4 long-acting birth control options to consider if the Supreme Court limits contraception and abortion access
- There are concerns that Roe v. Wade, a Supreme Court decision that protected the right to abortion access, could be overturned depending on who replaces the late Justice Ruth Bader Ginsburg.
- Pro-choice advocates also fear challenges that could make birth control more expensive or difficult to access.
- As such, contraceptive users may consider seeking more long-acting and cost-effective options.
- IUDs, vaginal rings, and arm implants are options worth considering, Yale gynecologist Dr. Mary Jane Minkin told Insider.
- Visit Insider's homepage for more stories.
Supreme Court Justice Ruth Bader Ginsburg's recent death reignited a conversation about access to abortion and birth control in the US.
Ginsburg, who was known for her pro-choice stance, was part of the liberal faction of justices who protected the 1973 Roe v. Wade decision — which says pregnant women have the right to abortions without excessive government intervention — since she joined the court in 1993.
President Donald Trump's pick to replace Ginsburg is Judge Amy Coney Barrett, a conservative judge who, in 2006, signed an Indiana newspaper ad that called for Roe v. Wade to be overturned, the Guardian reported.
If confirmed as expected, Barrett would shift the court to be majority conservative. That means, for the first time, potential challenges to overturn Roe v. Wade could be successful, potentially altering reproductive rights as we know them.
The conservative court accept challenges to the Affordable Care Act, potentially hiking birth control prices if employers are no longer required to cover contraception through insurance. It could prevent Planned Parenthood from providing affordable birth control, which would disproportionately affect low-income people.
As for abortion, challenges to Roe v. Wade may not result in uniform bans or limitations. Some states will likely protect the decision, as New Jersey already did, but others may not.
In the case birth control access becomes limited or contraceptive prices become less affordable, Insider spoke with Yale University gynecologist Dr. Mary Jane Minkin about long-acting birth control methods that don't require monthly refills or doctor's visits, and are all covered on health insurance.
Hormone-containing IUD
IUDs, or intrauterine devices, are small eraser-sized and T-shaped contraceptives that a healthcare provider inserts into the uterus to prevent pregnancy.
There are two types of IUDs, hormonal and non-hormonal, and each have benefits depending on your needs, Minkin told Insider.
A hormone-containing IUD, which is known by the brand name Mirena, releases the hormone progestin. The extra progestin causes cervical mucus to thicken so sperm can't travel through the mucus to fertilize an egg. Progestin also causes the uterine lining to thin out, which partially prevents the uterus from releasing an egg during ovulation.
The hormones are localized, meaning they mainly affect the cervix and uterus where they're released. Just a small amount of the progestin is absorbed into your blood stream, Minkin said.
Mirena is more than 99% effective at preventing pregnancy. It's also been shown to reduce endometriosis symptoms like cramping and pain in some users, though doctors are exactly unsure why this is.
This type of IUD lasts up to five years, Minkin said, and is an option to consider if you've been taking other hormonal birth control due to intense period cramps or heavy bleeding.
"If she's somebody who had rotten periods the Mirena IUD is very good because the progestin in the pill acts on the lining of the uterus, so it limits the amount of flow and women tend to get much lighter periods," Minkin told Insider.
If you ever decide you want to get pregnant, you can remove Mirena and your fertility will go back to normal, Minkin said.
Hormone-free IUD
A hormone-free IUD also sits in the cervix, but doesn't contain progestin like its hormone-containing counterpart.
This IUD, known by the brand name Paragard, is made from plastic wrapped in copper, a substance that stunts sperm so they can't swim to eggs and fertilize them, according to Planned Parenthood.
A person who gets Paragard can keep it in their body for up to 10 years, and then get a new one from their healthcare provider.
Paragard is more than 99% effective at preventing pregnancy. Since it doesn't have hormones, it's not useful for treating pelvic pain or endometriosis.
This type of birth control is a good option for someone who doesn't react well to hormonal contraceptives, Minkin said. If you have adverse effects to birth control pills, like headaches, lower-than-usual sex drive, or severe mood swings, a hormone-free IUD could be a good option.
Additionally, some people can't use hormonal birth control due to health conditions like heart disease, high blood pressure, and diabetes, so Paragard is a better option.
Paragard won't change how much you bleed during your period.
Like Mirena, Paragard's effects are temporary, and if you choose to get pregnant, you can remove it and your fertility will return to normal.
Arm implant
Associated Press/Merck
Nexplanon is similar to hormonal IUDs in that it releases the hormone progestin and and is inserted into the body for an extended time period.
But instead of sitting in the cervix, Nexplanon is an implant the a healthcare provider injects into your upper inner arm. That means the hormones it releases are absorbed into the bloodstream more than with an IUD, but a similar amount as a birth control pill.
For some people, this can increase the likelihood of side effects like mood swings, weight gain, and irritability.
It lasts for up to three years, Minkin said, and if you remove it, your fertility will go back to normal soon after removal.
The implant is more than 99% effective at preventing pregnancy.
Some Nexplanon users complain of spotting, or a small amount of vaginal bleeding between periods, during the first few months of use, but Minkin said that's the method's only drawback. After continued use, some users stop getting their periods altogether.
And if you prefer not to have a device inserted up your vagina into your cervix, the arm implant could be a good alternative.
Vaginal ring
Though not as long-lasting as the above options, the vaginal ring could be a welcome option for birth control users who prefer to take things into their own hands, according to Minkin.
Known by the brand name Annovera, the silicone vaginal ring lasts for one year and contains the hormones estrogen and progestin to prevent pregnancy.
You insert the ring into your vagina yourself, Minkin said, and then take it out after three weeks when it's time to have your period.
"You wash it with a little soap and water, you keep it in your closet, and at the end of that week, you put the same ring in," Minkin said, adding that it could be a good option for someone who wants a year's supply of birth control without committing to three, five, or 10 years of contraception.
It's 97.3% effective at preventing pregnancy, and potential side effects include headaches, nausea, spotting, and cramps.
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