Pre-marital sexual intercourse is more accepted than ever in the United States. A survey released in 2002 indicates that by age 20, 77 percent of Americans have had sex (whether marital or pre-marital) and, by age 44, 95 percent of Americans have had premarital sex. Attitudes toward sex outside marriage have become more lax and, in turn, one other issue has become mainstream: how to avoid unexpected pregnancy.

With so many people having sex before marriage, it’s safe to assume a vast majority of them aren’t doing so to create a family. They are often young and may have other life goals before becoming a parent (if they wish to become one at all) — so unplanned pregnancy prevention is more important to them than ever.

The vast majority of unplanned pregnancies occur because of one reason: the improper use or lack of contraceptives. There are only three ways to prevent an unplanned pregnancy, and it’s critical that anyone considering having sex understand the precautions involved before diving in.

1. Practice Abstinence.

The only sure way to avoid unwanted pregnancy is by practicing abstinence — that is, not engaging in sexual intercourse at all.

While this method may work for some, for the majority of sexually active adults, abstinence is not an option. In fact, abstinence-only education can do more harm than good. Those who are taught only to avoid sex are often not taught the methods of preventing unplanned pregnancy when they do engage in sex. Therefore, they usually are more likely to experience an unwanted pregnancy.

While abstinence can be a valid method of unplanned pregnancy prevention, it’s important that those considering having sex are also aware of the other two methods available to them.

2. Use Multiple Forms of Birth Control.

The proper use of birth control is by far the most effective way for those having sexual intercourse to avoid unwanted pregnancy. Using multiple forms of birth control is even better.

Not every form of birth control is best for everyone, so it’s important that people speak with their doctor about the best ways to prevent unplanned pregnancy in their sex life. Here are a few forms of birth control to consider:

  • Condoms: Condoms are the most popular and cheapest method of birth control. A latex sheath covers the penis to prevent unplanned pregnancies as well as sexually transmitted infections (STIs). When used properly, condoms are 98 percent effective, but with typical use, they are actually only 85 percent effective. Make sure to use condoms correctly to maximize their prevention of unplanned pregnancy and STIs.
  • Hormonal Birth Control Pills: Women can take birth control pills to prevent ovulation and pregnancy, but this method does not prevent STIs. You will need to take your daily pill at the same time every day in order for this method to be effective. When used properly, the birth control pill is 91 percent effective. A prescription is required for this contraceptive.
  • Birth Control Implant: Otherwise known as Nexplanon, the birth control implant is a small rod inserted into a woman’s arm that prevents ovulation and thickens the mucus on her cervix for up to four years to prevent pregnancy. This birth control method must be inserted by a doctor, and it is 99 percent effective.
  • IUD: An IUD (intrauterine device) is another inserted method of birth control. It’s a tiny device implanted into a woman’s uterus to block the movement of a sperm cell to an egg and prevent ovulation. There are hormonal and non-hormonal IUDs, and they can last for years. They are 99 percent effective and can even be used as a form of emergency contraception (more on that below).
  • Fertility Awareness Methods: Women and men using Fertility Awareness Methods (FAMs) track a woman’s ovulation cycle to avoid having sex when she is ovulating (or, if they wish to start a family, have sex during this time). Also known as “the rhythm method,” FAMs are only 76 to 88 percent effective because they are difficult to use and a woman’s cycle can be unpredictable. It’s recommended that couples use an additional form of birth control with this method.
  • Vasectomy or Tubal Ligation: Both of these methods are permanent forms of sterilization, often used when people are finished adding to their family or know they do not want any children. A vasectomy involves a cutting of the tubes in the scrotum that carry sperm, while a tubal ligation is a procedure that closes or blocks the fallopian tubes, preventing further ovulation. There is a very rare chance that these procedures can naturally reverse themselves, or a reversal procedure can take place, but they are otherwise 99 percent effective at preventing unplanned pregnancy.
  • Withdrawal Method: Also known as “the pull-out method,” the withdrawal method involves removing the penis from the vagina before ejaculation. This can be difficult timing to navigate, which is why the withdrawal method is only 78 percent effective. Use another form of birth control in addition to this one.

Not all of these methods will protect against STIs as well as unplanned pregnancies, which is why many medical professionals will advise the use of one or more methods. Learn about more methods of unintended pregnancy prevention here.

3. Utilize Emergency Contraception, if Needed.

The last method of unplanned pregnancy prevention is often used when people fail to use birth control or their birth control method is used improperly. As a last effort to avoid unwanted pregnancy, they utilize emergency contraception.

Emergency contraception comes in a couple of forms:

  • “Plan B” Pill: Also known as “the morning-after pill,” this emergency contraceptive pill must be taken with 120 hours (5 days) after having unprotected sex. You can either buy this pill over-the-counter in pharmacies or obtain a prescription from a nurse of doctor. These pills work best when taken as quickly as possible after unprotected sex.
  • IUD: When an IUD is inserted within 120 hours of unprotected sex, it will prevent an unwanted pregnancy by disrupting a sperm cell’s movement to an egg.

Contrary to popular belief, emergency contraception like the Plan B pill does not induce an abortion. Pregnancy does not occur right after sex, so taking emergency contraception as soon as possible after unprotected sex can prevent a pregnancy from occurring. Emergency contraception will not affect an existing pregnancy.

Which form of emergency contraception you use will depend upon several factors. Planned Parenthood provides more advice for this topic here.

Hands down, the most effective method of unintended pregnancy prevention is correctly using multiple forms of birth control every time you have sex. Women can get pregnant even during their first time having sex, and it only takes one unprotected encounter to result in an unplanned pregnancy.

If you have more questions about how to avoid unexpected pregnancy, please speak with your doctor.