Birth Control
Most women can become pregnant from the time they are in their early teens until they are in their late 40s. About one half of all pregnancies are unplanned. Birth control helps a woman plan her pregnancies.
Methods of Birth Control
There are many methods of birth control. Each method has good points as well as side effects. Birth control allows a woman to plan her family — both the number and spacing of children. The birth control pill, injections, vaginal ring, skin patch, intrauterine device (IUD), diaphragm, Lea's Shield, and cervical cap require a prescription. Condoms and spermicides do not. More than one method may be used at the same time. For instance, a barrier method may be used with any other method.
Barrier Methods & Birth Control
The birth control pill, injections, vaginal ring, skin patch, intrauterine device (IUD), diaphragm, Lea’s Shield, and cervical cap require a prescription. Condoms and spermicides do not.
More than one method may be used at the same time. For instance, a barrier method may be used with any other method.
Barrier Methods
Barrier methods include spermicides, condoms (male and female), the diaphragm, the cervical cap, and Lea’s Shield.
Barrier methods are effective when used the correct way every time you have sex. Even one act of sex without birth control can result in pregnancy.
Intrauterine Device
The IUD is a small, plastic device that is inserted and left inside the uterus to prevent pregnancy. Although there have been several types of IUDs, currently only two are available in the United States: the hormonal IUD and the copper IUD.
Hormonal Contraception
With hormonal birth control, a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. When there is no egg to be fertilized, pregnancy cannot occur.
Birth Control Pills
One of the most popular methods of hormonal birth control is the birth control pill (oral contraceptive). Most birth control pills are combination pills. They contain the hormones estrogen and progestin.
Injections
One type of injection of hormonal birth control, called depot-medroxyprogesterone acetate (DMPA), provides protection against pregnancy for three months. This means a woman needs only four injections each year.
Vaginal Ring
The vaginal ring is a flexible, plastic ring that is placed in the upper vagina. The ring releases both estrogen and progestin continuously to prevent pregnancy. It is worn for 21 days, removed for 7 days, and then a new ring is inserted.
Skin Patch
The contraceptive skin patch is a small (1.75 square inch) adhesive patch that is worn on the skin to prevent pregnancy. It is a weekly method of hormonal birth control.
Natural Family Planning
Natural family planning used to be called the rhythm method or “safe period.” It also is called periodic abstinence or, more recently, fertility awareness. It isn’t a single method but a variety of methods.
Types of natural family planning include:
Basal body temperature method
Ovulation/cervical mucus method
Symptothermal method
Calendar method
Lactational amenorrhea
Withdrawal
The withdrawal method prevents pregnancy by not allowing sperm to be released in the woman’s vagina. This requires the man to take his penis out of the woman before he ejaculates. Drawbacks are that sperm can be present in the fluid produced by the penis before ejaculation and some men fail to withdraw completely or in time.
Sterilization
Sterilization for women and men works by permanently blocking the pathways of egg and sperm. This can be done by surgery.
Tubal sterilization is done by laparoscopy and minilaparotomy. The fallopian tubes are closed by tying, banding, clipping, blocking, or cutting them, or by sealing them with electric current.
Vasectomy involves cutting a man’s vas deferens so that sperm cannot mix with semen. The tubes that carry sperm to the penis are clamped, cut, or sealed so that the ends do not join again.
New Option for Sterilization
Women who want a permanent method of birth control now have an option that does not involve surgery. With this method, a tiny springlike device is inserted through the vagina into each fallopian tube. This device causes scar tissue to build up in the tubes. This build-up blocks the fallopian tubes and prevents the sperm from reaching the egg. It takes three months for the scar tissue to grow, so women should use another method of birth control during this period. This device can be inserted in a doctor’s office.
Choosing a Method At any given time, a couple may find one method of birth control suits their needs better than others. Most women and couples use many methods over their lifetime.
All methods have a chance of failure. When a method is used correctly each time, the failure rates are lower. Choose a method you will be able to use on a regular basis. If your method fails, you may want to consider emergency contraception.
