Effectiveness: 84 to 91 percent for women who have not given birth; 68 to 80 percent for women who have given birth (9-12 pregnancies per 100 women each year who have not given birth; 20-24 pregnancies per 100 women each year who have previously given birth).
What is it? It's small round bowl-shaped piece of synthetic sponge, containing spermicide, with a nylon loop attached to the bottom for removal.
How does it work? The sponge is a physical and chemical barrier. It physically covers the cervix and prevents sperm from entering the uterus, and the spermicide stops sperm from moving. You moisten it with water, gently squeeze the sponge, then it insert along the back wall of the vagina with the indention toward the cervix. It can be inserted up to 24 hours before sex and can be use for multiple acts of sex. It must be left in vagina for 6 to 8 hours after intercourse. To remove, you just pull the attached loop. Do not leave it in place for more than 30 hours.
STD protection: No; you will still need to use condoms if you are concerned about STDs.
Benefits: Readily available, easy to use and easy to carry. Because it can be inserted up to 24 hours before sex, it doesn't need to interrupt foreplay. It does not affect your natural hormones and can be used during breastfeeding.
Disadvantages: It should not be used if you have any vaginal bleeding, including during your period. May irritate your vagina, particularly if you are allergic to spermicide or polyurethane. If the sponge is left in too long, it creates a higher risk of yeast infection and small risk of toxic shock syndrome (as with anything left in the vagina for 24 hours or more). Some research indicates that frequent use of spermicide may increase the risk of HIV infection by irritating the vagina. Serious complications are rare, but always talk with your health care provider about risks and benefits.
Availability: Readily available at drugstores.
Cost: $9 to $15 for pack of 3.*
Notes: It's less effective for women who've given birth. Not recommended if you have had toxic shock syndrome; recently gave birth or had a miscarriage or abortion; or are allergic to sulfa drugs, polyurethane or spermicides.
* The Affordable Care Act requires insurance companies to cover with no co-pay any FDA-approved contraceptive method prescribed by your doctor, including barrier methods, hormonal methods, implanted methods, emergency contraception, female sterilization and patient education and counseling. These estimated costs apply to women who do not have insurance coverage or who work for a "religious employer," who may be exempt from providing contraceptive coverage. For details about what your insurance covers, contact your benefits coordinator or health insurance provider.