What: Approved by the FDA in 2006, this is a matchstick-size rod that is implanted by a doctor under the skin of the upper arm, where it releases a low dose of progestin (etonogestrel). It stays in place, invisible but detectable with a little prodding, for up to three years.
Failure rate*: 0.05%
Who: Women who have just given birth and know they won't remember or have time to return to the doctor for an IUD; women who have grown weary of the pill; women who would rather have something implanted in their arm than their uterus.
Why:
- It's impressively effective for three years—which is just slightly longer than the average American family waits to have another baby.
- It's safe to use after giving birth, says Carusi.
- There's nothing to remember.
Why not:
- The implantation is a minor surgery and must take place in a doctor's office.
- The idea of having a device under their skin makes some women uncomfortable.
- According to the manufacturer, it is unknown if the risk of blood clots with the implant is different than with birth control pills.
- There's not a lot of data on the effectiveness for overweight women.
- Carusi says that some women report irregular, hard-to-predict bleeding.
- A botched insertion or removal, while rare, could lead to serious problems.
- It takes time to get used to. Carusi often advises patients to give it six months to a year.
