Which birth control is the best at preventing pregnancy?

It’s true what you learned in health class: The only 100% guaranteed way to not get pregnant is through abstinence. However, if that doesn’t work for your lifestyle, there are plenty of very, very good birth control options available today that are highly effective at preventing pregnancy.

From oral contraceptives to IUDs, women have options for safe sex—thank you, modern medicine! Each type of contraception has different levels of effectiveness depending on “perfect use” (for example, never, ever missing a pill or having a condom break) or “typical use” (what most people do). 

Your chance of getting pregnant varies widely depending on which one you use. Other factors like weight, medication, antibiotics, and more can affect a birth control’s effectiveness, so you should always check with your doctor first.

Related: How does birth control affect your fertility?

Wanting to have a baby on your own terms, or not at all, is normal. In fact, the number of women who want to use a family planning method has increased from 900 million in 2000 to 1.1 billion in 2020, according to the World Health Organization (WHO). 

Now is the perfect time to figure out which type of birth control is the most effective, easy to use, and the right choice for you.

Read about your chances of getting pregnant on each type of birth control below, so you can make an informed decision about your future. If you have further questions about which type is right for you, speak with your OB-GYN. 

Chances of getting pregnant on birth control pills

Birth control pills contain estrogen and progestin to stop ovulation, thicken cervical mucus, and thin the lining of the uterus to prevent pregnancy. They have a 91% effective rate with typical use.

That means there is a 9% chance of pregnancy, or 9 out of 100 women will get pregnant in a year with typical use of this method. With perfect use (such as never forgetting a pill and taking it at the same time each day), the number drops down to fewer than 1 woman out of 100 will become pregnant.

Chances of getting pregnant on the mini pill

Often prescribed when you’re breastfeeding, the mini pill contains progestin only, which is a synthetic form of the hormone progesterone. Nine in 100 women will get pregnant on the mini pill with typical use, but fewer than 1 in 100 women will get pregnant with perfect use (meaning taking a pill at the same time every day and never missing a day) within a year.

Chances of getting pregnant with birth control injections

The birth control injection Depo-Provera (AKA, the Depo shot) contains progestin to prevent pregnancy. This method requires just one injection every 13 weeks—making it much easier to keep track of than a daily pill.

However, a doctor or nurse must administer the shot. With typical use, 6 in 100 women will get pregnant within a year, and that number drops to fewer than 1 in 100 women with perfect use—i.e., never having a delayed injection.

Chances of getting pregnant on the patch

A contraceptive skin patch is 91% effective with typical use, meaning 9 out of 100 women will get pregnant within a year. Fewer than 1 out of 100 women will get pregnant on the patch with perfect use, which involves wearing it on the buttocks, chest, upper back, upper arm, or abdomen for a week at a time for three weeks in a row.

The patch must be replaced on the same day of the week without skipping, but it can be done at home. It is less effective in women who weigh more than 198 pounds.

Related: These are your actual odds of getting pregnant each month

Chances of getting pregnant on the vaginal birth control ring

Known as the NuvaRing or Annovera, the vaginal birth control ring is 99% effective when used perfectly and 91% effective with typical use, meaning about 9 out of 100 women will get pregnant within a year.

The ring is a flexible piece of plastic prescribed by a doctor that you insert at home in the upper vagina. It releases estrogen and progestin to stop ovulation, and it must be replaced every 21 days.

Chances of getting pregnant using the condoms or barrier method

The barrier method of birth control involves using condoms, the contraceptive gel Phexxi, spermicide, sponges, diaphragms, and/or cervical caps to prevent sperm from reaching the egg. Some barriers, like condoms, also protect against sexually transmitted infections (STIs).

Diaphragms and cervical caps must be prescribed by a doctor, but condoms, spermicide, and sponges can be purchased over the counter. Because the barriers could break or become dislodged during sex, about 18 to 28 out of 100 women will become pregnant in a year with typical use.

