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July 21, 2011

Your Best Birth Control

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Diaphragm and Cervical Cap
What it is: The diaphragm is a flexible latex cup that sits over the cervix. The silicone FemCap is similar but smaller. The diaphragm comes in many sizes (the cap, only three), so your chances of a good fit are better.
How it works: Coat it with spermicide, fold it in half, and push inside the vagina until it covers the cervix. The spermicide immobilizes his swimmers, and the cap physically blocks the opening to the uterus. You must leave it in for at least six hours following sex-and remove it within 24 hours (48 hours for the cap) to reduce the risk of a bladder infection.
Caveats: Pregnancy and delivery change the shape and size of the cervix, so failure rates go up drastically after kids, especially with the cap. Both are a no-go if you're allergic or sensitive to spermicides. If you're prone to bladder infections, the cap is a better choice.
Failure rate: Diaphragms: 6 percent with perfect use; 16 percent with typical use.
Caps: 9 percent with perfect use; 16 percent with typical use. If you've had a child, 26 percent with perfect use; 32 percent with typical use.
Cost: $15 to $75, plus the cost of a doctor's exam.
How soon you can get pregnant: Immediately after stopping.

What it is: Permanent birth control, usually either tubal ligation ("having your tubes tied") or the Essure procedure, which involves placing tiny coils into the fallopian tubes.
How it works: Tubals are done laparoscopically under local or general anesthesia. Fallopian tubes are closed off so that eggs can't reach the uterus. With Es-sure, doctors only numb the cervix be-fore inserting soft metallic coils into the tubes.
Caveats: Complications of anesthesia or bleeding problems are rare but possible with tubals. Essure is considered safer, though complications can in-clude improper placement or expulsion of the coils, or perforation of the uterus.
Failure rate: About 1 percent for tubals; less than 1 percent for Essure. Failure can result in ectopic pregnancy, which requires emergency surgery.
Cost: $1200 to $3000 for Essure; $2500 to $4000 for tubal ligation.
How soon you can get pregnant: You can't; that's the point.

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