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This or That: Barrier or Chemical Birth Control To Prevent Unwanted Pregnancy
It's 2022, and the goal is to prioritise body autonomy and reduce taboo around safe and pleasurable sex. Thanks to remarkable progress in medicine, there are now many ways to prevent unwanted pregnancies, UTIs and STIs—including barrier and chemical methods of contraception. What's your pick?
When it comes to safe sex, you have to keep the three Ps in mind—pleasure, permission and protection. Sex must have enthusiastic and sustained consent and participation, mutual satisfaction and proper precautions for unwanted pregnancies, sexually transmitted infections (STI) and urinary tract infections (UTI). However, for the longest time, the burden of birth control and protection has fallen upon folks with a uterus. While they struggle with the various side effects of hormonal medication or surgeries, people with a penis have had very few options available, even when they have been willing to step up and equally participate. In India, the major types of birth control can be divided into barrier and chemical methods, apart from surgical (and mostly permanent) procedures like vasectomy, hysterectomy or tubal ligation.
Barrier method of contraception refers to internal and external condoms as well as diaphragms. These tools are used on a temporary basis, by inserting in or around the genitalia, to block the exchange of bodily fluids. Chemical methods, on the other hand, include options like hormonal injections, oral contraceptive pills, spermicide creams and intrauterine devices (IUD). While injections and pills are hormonal and spermicides non-hormonal, IUDs can have both options.
Check out this comprehensive table below, provided by Artika Singh, menstrual and sexual health educator and the founder of the Taarini Foundation, where she describes what each method entails.
Related story: Are You Using Birth Control Correctly?
| Barrier Methods | Chemical Methods |
|---|---|
| 1. Condoms are available at many price points. They're affordable and can also be found for free. Diaphragms have different prices for different versions. | 1. Birth Control Pills cost less than INR500 per month and spermicide gels are inexpensive as well. Hormonal Injections and IUDs may cost more, but they are also provided for free at government hospitals. |
| 2. Both condoms and diaphragms are available over the counter and can be used by self. | 2. While both pills and spermicides are self-administered, pills may require a prescription. Injections and IUDs require a doctor's assistance./td> |
| 3. Condoms are used each time you have sex. Diaphragms can be inserted a little before sex (approx 2 hours) & removed within 6-7 hours after. They should not be left in for more than 24 hours. | 3. Birth control pills are taken every day till the time contraception is needed (excluding period days). Spermicide gels are used during Penis In Vagina sex. Hormonal injections are periodical, most commonly taken once every 3 months. A single IUD can last from 3 to 5 years. |
| 4. Temporary methods, used only during time of Penis In Vagina /Vagina Engulfing Penis sex. | 4. All are reversible methods, one can stop taking them when they wish—taking away contraceptive effects. |
| 5. Condoms have practically no side effects, and those allergic to the latex material may opt for a non-latex alternative. Faulty insertion of diaphragms may cause irritation or infection, and leaving them in for too long increases the risk of Toxic Shock Syndrome (TSS). | 5. All hormonal methods may have side effects caused due to the alteration of normal levels of hormones in the body. Symptoms include nausea, headaches, dizziness, mood swings, weight gain, anxiety & low mood. Doctor's consultation, especially for those with Premenstrual Dysphoric Disorder (PMDD), is advised before making a choice. IUDs may not cause these visible symptoms, but uterine perforation may occur during insertion—causing abdominal pain. |
| 6. Condoms protect against STIs, but the chances of UTIs are not zero. Diaphragms only protect against unwanted pregnancies. | 6. They do not protect against STIs or UTIs. |
| 7. With proper usage, internal condoms are 95 percent effective, while external ones are 98 percent. With proper insertion, diaphragms stand at 92 to 96 percent. However, ground studies suggest that self-insertion (without a doctor) may be faulty and lead to faulty. | 7. When used perfectly, birth control pills are 99 percent effective. However, they have to be taken daily and faulty dosage intake may bring down the effectiveness to 91 percent. The same applies to hormonal injections. While IUDs are close to 99 percent effective, spermicides are only 72 percent effective even with perfect usage—making it unfavourable as a sole method of contraceptive. |
What's the verdict?
There is no this over that when it comes to birth control and protection. It is an indispensable part of all-accessible global healthcare and it completely depends on the individual which method works for them. Especially in the case of hormonal methods, as Singh suggests, it is extremely important to make the choice based on a doctor's prescription and personal medical history. Side effects may differ from person to person, and it's better to have professional guidance before starting regular medication. It's not about one method being better than the other, but about what works best with your body and resources. Moreover, condoms must be used in the case of PIV/VEP sex even if one is on other forms of contraception to prevent transmissible diseases. In the end, while contraceptive science is progressing rapidly around the world, the first step is for it to be accessible, affordable and an open topic of conversation that includes everyone but the stigma.
Related story: Choosing The Right Contraceptive Method—Everything You Need To Know
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