Finally … No matter which method of birth control you choose, be sure that you know how it works, how to use it, and what side effects may occur. Even with methods that do not need a prescription, you need to learn how to use the method.
_________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © February 2003 The American College of Obstetricians and Gynecologists
Birth Control Pills
Birth Control Pills Birth control pills (also called oral contraceptives or “the pill”) are used by millions of women in the United States to prevent pregnancy. The pill is safe and effective for most women.About Birth Control Pills
Birth control pills are a type of hormonal birth control. With these methods, a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. When there is no egg to be fertilized, pregnancy cannot occur. The hormones also cause changes in the cervical mucus and uterus that help prevent pregnancy.
The pill must be prescribed by a doctor. It is a very effective form of birth control. When women use the pill correctly, fewer than one in 100 will get pregnant over one year. However, about three in 100 typical users (3 percent) will become pregnant.
Combination Pills
Combination birth control pills contain the hormones estrogen and progestin (a synthetic form of the hormone progesterone). There are many different brands with different doses of hormones. This gives a woman a choice in finding a pill that is right for her.
How They Work
Estrogen and progestin, which are produced in the ovaries, affect the menstrual cycle and fertility. By altering the natural levels of these hormones, birth control pills can affect ovulation and other reproductive functions.
How To Take Them
You can start taking the pill on the first day of your period. You will not need a backup method of birth control.
For convenience, many pill users start taking the pill on the Sunday after their periods start. You can start even if you are still bleeding.
Pills only work if you take them correctly. Do not skip pills for any reason — even if you bleed between periods or feel sick.
If You Miss a Pill
You may forget to take a pill once in a while. If you forget to take one pill, take it as soon as you remember.
Take the next pill at the normal time. It is okay if you have to take two pills in the same day.
If you forget to take two or more pills, use a backup method of birth control.
If you miss some pills, you may have some spotting or light bleeding even if you make up the missed pills. These side effects are not harmful.
Benefits
The combination birth control pill has benefits in addition to preventing pregnancy. The pill also helps to keep your periods regular, lighter, and shorter and reduces menstrual cramps.
Side Effects
Some women have side effects when they are on the pill. These may include:
Headache
Tender breasts
Nausea
Irregular bleeding
Missed periods
Depression
Most side effects are minor and often go away after a few months of use.
Risks
Some women should not use birth control pills. The pill may not be a good choice for women who smoke and are older than age 35 years and have certain health problems or have a family history of certain health problems. Talk to your doctor about whether the pill is a good choice for you.
Although rare, the pill can cause severe illness in some women. The most serious problem is cardiovascular disease, such as blood clots in the legs or lungs, heart attack or stroke.
Progestin-Only Pills
Some women may want or need to take another type of birth control pill that contains only progestin. It does not contain estrogen. It is called the progestin-only pill or the minipill. This type of pill is not as effective as pills that contain estrogen.
How They Work
Progestin-only pills contain only a small dose of progestin — about 25 percent to 70 percent of the amount in the combination pill. Minipills prevent ovulation in about one-half of a woman’s menstrual cycles. They also change cervical mucus. The mucus thickens, making it hard for sperm to penetrate the cervix.
How To Take Them
The minipill comes in packs of 28 pills. All the pills in the pack contain hormones. It is important not to miss a pill.
Benefits
Progestin-only pills do not offer the same benefits that pills with estrogen offer. Most people who choose the progestin-only pill do so because there are reasons they should not take estrogen.
Side Effects
Women who take the progestin-only pill may have more bleeding or spotting days than women who take birth control pills that contain estrogen.
Risks
The progestin-only pill must be prescribed by a doctor. A total of three to six women per 100 will get pregnant while on the progestin-only pill. Pregnancy rates are increased in women who weigh more than 130 pounds.
Finally … The pill is a good choice for women who may want to get pregnant later. It is a safe and effective way to prevent pregnancy. It is easy to use, convenient and reversible. The pill may protect against some cancers.
