Birth Control Methods Chart

This suite of birth control method resources was designed to support providers when having client-centered contraceptive counseling conversations. Providers can refer to these resources, helping clients gain a deeper understanding of their options and to identify their priorities and preferences for a birth control method.

Birth Control Methods Chart

The birth control methods chart, revised in 2024, was designed for providers to use in conversation with clients and takes client autonomy into account by presenting methods that clients can start and stop on their own and those that require provider involvement (prescription or procedure). This framework offers providers multiple ways to center a client’s specific preferences. The chart highlights method characteristics, including possible side effects, and use and frequency, so clients can make informed decisions, based on their own preferences. Within each table, the methods are listed in order of pregnancy risk, and side effects are alphabetized within each method.

For more information on the chart, click on the drop-downs below.

Providers can also use the interactive Birth Control Methods Counseling Tool when having real-time conversations with clients about what’s most important to them in a birth control method and which options feel right. This tool provides new and additional information about each of the birth control methods, beyond what is included in the Birth Control Methods Chart.

Actual Size and Body Placement Charts

Recognizing that access to birth control and anatomy models can be challenging for providers, two additional charts are also included. They show the actual size of each birth control method and its placement on or within the body, and are intended to be used with the birth control methods chart. Download these charts under Supplemental Materials.

Client Autonomy

The RHNTC found that the client autonomy framework maps to the top three commonly reported contraceptive values—side effects and safety, method effectiveness/reliability, and ease, duration, or frequency of use—in a systematic review of 423 original research articles from 93 countries.

To address client autonomy, the chart's contraceptive methods are grouped into five categories: 1) clients can start and stop on their own; 2) requires provider to start with a prescription (clients can stop on their own); 3) requires provider for clients to start and stop (reversible methods); 4) requires provider to perform procedure (permanent methods); and 5) emergency contraception. Methods are listed in order of effectiveness within each table. 

The most autonomous methods have fewer side effects and require more frequent use, while the least autonomous methods are the most effective and easiest to use. While tiered contraceptive effectiveness has contributed to provider bias, clients also highly value effective methods. 

Method Characteristics to Explore with Clients

The birth control methods chart gives providers multiple starting points to center a client’s preferences, including: number of pregnancies expected, use & frequency, period changes, potential side effects, and other considerations. Each category is defined below, along with additional information to address nuances within each category. 

• Number of Pregnancies Expected is the number of pregnancies that occurred during one year of constant use of a given method per 100 people (the Pearl Index). This calculation allows providers to understand how effective a contraceptive method is at preventing pregnancies with real-world use.
• Use & Frequency includes information on how to use each method and how often it should be used.
  • Within the chart, asterisks have been used to denote products that have not been approved by the FDA for extended duration, including the use of the non-hormonal copper IUD for EC. However, there is an abundance of evidence available to support extended use for these methods demonstrating their safety and efficacy.
• Period Changes include the potential impact of a contraceptive on menstruation. Unpredictable spotting (as opposed to just spotting) was added for the implant, as breakthrough bleeding is the most common complaint.
• Potential Side Effects includes the most common reactions to each method and are listed alphabetically for each method.
• Other Considerations include a wide range of additional information that providers may find useful in counseling clients.
  • Discretion: Four methods (implant, hormonal IUD, copper IUD, and shot) were highlighted for their potential to be used discreetly, but felt by partners to improve counseling for clients facing reproductive coercion.
  • Prevents STIs: Two methods (internal condoms and external condoms) protect people from STIs.
  • Requires a cooperative partner: Indicates the need to engage a sexual partner who is not the client being counseled to successfully use the contraceptive method.
  • Weight vs. body mass index (BMI): Weight is used instead of BMI to alleviate the need to calculate a client’s BMI when counseling. BMI is used once for the patch because there is currently only BMI data on efficacy for the patch.
  • Delay in fertility return: Only included for the shot due to the potentially significant delay in return to fertility. Most other methods may briefly impact return to fertility; see Interactive Counseling Tool for more information.

The RHNTC drew inspiration from Partners in Contraceptive Choice and Knowledge (PICCK) and Illinois Contraceptive Access Now (ICAN!) when developing this chart.

Additional Notes and Citations

Use of the non-hormonal copper IUD for EC has not been approved by the FDA. Cason P, Cwiak C, Edelment A, et al.[Eds.] Contraceptive Technology. 22nd edition. Burlington, MA:Jones-Bartlett Learning, 2023.