Pregnancy and contraception

As well as STIs, another risk associated with having sex is the chance of becoming pregnant. Only vaginal sex carries the risk of pregnancy; oral and anal sex do not carry this risk.

Any instance of unprotected vaginal sex, in any position, can lead to pregnancy. It is even possible for a girl to become pregnant if she has sex during her period, as the sperm can survive inside her body for up to 7 days.

The only guaranteed way to avoid pregnancy is to not have vaginal sex. However, if you are having vaginal sex, then it is important to consider using some form of contraceptive to reduce the risk of pregnancy – although it’s important to know that no method of contraception is 100% reliable.

Define it!

The term ‘contraception’ refers to methods that are used to prevent pregnancy. Certain methods of contraception can also be used to prevent STIs.

There are many different methods of contraception available – you can click through the slide panel below to find out more.

  • Condoms

    This method of contraception can protect against STIs, as well as preventing pregnancy. Both male and female condoms are available.

    The male condom is made of very thin rubber and is fitted over a man's erect penis, to prevent semen from entering his partner's body when he ejaculates (it is the sperm contained in semen which can cause a woman to become pregnant if it comes into contact with the vagina).

    To protect against both STIs and pregnancy, the male condom must be put on the penis before it comes into contact with the vagina, anus or mouth, and it must stay in place the whole time you are having sex. If the condom splits, tears or slips off during sex, you must stop and put another one on. If this does happen, it can mean that there is a risk of pregnancy and/or a sexually transmitted infection.

    Once the couple has finished having sex and there is no longer any contact between them, the condom can be removed and thrown away (it should never be flushed down the toilet). A condom can only be used once and they do have expiry dates - if a condom is out of date, it could be more likely to split and it shouldn't be used.

    The female condom is similar to a male condom, but it is inserted inside of the vagina instead. It lines the vagina to protect against unwanted pregnancy and STIs by stopping the semen/sperm from coming into contact with the vagina.

  • The contraceptive pill

    This method of contraception comes in the form of a pill taken by women, and it can be a very effective method of avoiding unwanted pregnancy... however, it does not protect against STIs.

    The most common form is known as the combined pill, which contains a combination of two hormones similar to those produced naturally by the body – oestrogen and progestogen. The presence of these hormones prevents pregnancy by stopping eggs from being released by the ovaries (ovulation), making it harder for sperm to reach the egg and making the uterus (womb) lining thinner so that any eggs that are fertilised cannot implant and grow.

    For the combined pill to be effective, one pill must be taken at the same time every day. If any days are missed, then this method of contraception may be temporarily less effective (depending on how many pills have been missed) and another type of contraception may have to be used for a period of time (e.g. condoms) while the pill becomes effective again.

    Having an upset stomach (vomiting and/or diarrhoea) can make the combined pill less effective. Some medicines can also reduce the effectiveness of the combined pill, including antidepressants and antibiotics used to treat certain STIs.

    The alternative to the combined pill is the ‘mini pill’ – this works in very much the same way as the combined pill, but only contains one hormone (progestogen)…it doesn't contain oestrogen.

  • Contraceptive injections

    These injections are given to women by a trained doctor or nurse and they contain the hormone progestogen. It can prevent pregnancy from occurring, but it does not provide protection against STIs.

    The contraceptive injection works in a similar way to the contraceptive pill, by the presence of progestogen working to prevent pregnancy by stopping ovulation, thickening the mucus around the cervix to make it harder for sperm to get through and making the lining of the womb thinner to prevent implantation of a fertilised egg.

    Instead of a woman having to remember to take a pill every day, one injection does the same job over a long period of time. The injection can work for between 8 and 13 weeks at a time and, unlike the contraceptive pill, it is not affected by vomiting, diarrhoea or other medication.

  • Contraceptive implants

    A contraceptive implant is a small plastic rod, which is inserted just beneath the woman’s skin in her upper arm. It needs to be fitted by a specially trained doctor or nurse.