________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © February 2003 The American College of Obstetricians and Gynecologists
Emergency Contraception
Emergency contraception is used to prevent pregnancy after having sex without birth control or if a problem occurred with the method of birth control used. It is a good option for women who have had unprotected sex and do not want to become pregnant.
Reproduction
A woman can get pregnant if she has sex around the time of ovulation. During sex, the man ejaculates sperm into the vagina. The sperm travel up through the cervix and into the fallopian tubes.
If a sperm meets an egg in the fallopian tube, fertilization — union of egg and sperm — can occur.
About Emergency Contraception
Emergency contraception is a type of hormonal birth control. It can be used if you have unprotected sex and don’t want to get pregnant. It should not be used on a routine basis. You may need emergency contraception if:
You didn’t use any birth control.
You had sex when you didn’t plan to.
A condom broke or slipped off.
A diaphragm or cervical cap became dislodged.
Birth control was not used correctly.
You were forced to have sex (rape).
The most commonly used method of emergency contraception is pills (also known as the “morning-after pill”). The intrauterine device (IUD) also can be used for emergency contraception.
If you have had unprotected sex, call your doctor’s office right away. Be sure to tell them you need treatment without delay. In some cases, your doctor can call in a prescription for you to your drugstore. You also can call the Emergency Contraception Hotline (888-NOT-2-LATE) to find a doctor who will provide you with a prescription.
Do not use emergency contraception routinely instead of birth control. Regular use of a birth control method is not only more effective, but provides health benefits that emergency contraception does not have.
How Emergency Contraception Works
Emergency contraception is highly effective in preventing pregnancy. Pills must be started within 72 hours of having unprotected sex and will reduce the risk of pregnancy by at least 75 percent. If you are already pregnant, emergency contraception will not work.
There are two types of emergency contraception pills. One type is combined birth control pills (containing both estrogen and progestin). The other type contains only progestin and is safer for women who can’t take estrogen.
Both types of pills work the same way. The hormones in these pills prevent pregnancy because they disrupt the normal patterns in the menstrual cycle. Depending on where a woman is in her menstrual cycle, these pills may:
Prevent ovulation
Block fertilization
Keep a fertilized egg from implanting in the uterus
How to Take Emergency Contraception
Emergency contraception pills may be prescribed to you in one of three forms:
A specific dosage of regular birth control pills (contains estrogen and progestin)
A prepared kit of four pills (contains estrogen and progestin) that may come with a pregnancy test
A package with two pills (contains progestin only)
For the pills to work, timing is everything. The sooner you start them, the better. The pills are given in two doses. To prevent pregnancy, the first dose of pills must be taken by mouth within 72 hours of having unprotected sex. A second dose is taken 12 hours after the first dose.
Side Effects
Besides the typical side effects of nausea and vomiting, other side effects may include:
Abdominal pain and cramps
Tender breasts
Headache
Dizziness
Fatigue
Follow-up Care
If you use emergency contraception pills within 72 hours of unprotected sex, your chance of getting pregnant is greatly reduced. However, there is still a chance you could become pregnant. If you do become pregnant, emergency contraception will not have any effect on the pregnancy or the health of the baby.
Keep in mind that emergency contraception does not prevent sexually transmitted diseases (STDs).
Finally … Using birth control when you have sex is the best way to prevent unwanted pregnancy. However, if you have sex without birth control, you can use emergency contraception. It is simple and safe.
________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © February 2003 The American College of Obstetricians and Gynecologists
The Intrauterine Device
The intrauterine device (IUD) is a type of birth control. It is a small, plastic device that is inserted and left inside the uterus to prevent pregnancy.
Types of Intrauterine Devices
Although there have been several types of IUDs, currently only two are available in the United States: the hormonal and the copper. The hormonal IUD must be replaced every five years. The copper IUD can remain in your body for as long as 10 years.
The IUD is a very popular method of birth control throughout the world. However, in the United States, less than 1 percent of women using birth control use an IUD.
How an IUD Works
Both types of IUDs are T-shaped, but they work in different ways. The hormonal IUD releases a small amount of progestin into the uterus. This thickens the cervical mucus, which blocks the sperm from entering the cervix.
