Tip of the iceberg

Condoms and pills may not be your best bet for contraceptives at university.

Sex — it’s everywhere on campus. The opportunities for sexual experiences during your university years seem endless, but the variety of birth control methods are not so vast. So how do you prevent sex from leading to an unwanted pregnancy? 

Going into this piece, I have been a committed — if not inconsistent — user of the birth control pill, which I started the summer before university. I asked for something that would have me covered at university and was handed the pill — no discussion of other options. Two years later, I wonder what exactly is out there and whether or not it’s worth my time to switch to a method that keeps me safe despite my forgetful mind.

This piece focuses on female birth control (there really aren’t that many male birth control options). There is a double standard that puts the responsibility of contraception on women. This forces women to compromise between what they can afford and the contraceptive effectiveness that they need. This double standard is as real as the difficulties — due to factors like the number of sperm produced, side effects and the lack of oral testosterone — developing a viable form of male birth control. Male birth control could certainly exist in our lifetime, but researchers still have a lot of upstream swimming ahead of them.

For all the social and scientific barriers to accessing a method of birth control, there are many viable options for preventing unwanted pregnancies. Ultimately, the most important thing is that your chosen method works. This article discusses several, though not all, options for women.

“You’re in university to further your career and establish yourself in life, and having unwanted pregnancies would certainly interfere with that plan,” said Dr. Ellen Wiebe, a clinical professor in the department of family practice in UBC’s faculty of medicine. “So you want one that works.”

For those who love sex, drugs and science, here’s the low-down on what’s available at UBC and where you can get some (pun intended). 

Rolling on

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First things first — contraceptives prevent pregnancy, but don’t necessarily protect against disease. Some contraceptives, like condoms, do both. Others, like the pill, do nothing to prevent STIs. Make sure you keep this in mind when changing sexual partners and trying out new forms of contraception.

Of the eight women that The Ubyssey interviewed, all of them usually — if not always — used condoms during intercourse.

“I would never have sex with someone without a condom,” said Karis Gill, a third-year exchange student at the Sauder School of Business who exclusively uses condoms and the withdrawal method to prevent pregnancy. “They’re a physical barrier and I need that tangible protection.”

Meanwhile, for students using another form of contraception, condoms provide an additional (if fallible) level of protection. While condoms fail only 2 to 18 per cent of the time, some students aren’t so sure their popularity as the go-to method for university students is merited.

“I use [condoms] because I don’t want to use any of the other [methods of contraception],” said Gill. “They’ve worked pretty well so far.”

Poppin’ pills

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In addition to condoms, the pill was a popular method among the women interviewed. Most of the users of the pill saw it as a precautionary measure when involved with multiple partners. 

“I don’t have any way of knowing when I’m going to have sex or any capacity to plan for it,” said Jessica Li, a second-year science student. “So the mobility of [the pill] is definitely really important to me.” 

Although she echoed Li's mention of the “safety net” provided by the pill, Berit Beattie, a third-year student in the faculty of arts, also noted that it’s not as easy as some may think to take it at the same time every day. When not taken consistently and in a timely manner, the effectiveness of the pill can decrease to 92 per cent.

“I’m not that great at taking the pill on time,” said Beattie, a user of the pill for almost five years before stopping earlier this semester. “I like the pill, but I just need to get my act together a bit.”

Even though the pill is up to 99 per cent effective and requires less forethought than a condom, some students mentioned the difficulty of finding a prescribed form of contraception without parental support.

“I was going to college, so I just wanted to be safe, but there were a few cultural differences with my family and so my parents weren’t as okay with me getting a prescription,” said Anjali Bhatt, a third-year commerce student from the United States. “I’m also concerned about insurance. The only thing that’s stopping me [from getting the pill] right now is just figuring it out with my insurance and my parents.”

If you are using AMS’ Health and Dental Plan or your own MSP plan, your medical history cannot be disclosed to anyone without your explicit permission. Get your fill (prescription, that is), children of helicopter parents — no one’s going to tell on you. 

Familial difficulties aside, finding the right fit for your birth control can also be as much of a hassle as going to your least favourite professor’s office hours. Mood swings, skin problems, an increased risk of blood clots and depression have all been linked to hormonal birth control methods, and depending on your medical history, you may need to shop around a bit before you settle on one brand.

“I had to try three different pills because the first two really affected my mood,” said Sian Leslie, an exchange student in the faculty of arts. “Now I’ve been on this one for a year and it’s good, but it definitely took some effort to find the right one.”

It goes where?

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On the other hand, IUDs — the birth control method of choice among female doctors — are recently slowly gaining traction among young women despite having been around longer than the more mainstream pill and condom combination.

Given that they are also more effective than both condoms and the pill, it was surprising that only one interviewee had ever used an IUD before, and that only two others had seriously looked into it. 

“It kind of freaks me out,” said Leslie on the prospect of using an IUD. “I’d rather have control over what I’m putting in my body than to just have something up there.”

Wiebe, however, wants students to know that it’s definitely not anything to be afraid of. In fact, it’s “perfect” for women looking for a reliable and long-lasting option “from their first day of university to the day that they cross the stage.”