With condoms specifically, 15 out of 100 women will get pregnant in a year with typical use and only 2 out of 100 women will get pregnant with perfect use. You can also lower your pregnancy risk by pairing condoms with other methods, like spermicide, the pill, and/or the pull-out method.

Related: Could a real, actual male birth control pill be in our future?

Chances of getting pregnant using a hormonal IUD

Intrauterine devices (IUDs) are known as long-acting reversible contraception (LARC), which are highly effective in preventing pregnancy and perfect for those who don’t want to keep track of a daily pill or a weekly patch.

Hormonal IUDs include Mirena, Kyleena, Liletta, and Skyla, and work for 3 to 7 years. These work by releasing progestin, which thickens the cervical mucus and stops ovulation. They are 99% effective, with fewer than 1 out of 100 women getting pregnant within a year, and must be inserted by a healthcare provider.

Chances of getting pregnant using a copper IUD

The copper IUD called Paragard is wrapped in copper to keep sperm away from the egg without using hormones. It lasts for 10 years and can also be used as emergency contraception if inserted within 5 days of having unprotected sex.

It is one of the most highly effective forms of birth control and emergency contraceptive, as it is 99% effective with fewer than 1 out of 100 women getting pregnant within a year. It must be inserted by a healthcare provider.

Chances of getting pregnant using a birth control implant

The birth control implant called Nexplanon is a small rod inserted in your arm by a doctor. Once it’s in, you don’t have to think about it again for five years. Like other LARC methods, it is more than 99% effective, meaning fewer than 1 out of 100 women will get pregnant within a year while using it.

Chances of getting pregnant using the pull-out method

The pull-out or withdrawal method involves removing the penis from the vagina area before ejaculation to prevent sperm from reaching the egg. When done perfectly (as in, before any seminal fluid is released), about 4 out of 100 women will get pregnant within a year.

With typical use, the number jumps to 22 out of 100 women because it can be difficult to time it right. Combine this method with other forms of birth control to maximize effectiveness.

Related: Which birth control method should I use after baby?

Chances of getting pregnant using the fertility awareness method

There are only a certain number of days you can get pregnant in each menstrual cycle, and the fertility awareness method aims to help you track those days so you can avoid sex (or use the barrier method) during the fertile period.

You can get pregnant from five days before ovulation to one day after ovulation, so the fertility awareness method requires daily cycle tracking to figure out those seven fertile days. This is done with an app, by checking basal body temperature (BBT), by using ovulation strips, and/or by checking changes in cervical mucus.

When used perfectly, fewer than 1 to 5 women out of 100 will become pregnant in the first year. With typical use, 12 to 24 women out of 100 will become pregnant.

Related: A new birth control app has been approved by the FDA

Chances of getting pregnant while breastfeeding

After having a baby, ovulation can be delayed if you are exclusively breastfeeding at least every four hours during the day and at least every six hours at night for up to six months postpartum.

Breastfeeding acts as a natural contraceptive; however, because ovulation occurs about two weeks before your period begins, you can get pregnant without ever having a postpartum period.

Breastfeeding as birth control is known as the lactational amenorrhea method (LAM), which requires frequent and exclusive breastfeeding to work. It is less effective when exclusively pumping. In perfect use, this is 98% effective, with 2 out of 100 women using LAM getting pregnant each year.

Chances of getting pregnant with a morning after pill

If your birth control method fails or you have unprotected sex, you can take emergency contraception known as a morning after pill. Without using birth control, women have a 5% to 25% chance of getting pregnant each month depending on their age.

The morning after pill (like Plan B) can reduce your chance of getting pregnant that month by 75% to 89% if taken within three days after unprotected sex, but they start to be less effective if you weigh 165 pounds or more. If that’s the case, having a copper IUD inserted or getting a prescription for Ella is a good option for emergency contraception. Keep in mind also that the longer you wait, the less effective Plan B becomes.

A version of this story was originally published on May 27, 2022. It has been updated.