The copper IUD releases a small amount of copper into the uterus. A copper IUD does not affect ovulation or the menstrual cycle. It causes a reaction inside the uterus and fallopian tubes. This can prevent the egg from being fertilized or attaching to the wall of the uterus. The copper seems to work as a kind of spermicide.
Inserting the IUD
A doctor must insert and remove the IUD.
Benefits
During the first year of use, about eight out of 1,000 women using the copper IUD will become pregnant. This makes it one of the most effective forms of birth control available. The hormonal IUD is even more effective.
Risks
Serious complications from use of an IUD are rare. However, some women do have problems. These problems usually happen during, or soon after, insertion:
Expulsion: The IUD is pushed out of the uterus into the vagina. It happens within the first year of use in about 5 percent of users.
Perforation: The IUD can perforate (or pierce) the wall of the uterus during insertion.
Infections: Infections in the uterus or fallopian tubes can occur. This may cause scarring in the reproductive organs, making it harder to become pregnant later.
Pregnancy: Rarely, pregnancy may occur while a woman is using an IUD.
Side Effects
Menstrual pain and bleeding are increased with the copper IUD, but decreased with the hormonal IUD.
Finally … The IUD offers safe, effective and reversible protection against pregnancy for many women. Weighing the benefits and risks of using an IUD, and knowing your medical and sexual history, will help you and your doctor decide whether this method of birth control is right for you.
________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © March 2003 The American College of Obstetricians and Gynecologists
Pregnancy
Most women in the United States give birth to healthy babies. Despite this, many women worry about birth defects.
Amniocentesis and Chorinonic Villus Sampling
Most women in the United States give birth to healthy babies. Despite this, many women worry about birth defects.
About Birth Defects
About 3 percent of babies born in the United States have some type of major birth defect.
A baby may be born with more than one birth defect.
In most cases, there is no known reason for a birth defect. In some cases, birth defects are inherited. Others can occur if the fetus is exposed to certain drugs (including alcohol), chemicals or viruses during key stages of growth during pregnancy.
Genetic Problems
Genes are passed by parents to their newborn through tiny structures called chromosomes. Chromosomes are present in every human cell. The mother’s egg and the father’s sperm each contain 23 chromosomes. When the sperm joins the egg, the genes and chromosomes of both parents unite to form those of the fetus.
Thus, an error in a chromosome or a single gene may result in birth defects.
A birth defect can be passed from the parents to their baby through their genes. This is called a genetic disorder.
A defect also may result from problems with the number or structure of whole chromosomes. There may be too many or too few chromosomes. In Down syndrome, for instance, there is an extra (third) copy of one of the chromosomes.
Some genetic problems can be found in two ways:
Amniocentesis — studying the amniotic fluid that surrounds the fetus
CVS — studying the chorionic villi that make up the placenta
For these procedures, a sample is taken to be tested from either the amniotic fluid that surrounds the fetus or the placenta.
Who Should Be Tested?
Your doctor can tell you about your genetic risks and the tests you can have. Only you and your partner can decide whether to have a test.
Testing should be offered to:
Pregnant women who will be 35 or older on their due date
Couples who already have had a child with a birth defect or have a family history of certain birth defects
Pregnant women with other abnormal genetic test results
A normal test result on the fetus cannot ensure that the baby will be normal.
Amniocentesis Amniocentesis is the most common procedure used to test for birth defects. It is done at 16 to 18 weeks of pregnancy in most cases.
The Procedure
With amniocentesis, a sample of amniotic fluid is withdrawn through a needle from the sac that surrounds the fetus.
The amniotic fluid is sent to a lab. The cells are grown in a special fluid for several days. Then, tests are done.
Results
It may take about two weeks for enough cells to grow and tests to be performed.
Tests of the amniotic fluid itself are another way to find some defects. One such test is the alpha-fetoprotein (AFP) test. Too much AFP in the amniotic fluid can be a sign of fetal defects, such as open neural tube defects or openings in the fetal abdomen.
