Last month we covered how to find reproductive Health clinics and access their services if you're uninsured. While different people need different reproductive health services for different reasons, one purpose most people use them for most of the time, is to obtain contraception to prevent an unwanted pregnancy. Certain contraceptive methods may also reduce the risk of STD transmission, or can help to alleviate symptoms of disorders like polycystic ovary syndrome.
Unfortunately, depending on what kind of contraception best suites your needs, getting it if you don't have medical insurance can be expensive. Here are some ways you might be able to reduce your costs, without forgoing contraception or increasing your risk of an unwanted pregnancy.
The Condom: Many people reach for the rubber love-glove as their first method of contraception, and for some this remains their method of choice. When used correctly, condoms or "male" condoms, are 98% effective in preventing an unwanted pregnancy(1), and remain the best protection against HIV(2) and certain other STDs for those that are sexually active.
The costs of condoms over a year can vary widely, depending on how many instances of sexual contact requiring protection you have in a twelve month period. As it is necessary to use a condom for each time you have sex even if neither party climaxed, if you're having intercourse multiple times a day, every day, using condoms becomes less cost effective, especially if you're not worried about contracting an STD (i.e. you and your partner are in a monogamous relationship, and you both have tested negative for STDs).
Pros: 98% effective against unwanted pregnancy with consistent and perfect use, no prescription necessary, can be used immediately, widely available
Cons: Some users may feel a "loss of intimacy and spontaneity" or discomfort, consistently perfect use is rare
How to get it: Condoms are widely available from many different retail outlets, from drug stores, to specialty shops, to the ubiquitous supermarkets across the American landscape. While the price per unit can range up to $1.50 per unit for premium varieties in a national pharmacy chain, online retailers may carry the varieties, for less. Drugstore.com for example, sells Durex Performax Intense condoms for $7.99, $6.00 less than the recommended retail price. Beyond trawling amazon.com for the prophylactic of your choice, searching via Google's shopping engine may also help you to find the best value on barrier contraceptives.
Larger manufacturers also often issue coupons or provide special offers through their official websites or through the SmartSource printable coupon service. Trojan is currently offering up to $5.00 off select products through this form here. Then there's also CondomUSA's free sample section, which will send a free sample of condoms for the price of shipping and handling.
The "Female" Condom: Similar to the male condom in that it is also a barrier method of contraception and STD prevention, the female condom is worn internally for penetrative intercourse. 95% effective against unwanted pregnancy with perfect use(3), it also provides some protection against the transmission of STDs.
Female condoms typically cost between $2.50 and $4.00 per unit, and while they are more expensive than male condoms, they enable the receptive partner to take control of their sexual health and/or fertility if their partner refuses to wear a "male" condom. Female and male condoms should never be used together during intercourse as they are likely to break.
Pros: 95% effective against unwanted pregnancy with perfect and consistent use, no prescription necessary, allows the receptive partner more control over their sexual health, can be used by people allergic to latex
Cons: Not as widely available as the male condom, higher price per unit, the failure rate from typical use of female condoms is somewhat higher than male condoms or barrier contraceptive methods suggesting that some find it more complicated or difficult to use, some users feel it reduces feeling during intercourse
How to get it: While not as widely available as the male condom, female condoms are available throughout the United States from Planned Parenthood, other family planning and reproductive health clinics, pharmacies, in some supermarkets and online. As of this writing, the national drugstore chain Walgreens stocks the FC2 and is currently offering a three count package for $4.79, which brings the price per unit down to about $1.60. This third party retailer at Amazon.com sells a ten count package for $12.25, bringing the cost down to $1.23 unit, which comparable to what one would pay per unit at a drug store for male condoms. If your pharmacy, supermarket or reproductive clinic doesn't currently stock female condoms, ask them to do so in the future.
The Diaphragm: the diaphragm is a shallow dome-shaped cup with a flexible rim; it works by covering the cervix to block sperm from entering the opening to the uterus. To improve effectiveness, spermicidal cream, gel, or jelly should be used in conjunction with the diaphragm. When used as directed, only 6 in 100 women will become pregnant over a year of using the diaphragm as their contraceptive method.
In order to get a diaphragm, you must first be examined by a health care provider and be given a prescription, which can filled by most local pharmacies. Unfortunately, the requirement of an examination increases the upfront cost of the diaphragm and makes it less convenient option for some. Depending on your appointment cost and the cost of the diaphragm itself, the combined total ranges from $65 - $275, plus an additional $8- $17 for a spermicide kit. However, the diaphragm, when properly cleaned and cared for can last up to two years, which will off-set some of these higher costs.
