your upper arm. It releases a low, steady dose of synthetic progestin to thicken your cervical mucus and thin the lining of the uterus, preventing pregnancy.
Nexplanon is actually the most effective birth control option out there, with a failure rate of only .05 percent. That means that out of 10,000 women, only five using the implant will get pregnant within a year. This is almost always due to incorrect insertion rather than the implant itself.
Can you get pregnant if you have had the Depo-Provera shot?
The most common reason for pregnancy with Depo-Provera — a shot that contains the hormone progestin — is not getting it on time (every 12 to 13 weeks). If you do stay on top of it, the pregnancy rate after one year of use is very low. But with typical use, the failure rate hovers around 6 percent. If you think it will be hard to keep up with your shots, you should look for another method of birth control.
Can you get pregnant on the patch?
The birth control patch, like the birth control pill, contains synthetic estrogen and progesterone that "fools" your body into thinking it's pregnant. You wear the patch on your belly, upper arm, butt or back, and your skin absorbs the hormones into your body.
The patch has a similar rate of effectiveness to the birth control pill — around 9 percent. The main reason women get pregnant on the patch is because they forget to take it off and replace it once a week. With "perfect" use, however, the effectiveness rate is around 99 percent.
Can you get pregnant if you use spermicide?
If you're just using spermicide — a chemical that you put deep within the vagina before you have sex — alone, it's not a reliable method of birth control. More than a quarter of all women — 28 percent — will get pregnant using just this method.
Spermicide helps prevent pregnancy by blocking the entrance to the cervix so sperm can't get to the egg, as well as slowing sperm down. It's great to use in addition to other birth control methods such as condoms, diaphragms or cervical caps, but not reliable enough to use by itself.
Can you get pregnant if you use vaginal contraception?
Contraception that you insert into your vagina — such as a diaphragm cervical cap or sponge — is not as effective as hormonal methods. For most women, vaginal contraception offers around an 88 percent chance at preventing pregnancy. The main reason why these forms of birth control fail is because they weren't inserted correctly, or if you don't use them every time you have sex.
If you want to boost their effectiveness, use a spermicide. And if you've had at least one baby, think twice about using the sponge. In these cases, it only has an effectiveness rate of about 75 percent. (However, diaphragms and cervical caps are both re-fitted after you give birth, which makes it much less of an issue.) If you do choose to use a sponge after giving birth, you should wait at least six weeks.
Can you get pregnant if you use condoms?
If you use condoms perfectly every single time you have sex, they're 98 percent effective at preventing pregnancy. But most people don't use them perfectly, so in real life, condoms are about 85 percent effective. That means almost one in five women will get pregnant each year if they just use condoms.
The best way to make sure condoms are as effective as possible is to use them correctly. Some of the most common mistakes include:
- Putting them on too late, or pulling them off too early
- Not leaving space at the tip of the condom for semen
- Not checking for damage before use
- Using an oil based-lubricant like Vaseline or massage oil, which can damage the latex
Can you get pregnant if you have had a bilateral tubal ligation?
The chances of getting pregnant naturally after a tubal ligation, where the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy, are very low, just 0.5 percent. That means only about one of every 200 women who have this surgery get pregnant each year.
How to prevent your birth control from failing
The best way to make sure your birth control works is to pick the method that's right for you. For example, if you don't think you'll be able to remember to take a pill every day, you'd be better off using a semi-permanent option, such as an IUD or implant. These also are the most effective options.
On the other hand, if you're squeamish about hormones or need to avoid them because you have a chronic health condition such as high blood pressure, a barrier option such as condoms or a diaphragm would be a better choice. Just keep in mind that since barrier methods are less effective than an IUD or a hormonal method, if you're actively trying to avoid pregnancy, you may want to consider doubling up — with, say, condoms and spermicide — for extra assurance.
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