One type of AFP test is a blood test. It checks the levels of AFP in the woman’s blood.
Risks
Although amniocentesis is fairly safe, there is some risk involved. Side effects that may occur include:
Cramping
Bleeding
Infection
Leaking of amniotic fluid after the procedure
Miscarriage
Injury to the fetus from amniocentesis is rare.
Chorionic Villus Sampling
CVS can be done earlier in pregnancy than amniocentesis. In most cases, it is done about 10 to 12 weeks from the woman’s last menstrual period.
The Procedure
With CVS, a small sample of cells is taken from the placenta where it is attached to the wall of the uterus.
Results
CVS can detect most of the same defects as amniocentesis. One defect that cannot be detected by CVS is open neural tube defects.
The results of CVS can be obtained earlier in pregnancy and more quickly than with amniocentesis.
Risks
CVS may carry a slightly higher risk of miscarriage than amniocentesis.
Advantages of Each Method
Amniocentesis and CVS both have advantages. With amniocentesis:
It often is easier to have done because it is more widely available.
It offers a lower risk of miscarriage than CVS.
It can test for neural tube defects because it tests the amniotic fluid.
On the other hand, CVS can be done earlier in pregnancy.
Options
Most of the time, tests show normal results, which reduce patients’ fears and anxieties. If your tests diagnose a major birth defect, you have tough choices to make.
Before you decide, get as much information about the defect as you can — from doctors, counselors or parents of a child with the same type of defect. Ask friends or family for advice and support. Knowing as much as you can will help you to make the best choice.
Finally..
If you have certain risk factors, you may be offered amniocentesis or CVS to try to detect certain birth defects. Whether you have the test done is up to you. Some people choose not to get this information. Keep in mind that in most pregnancies, babies are born healthy.
___________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright December 1999 The American College of Obstetricians and GynecologistsThe birth control pill, injections, vaginal ring, skin patch, intrauterine device (IUD), diaphragm, Lea’s Shield, and cervical cap require a prescription. Condoms and spermicides do not.
More than one method may be used at the same time. For instance, a barrier method may be used with any other method.
Barrier Methods
Barrier methods include spermicides, condoms (male and female), the diaphragm, the cervical cap, and Lea’s Shield.
Barrier methods are effective when used the correct way every time you have sex. Even one act of sex without birth control can result in pregnancy.
Intrauterine Device
The IUD is a small, plastic device that is inserted and left inside the uterus to prevent pregnancy. Although there have been several types of IUDs, currently only two are available in the United States: the hormonal IUD and the copper IUD.
Hormonal Contraception
With hormonal birth control, a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. When there is no egg to be fertilized, pregnancy cannot occur.
Birth Control Pills
One of the most popular methods of hormonal birth control is the birth control pill (oral contraceptive). Most birth control pills are combination pills. They contain the hormones estrogen and progestin.
Injections
One type of injection of hormonal birth control, called depot-medroxyprogesterone acetate (DMPA), provides protection against pregnancy for three months. This means a woman needs only four injections each year.
Vaginal Ring
The vaginal ring is a flexible, plastic ring that is placed in the upper vagina. The ring releases both estrogen and progestin continuously to prevent pregnancy. It is worn for 21 days, removed for 7 days, and then a new ring is inserted.
Skin Patch
The contraceptive skin patch is a small (1.75 square inch) adhesive patch that is worn on the skin to prevent pregnancy. It is a weekly method of hormonal birth control.
Natural Family Planning
Natural family planning used to be called the rhythm method or “safe period.” It also is called periodic abstinence or, more recently, fertility awareness. It isn’t a single method but a variety of methods.
Types of natural family planning include:
Basal body temperature method
Ovulation/cervical mucus method
Symptothermal method
Calendar method
Lactational amenorrhea
Withdrawal
The withdrawal method prevents pregnancy by not allowing sperm to be released in the woman’s vagina. This requires the man to take his penis out of the woman before he ejaculates. Drawbacks are that sperm can be present in the fluid produced by the penis before ejaculation and some men fail to withdraw completely or in time.