Pros: Portable, cannot usually be felt by you or your partner during intercourse, can be inserted hours before sex so there is no interruption of the proceedings, lasts for up to two years
Cons: Requires an examination and prescription, higher up-front costs, can be pushed out of place during intercourse, some women develop frequent urinary tract infections with diaphragm use, does not provide protection against STD transmission and spermicide use can increase the risk of HIV transmission
How to get it: First, as mentioned make an appointment with a health care provider. This can be done at most planned parenthood clinics, reproductive health centers and traditional OB-GYN offices. If you're uninsured or on Medicaid or another state health program, a planned parenthood, state-run clinic or charitable clinic are likely to be best bets for getting seen for an appointment and getting help with costs or financing. Once you've gotten a fitting and prescription for your diaphragm, there isn't too much you can do to decrease the cost of filling the prescription if you don't have insurance.
One way to decrease your overall cost is to clean and care for your diaphragm. Assuming it lasts a full two years, an upfront cost of $275 breaks down to a base cost of about $0.38 per day. This does not include the additional cost of spermicide applications which will vary depending on the frequency of intercourse.
The Sponge: Unavailable in the US market for over a decade after 1995, some people of a certain age may not have heard for the contraceptive or "Today" sponge, unless, they too watched Seinfeld reruns in junior high. This method offers some of the same benefits as a diaphragm but doesn't require a prescription or a medical visit in order to get it. The effectiveness of the sponge in preventing unwanted pregnancies varies depending on whether or not you've already given birth and whether or not it's used as directed. Women who have not already given birth and use the sponge as directed can expect 91% effectiveness rate in preventing pregnancy, but women using the sponge as directed who have given birth before can only expect about an 80% effectiveness rate in preventing pregnancy.
The sponge works by covering the cervix to prevent sperm from entering the uterus and by continually releasing a spermicide that stops sperm from moving. Like the diaphragm, it can be inserted hours before intercourse and worn for up to twenty-four hours after insertion. The sponge must be left inserted for an additional six hours after intercourse in order to be effective, and should never be left inserted for more than thirty hours.
Pros: Does not require a prescription, portable, can be inserted before sex so it is not necessary to interrupt foreplay, and cannot be felt by your or your partner during intercourse
Cons: Removal can be difficult especially for inexperienced users, does not protect against STD transmission, some users report it makes sex "dry"
How to get it: Despite being totally unavailable in the US market for over ten years, the contraceptive sponge is now widely available, and is at the time of this writing, also on sale at Walgreens. After browsing various online retailers, the best price per unit we could find for the sponge was $3.88 at otcitems.com, with prices from other retailers ranging from $4.18 to $4.66 per unit. There is also a 10% off coupon code for todaysponge.com up at RetailMeNot. In addition to being widely available online, and in some supermarkets and drugstores, the sponge is also available from family planning clinics.
The IUD: A T-shaped device that is inserted into the uterus, the IUD can last between 5 and twelve years, depending on the type used. It works by affecting sperm movement, preventing them from joining with an egg. The Mirena IUD also contains progestin, which prevents the ovulation, which also helps to prevent sperm and egg from joining together. The IUD is a highly effective form of birth control, with fewer than 1 out of 100 women who use the IUD becoming pregnant within a year.
It does not protect against or reduce the risk of STD transmission and may not be safe to use for some women who are on certain medications, have an STD, or have had a pelvic infection following abortion or child birth within the last three months.
Pros: Lasts for years, can be used while breastfeeding, may improve your sex life by enabling you and your partner to be more spontaneous
Cons: Some women experience mild to moderate pain after initial insertion, spotting, and/or irregular or heavier periods, there's also the possibility of IUD slipping out of place or pushing through the wall of the uterus, high upfront costs.
How to get it: To get an IUD, you have to first meet with a health care provider for a consultation. Consultation experiences can vary from clinic to clinic and you may have to have a pelvic exam and an ultrasound in addition to a discussion of your medical history and reasons for wanting to use the IUD with your provider before getting an IUD inserted. Costing between $500 and $1000 the upfront costs for an IUD and insertion can be high in comparison to other forms of birth control, but may even out as a single IUD lasts from five to twelve years. Even assuming that a $1000 IUD will last only five years, the per day cost breaks down to about $0.55 per day.
