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Birth Control. A Plethora of Options and a History to Prove it.

March 28, 2024
By
Ahma & Co Team

Image Credit: Anna Shvets
Image Credit: Anna Shvets

Birth control has become evermore varietous in modern times, but what many people don’t realize is that usage of pregnancy prevention methods has existed for many, many years. Around 3000 B.C.E., King Minos of Crete used the bladder of a goat as protection during intercourse, which is recorded as the first use of a “condom.” In 1850 B.C.E, Egypt combined crocodile dung and fermented dough to create the first spermicide. Years later, around 1000 C.E., evidence shows that Egyptians also used linen sheaths as protection and differentiated the color of the linen as a sign of class. Romans combined the methods and created condoms of linen and animal bladder. In New Guinea, the Djukas tribe designed a female condom made from a specific, 6-inch plant that entered the female's vaginal area before intercourse. From the span of the 1600s to the late 1800s, Black enslaved women relied on medicines from African folk remedies to avoid reproduction from white men who coerced them.

It wasn’t until 1855 that the first rubber condom was created. From then on, the criminalization of birth control and contraceptives grew strong. The Comstock Act that was passed in 1873 “defined contraceptives as obscene and illicit, making it a federal offense to disseminate birth control through the mail or across state lines.” In 1914, American birth control activist, sex educator, writer and nurse Margaret Sanger coined the term “birth control” and began her movement to make contraceptives available to all women in America. The use of a diaphragm during intercourse became a popular method of birth control in 1938. By 1960, after ten years of organization by Sanger and research by biologists, the first oral contraceptive, now commonly known as “the pill,” was approved by the FDA. 1965 brought about the court ruling in Griswold vs. Connecticut that allowed married women the right to birth control, but denied unmarried women access. Three years later, IUDs were introduced to the public and became widely used. The Supreme Court case Eisenstadt vs Baird in 1972 allowed access to birth control for unmarried women. In 1991, the use of an implant in the upper arm, called long acting reversible contraceptive (LARC), was approved, followed by the birth control shot -another form of LARC- in 1992. A year later, the first female condom was approved.

Today, the conflicts surrounding birth control and contraceptives continue, whether it be through domestic gag rules, or day-to-day quarrels with those of differing positions. Either way, we must acknowledge that the use of contraceptives has existed for thousands of years and has greatly improved in safety and protectiveness. Because of the wide variety, it becomes harder to weigh the options and find what is best for you--sometimes it takes trial and error. Specifically, after pregnancy and birth, your body may change and as such, you may need to switch the type of birth control you use. Below, we will discuss your options and provide insight into each one.

Barrier Methods

There is a plethora of birth control options, one being barrier methods, which also has a myriad options to choose from. Barrier methods range from condoms to spermicide, sponges, diaphragms and cervical caps. The main function of barrier methods is to prevent any sperm from reaching an egg. Some barrier methods, like spermicide, condoms, and sponges are easily accessible, while the diaphragms and cervical caps are obtained through prescription. Though very common, the American College of Obstetricians and Gynecologists highlights that 18-28 women out of 100 will become pregnant while using barrier methods. Despite this statistic, condoms also aid in the prevention of sexually transmitted infections, which is a huge plus.

Cervical caps, sponges, and diaphragms may be used starting six weeks after giving birth. Condoms and spermicide can be used at your leisure and comfortability--but it is important to note that spermicides may cause vaginal irritation.

Combined Hormonal Methods

While the name of this method may be misleading, combined hormonal methods do not mean using two types of birth control. Rather, the combined hormonal method’s name comes from the fact that they contain two hormones: estrogen and progestin. Options of this birth control type include the birth control pill, the patch, and the ring. The function of combined hormonal methods is to prevent ovulation. Alongside preventing pregnancy, these methods also have benefits including reducing menstrual symptoms, treating acne, and decreasing risk of cancer in the uterus.

While typically safe, these methods also have risks. These methods increase the risk of blood clots called deep vein thrombosis (DVT). After birth, women have a higher chance of developing blood clots--the combination of the two may make this even higher. Alongside this, the estrogen in combined hormonal methods may affect breastfeeding and milk supply. With these risks in mind, these methods should not be used until 4-6 weeks after giving birth.

