Contraceptive failure is a major source of unintended pregnancy. A study published in 2010 in British Medical Journal found that about 43 percent of pregnancies occurred when contraception was used inconsistently or incorrectly. The ideal birth control method is one that you use correctly. Contraception not only prevents pregnancy, but offers a range of potential benefits including preventing the transmission of HIV and other sexually transmitted infections, reducing the risk of certain reproductive cancers, and are also used to treat many menstrual-related symptoms and disorders. Dr Ranjana Sharma, senior consultant gynaecology at Indraprastha Apollo Hospitals in New Delhi, shares the common mistakes people make while using birth control and how to use various contraceptives properly.

Male Condom

How to use it effectively: Wear a condom before you are ready for intercourse and not mid-way through because it is possible for sperm to leak into pre-cum (a lubricant produced in the penis). It is safe practice for the men to put the condom on before any contact with the partner’s genital area. Also, it is important to make sure that you place and remove condom when the penis is fully erect. This makes rolling up and rolling down of the condom easy—preventing any chances of tearing. Lastly, Dr Sharma says that it is important to pinch the air out of the tip of the condom to make room for semen collection before one wears the condom.

Common mistakes to avoid:

• Wearing a condom that is too tight, very big or very small.
• Not checking the condom for expiry and damage.
• Tearing off the package using teeth or a sharp material.
• Using oil based lubricants with a condom. This can cause the condom to slip off and can damage the condom’s latex.
• Putting the condom the wrong way around. “In that case, throw the used one in the bin and take a new one,” says Dr Sharma.

Female Condom

How to use it effectively: It is important to squeeze the sides of the inner ring together with your thumb and forefinger while holding the condom at the closed end, and insert into vagina. It’s a lot like putting a tampon in. Push the inner ring up as far as it will go with your finger until it rests against the cervix. Be gentle with insertion. Avoid putting extra pressure to prevent discomfort.

Common mistakes to avoid:

• Not making sure that the condom isn’t twisted inside the vaginal opening. To check, insert your index or middle finger and you will feel a slight discomfort if something is wrong.
• Ignoring, overlooking or forgetting when the ring comes out on its own (expulsion) if it wasn’t put in properly. “Rinse it with cool or lukewarm water and you can re-insert the same ring as soon as possible,” says the doctor.
• Using a female condom with a male condom. “Friction between the both can cause damage to one or both of the condoms,” says Dr Sharma.

 

 

Contraceptive Gels

How to use effectively: Combine a barrier method along with the use of a spermicide to increase the efficacy of spermicide,” says Dr Sharma. Using spermicide on its own cannot prevent sexually transmissible diseases (STI). “So, backing up with a condom is a wise plan,” she adds.

Common mistakes to avoid:

• Not checking the expiration date of contraceptive gel, foam or cream.
• Not applying the gel atleast 10-15 minutes prior to sex. The gels need some time to act upon.
• Not reapplying the spermicide after the gap of an hour. “You’ll need to add more spermicide after an hour if you’re
• intending to have sex more than once,” says Dr Sharma.

 

The Pill

How to use it effectively: Stick to your pill schedule. This helps regulate the hormone levels in the body and provides a better protection against chances of pregnancy. “Take the pill at the same time everyday. Use alarms, reminders, apps or other methods to help with it unless you get used to a regular timing,” says the doctor.

Common mistakes to avoid:

• Missing a dose and not taking the skipped dose even after the passage of 48 hours. “In this case, you are no longer protected against pregnancy,” says the doctor.
• Not using additional contraception such as condoms even if you start taking pills in your mid-cycle.
• Not sharing the details of other medications you are taking, to the doctor. “Antibiotics interfere with the working of contraceptive pills. This reduces their efficacy,” adds Dr Sharma. “The doctor may suggest backing up with a barrier method in that case.”

Vaginal Rings

How to use effectively: Back up with a barrier protection (male or female condom) because vaginal rings do not protect you from STIs. “A vaginal ring works by staying in vagina for three weeks, after which you discard it and wait for seven days before replacing it with a new one,” explains Dr Sharma. A way to ensure its effectiveness is to not ignore or forget to insert a new ring straight away after a seven day break within 24 hours.

Common mistakes to avoid:

• Not putting it back in place within three hours if the ring slips out of your vagina. Rinse the ring with cold/lukewarm water before you place it back, says the doctor.
• Using certain combination medications such as aromatase inhibitors (medicine for chemoprevention in women at high risk for breast cancer) and products used to treat chronic hepatitis C. “Consult your physician for the same,” says the doctor.

IUD

How to use effectively: IUDs are effective immediately if inserted within seven days of the start of your period. Otherwise, you’ll need to use a backup method of contraception (such as condoms) for the first seven days after getting your IUD. Also, the first few months after implantation, it’s important to check and feel for the string ends confirming that the IUD is still in place,” advises Dr Sharma. Before you do that, ensure that your hands are clean, she adds.. But, if you cannot find your IUD string, or feel that something is wrong, do not try to force your finger into vagina and see your doctor.

Common mistakes to avoid:

• Not checking with a doctor incase of certain symptoms post insertion of IUD, such as cramps or bleeding that does not subside within 48 to 72 hours.
• Ignoring pain when having sex or overlooking the change in the smell and colour of vaginal discharge.
• Ignoring abnormal pelvic pain or pain when you pee. “When you encounter anything sensitive or unusual, see your doctor,” says Dr Sharma.

 

 

Contraceptive Implant

How to use effectively: As long as you’re not pregnant, you can have the contraceptive implant (Nexplanon) placed at any time during your menstrual cycle. If the implant is placed during the first five days of your menstrual cycle, you will be able to prevent a pregnancy right away. You’ll need to use supplemental contraception (such as condoms) for 7 days if it’s fitted on any other day of your menstrual cycle.

Common mistakes to avoid:

• Not wearing condoms in addition to the implant to gain protection from STDs.
• Taking antibiotics like rifabutin and rifampicin. These medicines reduce the effectiveness of the implant. “If you’re on any of these medications, you’ll need an alternative method of contraception such as condoms,” says the doctor.

Contraceptive Injection

How to use effectively: If you get the contraceptive injection (such as Depo-Provera ) during the first five days of your menstrual cycle, you’ll be protected against getting pregnant right away. If you get the injection on a different day of your cycle, you’ll have to use supplemental contraception for 7 days, such as condoms.

Common mistakes to avoid:

• Not taking a repeat injection before it expires or becomes ineffective (it lasts for 8-13 weeks depending on injection)
• Not using condoms to secure protection against STIs

The Morning-after pill

How to use effectively? “These pills perform best if taken within 72 hours, after which time their effectiveness begins to wane,” says Dr Sharma.

Common mistakes to avoid:

• “Not taking another pill if you throw up a few hours after taking the pill. The chances are that the body did not metabolise the pill, and hence it might lead to pregnancy,” says Dr Sharma.
• Taking the pill after your ovulation has already occurred. “Emergency contraception pills work by temporarily halting ovulation, but they won’t prevent you from becoming pregnant if your ovary has already released an egg,” explains the doctor. “You should go for other alternative birth control methods such as IUD and the doctor must put it in within 5 days after you have unprotected sex,” adds the doctor.