IUD

While the Paragard and hormonal methods that don’t contain estrogen—the shot, the Mirena IUD, the implant and the mini-pill—are safe for people who are postpartum to use immediately after giving birth, combination pills, which contain estrogen, shouldn’t be used until three weeks after giving birth, since estrogen can increase a postpartum person’s risk of blood clots.

The IUD is among the most effective methods out there. In fact, both types of IUD—Paragard and Mirena—are over 99% effective.

In other words:

Fewer than 1 out of 100 women will experience an accidental pregnancy during the first year of using an IUD.

IUD expulsion, where your IUD comes part of the way or all the way out of your uterus, happens in 2 to 10% of people with an IUD (that’s 2 to 10 out of every 100 people using an IUD) in the first year after insertion. If your IUD has come out of your uterus completely or partially (is sticking out of your cervix), it is no longer going to be effective as birth control, so if you don’t want to get pregnant, make sure you’re using a backup method of birth control, like condoms, if this happens.

Expulsion is more likely if you: 



1. Haven’t been pregnant
2. Are younger than 20 years old

3. Have very heavy or very painful periods (though these are reasons to use a hormonal IUD in the first place)

4. Had your IUD put in right after giving birth or right after having a 2nd trimester abortion.

5. Have a uterus that is an irregular shape (which can be something you’re born with or something caused by fibroids).

It could also happen if the IUD was placed too low in the uterus and just worked its way out. For people who have an IUD expulsion, the chance of expelling another IUD may be higher—around 20% (and up to 30% in some studies), meaning that 20 to 30 out of every 100 people who’ve expelled an IUD in the past will expel another IUD.
If you want to try an IUD again, consider asking your health care provider about inserting the IUD while using an ultrasound machine to make sure it’s inserted in the correct place.

No, most forms of birth control are not effective immediately, so you want to check with you doctor before having unprotected sex. Until then, use a condom for added protection.

Some methods are much easier to hide than others. The shot and the implant are invisible, so nobody will know you’re using birth control. The IUD is also very discrete, so that’s another possibility, though some guys may be able to feel the strings during sex. And if you are looking for a permanent solution, sterilization surgery is also undetectable, but there may be age restrictions and waiting periods for this procedure.

Yes. The American Congress of Obstetricians and Gynecologists—an association whose members make up 90% of doctors specializing in women’s health in the U.S.—has declared IUDs safe for women of all ages. They also noted that the IUD and the implant, another long-acting method, are more effective than any other form of reversible birth control.

There are two kinds of IUDs available in the U.S.—with hormones and without. Mirena, LILETTA, and Skyla IUDs release a small amount of the synthetic hormone progestin to help your body keep sperm from reaching your cervix. Both Mirena and LILETTA last up to 8 years; Skyla is slightly smaller than Mirena and lasts up to 3 years.

The Paragard IUD is hormone-free and doesn’t alter your periods. It’s made of plastic and a small amount of natural, safe copper and can work for up to 12 years.

It depends which kind you get. Skyla is approved for up to 3 years and Kyleena is approved for up to 5 years. Mirena and LILETTA are both approved for up to 8 years. The non-hormonal Paragard IUD is approved for up to 10 years but lasts for 12 to 20 years.

Levonorgestrel is one of the longest-studied types of progestin, and all the scientific evidence to date shows it is super safe. It’s used in hormonal IUDs, some emergency contraception pills, and certain birth control pills.

Skyla and Mirena are pretty similar, but Skyla lasts for up to 3 years while Mirena lasts for up to 8 years. Also, Skyla is slightly smaller than Mirena and was FDA-approved for women who’ve never had a child, though both IUDs are totally safe for most women to use, regardless of their parental status.

If you’re under the influence of alcohol—or anything else—a birth control method that doesn’t require action right when you’re about to get your freak on may be your safest bet. Fortunately, there are plenty of options. Note: These methods will cover you against pregnancy, but you should pair them with a condom for STI protection.

And speaking of covering all your bases, here are some tips for safer, smarter hookups.

The non-hormonal IUD is effective immediately after it’s inserted. The hormonal IUD is effective immediately if you get it inserted within 7 days of the start of your period. Otherwise it takes a little longer to become effective, so you should use a back-up method, such as condoms or internal condoms, for 7 days after insertion.