How to Talk to Your Partner About Birth Control
Birth control can be a tough discussion, but any sexual activity requires bringing this conversation into the open.
If you are unwilling or not ready to have children, avoiding the issue just puts you at risk of accidental pregnancy.
"The overturn of Roe v. Wade by the Supreme Court affects anyone who can get pregnant: cisgender women, transgender men, nonbinary or genderqueer folks," said Charlotte Cremers, M.S., a general practitioner based in London. "It is, thus, important to talk about birth control to avoid having sex and then regret it later."
The stats and your options
Between 2015 and 2017, 46.9 million of 72.2 million women ages 15 to 49 in the United States—that's 64.9 percent—used some method of contraception, according to the Centers for Disease Control and Prevention (CDC).
Birth control usage tends to increase with age, from 37.2 percent of women ages 15 to 19 to 73.7 percent among women ages 40 to 49.
The contraceptive options people use vary drastically. Most common—and, unfortunately, most vulnerable to human error—is the condom. The best prevention against sexually transmitted infections (STIs), male condoms are a simple birth control option that is 98 percent effective when used correctly.
There are a variety of hormone interventions, such as the many types of pills, the hormonal coil and the Depo-Provera injection. Aside from condoms, nonhormonal options vary from the copper coil, diaphragm, cervical cap and surgery to the rarely used and much mocked female condom.
Decide on the best option for you
Options for birth control are vast and largely very reliable. Before communicating them to a partner, figure out the best choice for you.
Identifying why you are seeking contraceptives is the first step, which a local clinic or primary care provider can help you to figure out, said Jeff Foster, M.B.Ch.B., a general practitioner at Nuffield Warwickshire Hospital in Royal Leamington Spa in England.
"When it comes down to control, the most important thing is to look at the reason why you're trying to achieve birth control, so if it is purely to stop you from having a baby, then that's a different process to having a new partner or several partners and being worried about risk," he said.
"The best time to have the birth control talk is before getting hot under the covers," Cremers said. "Talking about birth control before having sex can keep you from having unprotected sex, especially if you are not ready to get pregnant. It can also help you know whether your partner cares about your health and safety."
Before any fun takes place, be responsible and set aside a few minutes to discuss birth control. The more you practice, the easier it gets.
Never assume that someone is STI-free or they are already on birth control. If in doubt, remember these three C's: communicate, confirm and consummate.
Relationships and polyamory
In a committed relationship or a polyamorous one, you may want to become "fluid bonded," meaning you want to tear off the condoms and go skin deep. No matter how tempting it is, you should refrain until all parties have had a full STI screening and checkup.
"If you and your partner are on the same side about birth control, discuss various birth controls," Cremers advised. "Also, discuss the risks attached to each form of birth control and then decide what works best for you."
Ultimately, the person who is going to deal with the physical effects of birth control should make the final decision. However, discussing it can help identify the best options and eliminate unsuitable ones, such as the pill for forgetful folks.
Deciding when to have the conversation is crucial. This discussion should not be conducted in a rush. When in a committed relationship, you have the luxury of choosing a moment unobstructed by sexual desire.
Take the conversation out of the bedroom to avoid sexy distractions and ensure that neither of you has other obligations that will cut it short. Then book an appointment with your healthcare provider to discuss the details.
Dealing with misconceptions and poor education
Thanks to the internet and a lack of sex education in some places, there are numerous misconceptions about birth control running wild in the world. Perhaps the most notorious is the belief that some forms of hormonal birth control protect against STIs or are exclusively for young, sexually active people.
"You're always telling your patients that this isn't going to stop you from getting chlamydia, and it seems really obvious, but it still keeps happening," Foster said. "Sex doesn't turn off when you're 50, you keep going, and whilst, of course, they don't have to think about contraception because they've had menopause, that's the mistake. They're not being reminded about the barrier aspect of it."
Although the misguided belief that birth control increases the risk of getting cancer has largely been quashed, there is one belief still going strong, according to Foster.
"The big one we tend to see is about post-pill difficulties in getting pregnant, that seems really common," he said. "There's no evidence for that. Your natural cycle starts to kick in within three to six months."
If you have a partner who has fallen prey to misconceptions about birth control, remember it is not your job to educate them. Making a decision can be a collaborative process, but you are a romantic or sexual partner, not their sex educator.
"The best thing is to tell people that all forms of contraception are different, [but] success rates are over 99 percent in almost all of them, if used properly," Foster said. "They've been around for decades and are extremely successful with very few side effects, provided [they're] used properly and monitored, with virtually no risk."
For people who have either finished their child-bearing journey or do not want children at all, there are permanent options to explore.
Men may wish to have a vasectomy, where the tubes that carry sperm are cut off and sealed. The low-risk procedure is typically performed in an outpatient setting.
Women can undergo two types of sterilization: a tubal ligation, where the fallopian tubes are permanently blocked or clipped, or a salpingectomy.
"Salpingectomy is when you get your fallopian tubes removed," Cremers explained. "In doing so, you stop ovulation. While undergoing surgery is among the 100 percent most effective ways of preventing pregnancy, it comes with risks. Salpingectomy can wreak havoc on your psychological and sexual well-being. This surgical procedure is associated with vaginal dryness and low libido."
While undergoing any of these procedures is your choice, if you're in a committed relationship, being open about this process is crucial. It is unacceptable to trick someone who wants children into committing to a relationship with someone who does not want or is now incapable of having them.
If this step feels right, set aside time to dig deep into the topic with your chosen partner and explore the various options and risks before seeking a doctor to perform it.
Having a backup plan and checking in
While birth control is largely very effective, there is always a small chance of something failing, most likely due to human error.
Always keep some condoms on hand as a backup plan. Use them whenever you forget to take the pill or during any transition periods when changing contraceptives.
As annoying as some people find them, regularly using condoms is also advisable, even in committed relationships. They can act as an extra layer of insurance and, as always, a barrier against most STIs.
Above all, remember to check in with your partner. The side effects of birth control can be a trial to deal with, and a supportive sexual partner makes a huge difference in managing them.