    The implant works in a similar way to the contraceptive pill and the contraceptive injection – it releases the hormone progestogen into the bloodstream which prevents pregnancy by stopping ovulation, thickening the mucus around the cervix to make it harder for sperm to get through and making the lining of the womb thinner to prevent implantation of a fertilised egg.

    Once inserted under the skin, the implant can be effective for up to three years at a time, and it has been found to be over 99% effective.

  • Intrauterine device (IUD)

    The intrauterine device (IUD) is also referred to as the coil. It is a small, T-shaped plastic device which contains copper. The device is inserted through the vagina into the uterus (womb); it must be fitted by a specially trained doctor or nurse.

    Unlike the contraceptive pill, injection and implant, the IUD doesn’t contain hormones – it prevents pregnancy in a different way. The copper contained in the IUD is toxic to sperm so it stops the sperm from surviving inside the woman’s body; it also stops any fertilised eggs from becoming implanted in the womb.

    As soon as an IUD has been fitted, the woman is immediately protected against pregnancy...and the device can stay in place and prevent pregnancy for between 5 and 10 years.

  • Contraceptive patch

    The contraceptive patch is a small patch that is applied to the skin like an Elastoplast (plaster). The patch works in a similar way to the combined contraceptive pill, as it releases two hormones – oestrogen and progestogen – through the skin. The presence of these hormones prevents pregnancy by stopping eggs from being released by the ovaries (ovulation), making it harder for sperm to reach the egg and making the uterus (womb) lining thinner so that any eggs that are fertilised cannot implant and grow. The patch doesn’t protect against STIs.

    A woman will wear one patch continuously for seven days. On day eight, she will remove the patch and throw it away, then immediately put a new one on. The patch will be changed every week for three weeks (21 days); after three weeks, the woman doesn’t wear a patch at all for seven days. After this break of seven days, a new patch is applied and changed every week for three weeks, followed by another break of seven days and so on.

  • Emergency contraception

    If a woman feels at risk of pregnancy – perhaps because she has forgotten to take her contraceptive pill, had unprotected sex or a condom has split or come off during sex – she may be able to prevent pregnancy by using an emergency contraceptive. Emergency contraception can only work to prevent pregnancy up to five days after having unprotected sex.

    There are two types of emergency contraception:

    1. The emergency contraceptive pill (also known as the morning after pill)
    2. The intrauterine device (IUD)

    The IUD is the most effect method of emergency contraception, as long as it is fitted within five days (120 hours) of unprotected sex. It takes about 15 to 20 minutes to fit the IUD and, once it has been fitted, it can remain in place and be used as an ongoing method of contraception.

    There are two different types of emergency contraceptive pills available – one is most effective when taken within 72 hours of unprotected sex (but can also be taken up to 96 hours/four days afterwards); the other is effective up to 5 days after having unprotected sex. The sooner the pill is taken, the more effective it can be in preventing pregnancy.

    Emergency contraceptive pills are available from a doctor, a sexual health clinic or they can be bought from most pharmacies (as long as you’re over the age of 16). The IUD must be fitted by a specially trained doctor or nurse.

Key point

The majority of teenage pregnancies are unplanned and research has shown that teenage pregnancy is associated with poorer outcomes for both young parents and their child. Teenage mothers are less likely to finish school and gain qualifications, harming their future employment prospects; they are also more likely to raise the child alone as a single parent and live in poverty. There are also higher rates of poor mental health amongst teenage mothers.

So, while the idea of having a baby may seem really cute and exciting, the reality of being a parent is life-changing and can be extremely challenging. The pressure of parenthood can break up a relationship, leaving one person to raise the child alone as a single parent. The single parent may end up feeling isolated, lonely and depressed – all of their other friends are out having fun, socialising, going to parties, etc and they are stuck at home with a baby to look after (and with no spare time or money to do anything).