“Most of the reasons I hear are that they’re scared of the insertion and of things they’ve heard about them — which are in fact, not actual problems with IUDs,” said Wiebe. “There’s no question that more women use pills than IUDs … but it works better, it has fewer side-effects and is so much more effective.” 

Echoing Wiebe’s sentiment, Vassilena Sharlandjieva, a second-year science student, feels lucky that the IUD is so accessible and practical for her as a student at UBC.

“I think about women who do not have access to [the IUD] and I recognize that I’m so fortunate,” she said in a Facebook message. “It’s safe, reliable and I don’t have to be preoccupied about an unplanned pregnancy or birth control for the next three years.”

While IUDs aren’t provided by Student Health Services, they will refer those interested to a doctor in Vancouver who can insert an IUD. With the AMS plan, up to 80 per cent of the cost of IUDs is covered.

Put a ring on it

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None of the women who were interviewed had seriously considered the vaginal ring, which is a small and flexible plastic ring that slowly releases the same hormones as the pill over the course of three weeks. Wiebe insists that its convenience far outweighs the less glamourous details of its use, which requires the ring to be inserted and removed from the vagina for a week a month.

“They are so much more convenient than pills, so I’ve definitely asked myself why more women aren’t using them,” said Wiebe. “But when I show them to my patients, some of them just turn and say ‘ew’ to the idea of having to put that inside their vagina.”

Overwhelmingly, however, “women who choose to use the ring love it,” said Dr. Judith Soon, an associate member of UBC’s department of family practice. “If a woman is already used to using tampons, then it’s no different.”

Wiebe also noted that “it’s a great place to put birth control — in your vagina.” 

Get outta here

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While hormonal and barrier methods of contraception are most students’ standard routine, withdrawal (AKA pulling out) was not uncommon either. Withdrawal was cited by three of the seven women interviewed as their last-resort if they didn’t have anything else on them. It was an established routine for one of the women. 

“I’m very clear from the beginning that I expect them to pull out,” said Gill, who uses the withdrawal method of birth control in combination with condoms. “You just sort of get into a routine and barely even think about it anymore.”

Withdrawal, in addition to being reliant upon your partner to comply, also runs the risk of live sperm being present in pre-ejaculate. This means that without a condom, some foreplay can transfer live sperm into the vagina. We’re not talking an improbable, Glee-esque hot-tub impregnation, but a real — albeit small — risk of fertilization without intercourse.

On the other hand, fertility awareness — or counting days — was not mentioned once in any of the interviews. 

When using the counting days method, a woman monitors her body temperature and vaginal discharge to identify the fertile window during which she may become pregnant. The method requires careful planning and constant mindfulness, making it very time intensive. It also requires refraining from sex during certain times of the month.

Plus, with an average effectiveness of only 73 per cent, counting days is a lot of work for a relatively low reward.

Oops

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But what do you do when you plan and plan, and things still don’t go as you expected? Emergency contraception, commonly known as Plan B, is about 98 per cent effective when taken within 24 hours of sex. It is as good at preventing pregnancy as a post-coitus ride to the drug-store is awkward.

If the first episode of Master of None didn’t convince you, Plan B’s 89 per cent effectiveness rate — even when taken three days after the act — is perfect for when the condom breaks or you’ve skipped a pill or two. 

“I took Plan B for the first time this year, right after I stopped taking the pill,” said Beattie. “Honestly, I did not feel a thing. It was scary but — and I googled it — it does not make you infertile.”

Beattie is right — there is no evidence that Plan B affects fertility. Side effects can include nausea and cramping. The morning after pill may also induce your period.

However, Plan B should not be used a a regular form of birth control. 

As Bhatt and others put it, a temporary stomach ache is a small price to pay for peace of mind.

“I’d rather be sick than have a baby,” said Bhatt.

Whatever way you like it

Experts agree that women who are starting or re-evaluating their birth control method should make sure it suits them and their lifestyle.

After two years of using the pill, I am now reconsidering how well-suited it really is for my busy — and often forgetful — self. Perhaps something a bit more laissez-faire would work better for me.

“Convenience is extremely important,” said Soon. “[Young women] have so many other things going on in their lives — like studying for exams at odd hours and that kind of thing — that it’s quite difficult to have to use something just at the time of sex unless you’ve planned ahead.”

Experts widely recommend IUDs for university students because of its convenience and superior effectiveness.

“An IUD is an outstanding choice. It means [young women] don’t have to think about taking something every day,” said Soon. “Plus, it’s usually poor pill-taking that causes the majority of unintended pregnancies while on the pill.”

“When you look at the guidelines for gynecologist and obstetrics in Canada, all of these guidelines say the IUD is the top form of birth control for young women,” said Dr. Wendy Norman, an associate professor in UBC’s department of family practice. “But the level of usage that we see in other countries simply isn’t there. There’s definitely a lack of information.”

There is no one best contraceptive for you if you don't want to get pregnant — it's worth the time and effort to find the one best suited for you.

The best contraceptive is the one you’ll use and use correctly.


The Wellness Centre and Student Health Services’ online resources offer more information about all of the options and opportunities to consult an expert that are available on campus. The AMS has also summarized your coverage to make it easier for you to understand the financial impact of your contraceptive decision. 

For those of you adventurous enough to venture east of Blanca, Bedsider, SexualityandU and Options for Sexual Health have got all of your general contraception needs covered as well.