I am going to talk about modern contraception primarily. I do know that there are historical authors who are having their characters use things like sponges, early condoms, and withdrawal, so while the specific choices may not be the same for historical authors, you all are not off the hook. And fantasy authors, you too. In fact, one of my favorite good examples is a selkie vampire urban fantasy.
Disclaimer: This is not a comprehensive list. Think of this as more like a highlight reel, and based on the choices and circumstances surrounding your characters, you can go learn more.
Types of contraception: Surgical Methods: • Tubal ligation is actually most common worldwide, according to a UN study. Tubal ligation is performed to block fallopian tubes, and therefore stop release of eggs. That only eliminates the risk of pregnancy, so if STI’s remain a concern, other methods would need to be employed. • Vasectomy blocks or cuts the vas deferens to prevent sperm from being carried to the penis. This method addresses pregnancy prevention and also eliminates the risk of infection that would be carried in sperm. If infections not carried in sperm are a concern, then other methods would also need to be employed. Hormone centered methods: As an overall note – hormone centered methods currently focus on suppressing or altering estrogen and progestin to alter or suppress ovulation. As such they all carry mental health and other side effects for folks for whom hormone fluctuation causes issues, among other side effects. These methods only address pregnancy prevention, and therefore if STI’s remain a concern, other methods would need to be employed. There are health conditions where the stabilization of hormones, or the increase of them, is useful, so these methods can also be prescribed for other conditions too.
• The Pill – The pill refers to a variety of oral hormonal pills that can be taken to suppress egg release in the uterus.
• Hormonal Patch – a patch placed weekly to enact a slow release of hormones.
• Injectables – A variety of products that can be injected into the skin or muscle to enact a slow release of hormones over a period of time. • Implants – a hormone capsule inserted under the skin to release hormones over a longer period of time. They are considered a Long Acting Reversible Contraceptive (LARC) which makes them useful for folks who are certain that pregnancy is not in their immediate future.
• Emergency Contraception is also hormonal. It is provided in oral form after unprotected sex, giving the hormones a chance to try and beat the sperm. It will not end or interfere with a conception that has occurred prior to the pill being administered. Barrier Methods:
• Condoms – are available in both more well-known roll-on form and the internal form. The internal condoms are often harder to access, and more expensive, but can be inserted farther in advance of sexual activity. Condoms prevent pregnancy and most STIs. • Diaphrams and Sponges – Inserted vaginally prior to intercourse, and often treated with spermicide. If treated with spermicide, these methods can provide some STI protection. • IUDs – An Intrauterine Device (IUD) that is inserted into the uterus to thicken the cervical mucus and interfere with sperm travel, thereby preventing pregnancy. Many are made of copper, so are not useful to those with copper allergies. IUDs are also considered Long Acting Reversible Contraceptive (LARC). IUDs do not provide STI protection. Lifestyle Methods: Withdrawal – a method of engaging in sexual activity where one partner withdraws before ejaculation, in the hopes of eliminating partner contact with sperm. Generally sperm is transmitted prior to ejaculation, as well as during ejaculation, so this method somewhat reduces the likelihood of pregnancy or infection transmission, but not by much.
Fertility Awareness methods – These methods rely on monitoring of various bodily indicators along the menstrual cycle to determine days of higher likelihood of pregnancy conception. This method can be used both in prevention and attempts to provoke a pregnancy.
UN report on Contraceptive use: Note: the UN report focuses on a very cisgender approach to sexual activity. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Jan/un_2019_contraceptiveusebymethod_databooklet.pdf Guttmacher Institute Fact Sheet on Contraception in the US: https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states