Sterilization
Sterilization for women and men works by permanently blocking the pathways of egg and sperm. This can be done by surgery.
Tubal sterilization is done by laparoscopy and minilaparotomy. The fallopian tubes are closed by tying, banding, clipping, blocking, or cutting them, or by sealing them with electric current.
Vasectomy involves cutting a man’s vas deferens so that sperm cannot mix with semen. The tubes that carry sperm to the penis are clamped, cut, or sealed so that the ends do not join again.
New Option for Sterilization
Women who want a permanent method of birth control now have an option that does not involve surgery. With this method, a tiny springlike device is inserted through the vagina into each fallopian tube. This device causes scar tissue to build up in the tubes. This build-up blocks the fallopian tubes and prevents the sperm from reaching the egg. It takes three months for the scar tissue to grow, so women should use another method of birth control during this period. This device can be inserted in a doctor’s office.
Choosing a Method At any given time, a couple may find one method of birth control suits their needs better than others. Most women and couples use many methods over their lifetime.
All methods have a chance of failure. When a method is used correctly each time, the failure rates are lower. Choose a method you will be able to use on a regular basis. If your method fails, you may want to consider emergency contraception.
Finally … No matter which method of birth control you choose, be sure that you know how it works, how to use it, and what side effects may occur. Even with methods that do not need a prescription, you need to learn how to use the method.
_________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © February 2003 The American College of Obstetricians and Gynecologists
Later Childbearing
BirtToday, more and more couples are starting families later in life. Most women over age 35 have healthy pregnancies and healthy babies. There is no set age that is unsafe for women to become pregnant.
Fertility
Medical advances have opened the door for women to have safer pregnancies in their 30s and 40s.
Even so, some questions arise for these women. They may have concerns about whether their age will affect their ability to become pregnant, their health and the health of their baby.
There is no precise age at which you become less fertile.One reason that women may become less fertile is that ovulation, the release of an egg from one of the ovaries, occurs less often as a woman ages.
If you are in your mid-30s or older and are concerned about your fertility, or if you have not conceived after six months of having sex without any form of birth control, you may want to talk with your doctor.
Health Problems
Certain medical and obstetric problems occur more often as women age.
Some women have conditions — such as high blood pressure or diabetes — that are present before pregnancy.
About 10 percent of women over 35 have high blood pressure.
Women aged 35 and over also are more likely to have diabetes or to develop gestational (during pregnancy) diabetes.
Miscarriage — loss of a pregnancy before 20 weeks — occurs in about 15 percent to 20 percent of all pregnancies. It is more common in older women. Stillbirth — delivery of a baby that has died before birth — occurs more often in women over age 35 than in women aged 20 to 35.
Older women also are more likely to have infants of low birthweight (weighing less than 5 1/2 pounds).
Cesarean delivery also is slightly more common for women having their first child after age 35.
Being Prepared
Being prepared for pregnancy is the best way for couples of all ages to improve their chances of having a baby.
Preconception and Prenatal Care
Good health care before you become pregnant — sometimes called preconception care — will help you throughout your pregnancy.
Early and regular prenatal care — care before the baby is born — may increase a woman’s chances of having a healthy baby.
Genetic Counseling
Genetic counseling is advised for women who will be 35 or older when their baby is due, couples who have already had a child with a birth defect, and couples with a family history of genetic problems, birth defects, or mental retardation.
Testing
A number of tests can help detect disorders before, during and after pregnancy. Advances in medicine have made having a child safer.
Testing for genetic problems is offered to women who will be 35 or older when their baby is due. You will want to discuss with your doctor the pros and cons of having these tests done:
Amniocentesis
Chorionic villus sampling (CVS)
Personal Issues
A woman having her first child in her mid-30s or older may be faced with issues besides her health and that of her child. She may be used to having control of her life. It may take longer to become pregnant than she thought.
On the other hand, an older woman may feel sure that she is ready to have a child.