Unfortunately, if you've decided that the IUD is the best contraceptive method for you, there isn't much one can do to decrease the initial costs. Some clinics will provide this service on a sliding scale based on your income, or will help you work out a payment plan. You may also be able to lower your costs if you qualify for a federal or state medical program. Check out this chart to see if you might qualify for medicaid.
The Pill: One of the most popular and well known methods of contraception, the birth control pill works by releasing hormones that prevent a woman from ovulating. Without ovulation, the ovaries don't release an egg, which prevents sperm from being able to meet with an egg, which prevents pregnancy from occurring. The pill is one of the most effective forms of contraception with fewer than 1 in 100 women becoming pregnant over year, as long as it is taken as directed. When not taken as directed, about 9 in 100 women will become pregnant over a year of using the birth control pill.
Pros: Reduced menstrual cramps, lighter periods, enables more spontaneous intercourse, offers some protection against Pelvic Inflammatory Disease which can cause infertility if not treated. Some types of birth control pills may have other benefits such as protecting against acne, bone thinning, breast and ovarian cysts, and ovarian cancers.
Cons: Some women experience spotting, breast tenderness, nausea, decrease in sexual desire and mood swings, especially in the first three months of use, no protection against STD transmission, increases the risk of stroke and blood clotting in some women.
How to get it: In order to get birth control pills, you first need a prescription, and may have to have a medical exam. Depending on your provider, this exam can cost from $35-$250. However, some charity or state-run clinics may be able to give you the exam at a reduced cost, or at no cost depending on your income level, age, and occupation. The pills themselves typically cost from $15-$50 per month, with most prescriptions being for a three months' supply. Though these costs are fairly fixed, there are a few things you can do to lower the costs of your birth control pills.
First, ask your health care provider about getting a generic prescription instead of a name-brand pill. While not suitable for everyone since some women take specific kinds of birth control pills to treat symptoms for disorders like endometriosis, generics usually contain the same active ingredients and may be a good alternative for some women. Second, some reproductive health clinics and private health care providers are able to dispense free samples of birth control after they've approved you for a prescription. Asking about this option costs nothing, and can help stretch your contraceptive budget for the year a bit further. Some providers may place restrictions on how many free sample packs they will distribute to you, while others may be able to continue providing you with free samples as long as they have some in the supply closet. Finally, if you're dissatisfied with the cost of your current prescription but aren't able to procure free samples or a cheaper, generic prescription, find out what reproductive health and family planning services clinics are in your area and ask them if they can help you get your birth control pills at a lower cost. Some clinics are licensed to dispense birth control pills and may be able to help you get a three month supply for as little as $20 total.
Emergency Contraception Pill: If your contraception fails, or if you have sex without using a contraceptive device, you may still be able to prevent pregnancy from occurring with emergency contraception. The Morning-After pill or emergency contraception pill works by delivering a dose of hormones that prevent a woman from ovulating. Though the emergency contraception pill can be taken up to 120 hours after unprotected intercourse, it is more effective the sooner it is started. The Morning-After pill cannot terminate a pregnancy once it has occurred; it is not "the abortion pill". Pros: Safe, available from pharmacies without a prescription for those 18 and over, can reduce the risk of unwanted pregnancy by 89% if started within 72 hours of unprotected intercourse
Cons: Possible side-effects include: dizziness, breast tenderness, irregular bleeding, abdominal cramps, nausea.
How to get it: Emergency contraception pills are available over the counter from pharmacies for adults over 17 and is also available from Planned Parenthood. If you're under 17 you will need a prescription from a health center or private health care provider. Costs vary from $10-$70 for the emergency contraception pill, depending on where you get it, and which kind you use. Sometimes the makers of the emergency contraception pills offer manufacturer coupons. Right now, Plan B One Step is offering a $5 off manufacturer's coupon available to print from their website.
In addition to the methods listed here, there are some other contraceptive methods such as the patch, the ring and the shot, that we haven't covered. Also, be aware that the descriptions of the methods and the assessments of their pros and cons as listed here aren't necessarily comprehensive. To find out what contraception method would best suit your needs talk to a health care provider, or find out more about each method at Planned Parenthood's website. Hopefully this list will help you lower your contraception costs and take control of your fertility and sexual well being!
If you have any advice on how to find affordable reproductive health care, or questions about looking after you're health when you're on a budget, we'd love to hear from you! Email us: [email protected] or join us on Twitter: @cheerfulcheep.
