Family planning made easy: Birth control options in Singapore

birth control options in Singapore HERO
If a new baby isn't on your life plan any time soon (or ever!) then you're going to need know about your birth control options here in Singapore...

We love our kids, but right now we’re not planning on losing sight of our toes again, spending an entire summer with our heads in the loo or lamenting the woes of agonising heartburn. For now, we’re done. But what are the contraception choices available – both short and long term – and which birth control option will suit your lifestyle and future baby plans best? We’ve got the lowdown on the pros and cons of family planning picks in Singapore…

COMBINED ORAL CONTRACEPTIVE PILL
Birth control pills are a form of medication taken on a daily basis for 21 day cycles to prevent pregnancy. The pills release hormones (usually estrogen and progestogen) so that the cervix becomes less penetrable, the womb lining thins and ovulation may cease. No eggs = no bubba.
The pros: Aside from preventing an unwanted bun in the oven, the combination pill can also reduce period pains, regularise your cycle, reduce the risk of cysts in your breasts and ovaries, help prevent bone thinning, reduce PMS symptoms, be used to treat outbreaks of acne, and may even help prevent endometrial and ovarian cancer.
The cons: You have to take the pill every single day for it to be effective. For forgetful types, this is not ideal. Some women experience a decreased sex drive (although this can also be put down to ‘being a parent’ anyway), spot bleeding between periods and occasionally nausea. If you have an upset tum or throw up during your cycle, please do be aware that this can cause the pill to become ineffective…
Effectiveness: When used perfectly, it provides 99% protection. Studies have found that as we are not all perfect, the efficacy is more likely to be around 91% when taking into account ‘Swiss cheese memory moments’ and unforeseen stomach upsets.

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Both the combined pill and mini pill make for no-fuss birth control: just remember to take them! Photography: Simone van der Koelen via Unsplash

PROGESTOGEN ONLY PILL (MINI PILL)
Similar to the combined pill in that it has to be taken orally, the mini pill only contains the hormone progestogen. There a couple of other important differences though: the mini pill is taken WITHOUT a seven day break, and you absolutely MUST take it within a three-hour window at the same time every single day. It weaves its magic by thickening the mucus in the cervix (ewww) which stops those swimmers getting to an egg, and also stops ovulation.
The pros: Great for women who can’t take estrogen contraception pills (usually because of high blood pressure, carrying excess weight or a history of blood clots), and it’s also easy to stop whenever you decide on more babies. It usually halts periods altogether while you’re taking it, which is a bit of an extra bonus.
The cons: If you don’t take it at the same time every day, you will not be protected against pregnancy. It can also make periods irregular and heavy and side effects can include acne and sore boobs. It will become less effective if you suffer from diarrhea or vomiting at any time.
Effectiveness: Just like the combined pill, the mini pill is over 99% effective if taken correctly. Excellent news.

CONDOM
A condom is a thin latex sheath designed to fit over a man’s nether regions, and acts as a barrier between the sperm and the egg, resulting in no unplanned baby.
The pros: Condoms are the ONLY contraception that will also protect against sexually transmitted diseases. They are easy to pick up (throw them in with your weekly supermarket shop) and there are no unwanted chemicals messing with your hormones.
The cons: Let’s face it, they’re not very ‘sexy’ and can, uh hum, ruin ‘the moment’ (especially if you’ve left them in your unpacked supermarket bags). They can also break (disaster) and possibly even tear without you knowing. Horror. Effectiveness : When used correctly, condoms are 98% effective in preventing unplanned pregnancies. Do your research though – condoms that contain spermicide are the most reliable as they have chemicals that literally stop those sperm bad boys in their tracks.

CONTRACEPTIVE PATCH
A small, adhesive patch – a bit like a nicotine patch – the contraceptive patch sticks on your skin and delivers hormones straight into your bloodstream. It contains pretty much the same makeup as the combined pill, but without the need to take a pill every day. Each patch is left on for one week, and after three patches you have a seven day break to allow for your period. Easy peasy.
The pros: No having to remember to take a pill and no having to worry about where you left the condoms. Sex can be spontaneous (well as spontaneous as it can be with a tribe of younglings lurking outside your bedroom door). And because this one is delivered straight to your bloodstream, even if you are ill with diarrhea or vomiting (hangover included), it still works. More pros? It may offer some protection against ovarian, womb and colon cancer, it can help with heavy periods and it’s easy to stop – just whip it off.
The cons: All sounds like a great choice so far… However (why is there always a ‘however’?), it can increase blood pressure, cause headaches and maybe mess with your mood swings in the early months. It can also cause some spot bleeding and you may get some irritation on your skin where you wear the patch.
Effectiveness: 99% when used properly.