Along with these methods, reminders are necessary. Pills have to be taken around the same time each day, vaginal rings changed every 21 days, and a skin patch every week for three weeks. As a new mom with a busy, tiring schedule, this method may be hard to keep on top of. However, you may be used to this method from previous use and it will be no problem!

Implant

If reminding yourself to take a pill or change a ring or patch every so often is a hassle, the implant may be the method for you. Known as the get-it-and-forget-it birth control, the implant is a tiny stick that is placed under the skin of your upper arm by a healthcare professional. With this method, it can be inserted immediately after giving birth - whether vaginal or c-section. The main function of the implant is to release progestin, which both thickens cervical mucus preventing sperm from getting through and it stops ovulation.

Alongside being one of the best birth control options out there, with a effectiveness of 99%, it also will work for up to five years. And if it couldn’t get better--the implant isn’t permanent, if you decide you want another child well before the five year mark, no worries at all! It can be taken out and you can get pregnant almost immediately after.

Injection

Another method of birth control that prevents ovulation is the injection. It is a shot that releases depot medroxyprogesterone acetate (DMPA), a form of progestin. While not as forget-about-it as the implant, this method only requires you to receive a shot in your arm or rear end once every three months. This method is also available to use right after giving birth. If you remember to book an appointment and get your shot on time, this method is 99% effective. Like most birth control methods, it takes a little while for your body to get used to the hormones, as such, you may experience nausea, headaches, bleeding, and sore breasts.

Intrauterine Device (IUD)

The intrauterine device, or IUD, is another very effective form of birth control. The t-shaped device sits in your uterus, and depending on the type you receive, it will release a little bit of the hormone progestin or copper. Both work in the same way in that they prevent fertilization, however, the copper IUD does this by creating a toxic environment for sperm, while the hormonal IUD does this by thickening cervical mucus that ultimately prevents sperm from reaching the egg. Hormonal IUDs are approved to work up to three to six years; copper IUDs are approved to work up to ten years. In both cases, the IUD has a small chance of coming out of your uterus and causing occasional bleeding during the first months. The hormonal IUD can be very beneficial for those who have heavy and painful periods as those who use this method have experienced reduced bleeding or have no period at all.

Lactational Amenorrhea Method

As the name suggests, this method has to do with breastfeeding! One of the most amazing things about birthing bodies is that they also have a preset birth control in them. Though temporary, consistent and exclusive breastfeeding prevents ovulation. While this method doesn’t require any medical visits, it does require mothers to breastfeed very frequently--about every four to six hours. Alongside this, for this method to be an effective form of birth control, it does have to be exclusive breastfeeding--pumping and formula will decrease the effectiveness. This method does not cost a penny, except maybe your time. The only downside with this method is that it only prevents pregnancy for up to six months, or up until the time you receive your first period post birth. After menstruation, another form of birth control will be necessary, unless you’re ready for the next child!

Progestin-Only Pill

The hormone progestin has been a common pregnancy preventer in the previous methods. With the progestin-only pill, fertilization is prevented. But, this pill doesn’t contain estrogen like combined hormonal methods. Because of this, progestin-only pills can be taken immediately after birth, unlike other birth control pills. Alongside this, it has been recorded that these pills may stop your menstrual period or reduce menstrual blood. If you are a timely, organized mom, this pill may be for you--just beware, if you miss a pill within the three hour mark, you will need to utilize another method listed to prevent pregnancy.

Bilateral Tubal Ligation

After 40 long weeks, and many painful hours, you may realize that you don’t want to have any more kids. While the methods listed above are very preventative, bilateral tubal ligation is the only method that is 100%. This method, for female bodies, requires the closing off or removal of the fallopian tubes which prevents ovulation and fertilization. Reversals of this procedure aren’t always certain, so before you decide, make sure you truly don’t want to have kids anymore as the birth control prevention of this method is certain. If you have a partner with male anatomy, you may consider having them get a vasectomy.

With all of these possible methods in mind, think about your needs and your schedule to find the best option for you! It may take trial and error as one person is different from the next, but be glad for the many many options that we have today and the fact that we aren’t relying on animal bladder to prevent pregnancies anymore.

Ahma & Co Team

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