Finally… Most women have healthy pregnancies and normal babies. Many older women show no greater signs of problems than younger women.
________________
This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © November 1999 The American College of Obstetricians and Gynecologistsh Control Pills Birth control pills (also called oral contraceptives or “the pill”) are used by millions of women in the United States to prevent pregnancy. The pill is safe and effective for most women.About Birth Control Pills
Birth control pills are a type of hormonal birth control. With these methods, a woman takes hormones similar to those her body makes naturally. These hormones prevent ovulation. When there is no egg to be fertilized, pregnancy cannot occur. The hormones also cause changes in the cervical mucus and uterus that help prevent pregnancy.
The pill must be prescribed by a doctor. It is a very effective form of birth control. When women use the pill correctly, fewer than one in 100 will get pregnant over one year. However, about three in 100 typical users (3 percent) will become pregnant.
Combination Pills
Combination birth control pills contain the hormones estrogen and progestin (a synthetic form of the hormone progesterone). There are many different brands with different doses of hormones. This gives a woman a choice in finding a pill that is right for her.
How They Work
Estrogen and progestin, which are produced in the ovaries, affect the menstrual cycle and fertility. By altering the natural levels of these hormones, birth control pills can affect ovulation and other reproductive functions.
How To Take Them
You can start taking the pill on the first day of your period. You will not need a backup method of birth control.
For convenience, many pill users start taking the pill on the Sunday after their periods start. You can start even if you are still bleeding.
Pills only work if you take them correctly. Do not skip pills for any reason — even if you bleed between periods or feel sick.
If You Miss a Pill
You may forget to take a pill once in a while. If you forget to take one pill, take it as soon as you remember.
Take the next pill at the normal time. It is okay if you have to take two pills in the same day.
If you forget to take two or more pills, use a backup method of birth control.
If you miss some pills, you may have some spotting or light bleeding even if you make up the missed pills. These side effects are not harmful.
Benefits
The combination birth control pill has benefits in addition to preventing pregnancy. The pill also helps to keep your periods regular, lighter, and shorter and reduces menstrual cramps.
Side Effects
Some women have side effects when they are on the pill. These may include:
Headache
Tender breasts
Nausea
Irregular bleeding
Missed periods
Depression
Most side effects are minor and often go away after a few months of use.
Risks
Some women should not use birth control pills. The pill may not be a good choice for women who smoke and are older than age 35 years and have certain health problems or have a family history of certain health problems. Talk to your doctor about whether the pill is a good choice for you.
Although rare, the pill can cause severe illness in some women. The most serious problem is cardiovascular disease, such as blood clots in the legs or lungs, heart attack or stroke.
Progestin-Only Pills
Some women may want or need to take another type of birth control pill that contains only progestin. It does not contain estrogen. It is called the progestin-only pill or the minipill. This type of pill is not as effective as pills that contain estrogen.
How They Work
Progestin-only pills contain only a small dose of progestin — about 25 percent to 70 percent of the amount in the combination pill. Minipills prevent ovulation in about one-half of a woman’s menstrual cycles. They also change cervical mucus. The mucus thickens, making it hard for sperm to penetrate the cervix.
How To Take Them
The minipill comes in packs of 28 pills. All the pills in the pack contain hormones. It is important not to miss a pill.
Benefits
Progestin-only pills do not offer the same benefits that pills with estrogen offer. Most people who choose the progestin-only pill do so because there are reasons they should not take estrogen.
Side Effects
Women who take the progestin-only pill may have more bleeding or spotting days than women who take birth control pills that contain estrogen.
Risks
The progestin-only pill must be prescribed by a doctor. A total of three to six women per 100 will get pregnant while on the progestin-only pill. Pregnancy rates are increased in women who weigh more than 130 pounds.
Finally … The pill is a good choice for women who may want to get pregnant later. It is a safe and effective way to prevent pregnancy. It is easy to use, convenient and reversible. The pill may protect against some cancers.
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This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.
To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.
Copyright © February 2003 The American College of Obstetricians and Gynecologists