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Babies are cute and all that, but that doesn’t mean we want dozens of them! Photography: Jake Peterson via Unsplash

CONTRACEPTIVE INJECTION
Even if you’re a tad squeamish when it comes to injections, the contraceptive injection is only administered four time per year, so no drama. It’s another take on the combined pill, and works in much the same way by thickening that mucus in your cervix and preventing ovulation. It also thins the womb lining for extra measure. Jabs will be given in your bottom by a trained doctor or nurse. There are various different types of injections available in Singapore, so do speak to your doctor to discuss which one is best suited to you.
The pros: It’s long-lasting so you won’t have to worry about your contraception for months at a time, and it won’t be affected by other medication or stomach flu. There is also evidence that it helps provide protection against cancer of the womb and against Pelvic Inflammatory Disease.
The cons: You can’t take it back! Once you’ve had the jab you will have the protection against pregnancy, and the possible side effects, for at least three months. Reported side effects include weight gain, headaches, irregular periods and mood swings. It can also take up to one year after stopping the injections for your fertility to return to normal.
Effectiveness: Another 99% effective method of birth control, if administered correctly.

IMPLANT
A small, flexible tube, roughly the size of a bobby pin, that’s inserted (by a trained doctor or nurse, don’t panic!) just under your skin at the top of your arm. This is a long term option as it lasts for a whopping three years, and works by slowly releasing progestogen into your bod. You know the drill with these hormone-based contraceptives by now: practically impenetrable mucus in your cervix, etc, etc.
The pros: It’s the perfect pick if you absolutely KNOW that you don’t want a baby in the next three years, you don’t have to remember to take pills or change patches, and it can eventually stop your periods altogether until it’s removed. You can have it taken out whenever you want (by a doctor! Never attempt to try yourself!), and fertility will go back to normal once it’s gone.
The cons: Around 50% of women report that it causes irregular, heavy and longer periods initially.
Effectiveness: Another one weighing in at the 99% effectiveness mark.

CERVICAL CAP
An oh-so-sexy circular dome made of thin, silicone, the cervical cap is the female version of the condom (kinda), and is inserted into the vagina before sex. It covers the cervix, leaving the sperm shut out and unable to enter the womb. It needs to be left in place for around six hours after sex, and must also be used with spermicide. Your doctor will initially fit the cap to ensure the right size, and show you how to use it. Probably best to get a babysitter for that appointment…
The pros: It’s reusable (give it a wash, but probably not a good idea to hang out it out on the washing line), it’s eco-friendly (we’re all about the environment after all) and there are no side-effects (aside from not looking very sexy when inserting it).
The cons: It might take you a few goes to get the technique of inserting it correctly. Also, if you gain or lose more than around 3.2kg, you may need to have to have a new cap fitted as the old one won’t fit your cervix correctly (who’d a thunk it? Weight gain messing with cervix size!).
Effectiveness: When used correctly (and it can take some practice) it is around 92-96% effective.

INTRAUTERINE DEVICE (IUD)
More commonly known as a ‘coil’, once fitted (by a professional), it can protect against pregnancy for up to five years The nifty little device is usually made from copper and plastic, and works by changing the fluids in your womb and fallopian tubes, making them a hostile environment to sperm. Be gone, sperm. It’s inserted into your uterus, while the strings will be left hanging through your cervix. There are a few variants of the IUD available in Singapore, so speak with your doctor when deciding which one to go for.
The pros: Normal fertility levels will return as soon as you take it out, it often makes periods shorter and lighter, and it’s a great option if you have ruled out hormone-based contraceptives.
The cons: On the flip side of the women who end up with light periods, a possible side effect is longer, heavier, more painful periods (the number one reason that women end up having it removed). It can also be quite uncomfortable being inserted and removed.
Effectiveness: Three to five years with 98% protection! Woohoo!

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If you’re 100% sure you NEVER want to be pregnant again, then tubal ligation and vasectomy are permanent birth control options. Photography: Ryan Franco via Unsplash

TUBAL LIGATION
More commonly known as ‘getting your tubes tied’, tubal ligation is an option to consider if you want to DEFINITELY close the doors forever on the baby making factory. This is a permanent, irreversible form of birth control where a procedure will be carried out in hospital and a small cut will be made in your abdomen, so that your fallopian tubes will be cut or clamped. This procedure is sometimes offered when you are giving birth via a caesarean, but speak to your gynae about the pros and cons way in advance.
The pros: You’ll never have to worry about contraception again! This is a permanent solution, but it won’t affect your hormones (you will still have periods and you will still have a sex drive – kids permitting).
The cons: Whereas the ‘forever’ solution is a pro in most cases, life has a funny way of throwing some curveballs along the way, so you need to be 100% sure that you will not change your mind later down the line (says the woman who was 100% done at two, and then decided at 37 years old to have number three after all). There’s also the post-surgery recovery to consider (around a week, so not easy if you have toddlers leaping all over you), and the fact that if you DO get pregnant after this procedure (rare but it can happen), there is a high chance of ectopic pregnancy occurring.
Effectiveness: More than 99% effective three months post procedure.

VASECTOMY
A birth control option for the man folk to own: this surgical procedure involves the tubes from the testes to the penis being cut so that sperm is kept away from semen. The procedure takes around 40 minutes and will be carried out under local or general anesthetic.
The pros: It’s a minor procedure (especially compared to tubal ligation) and recovery time is quick. It provides a permanent solution to contraceptive conundrums (although it is sometimes possible to reverse).
The cons: Although a reversal attempt can be made, it is not always successful, so there’s no changing your mind later in life if you want to grow your family. Some men also report painful testes and/or swelling some months after the procedure, and in rare cases depression can also be an issue.
Effectiveness: 99% effective three months post procedure.

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