beachfamilyWhether it is birth control or having a baby, we have you covered. Deciding to prevent – or encourage – pregnancy is a big decision. Fortunately, it’s one we can help you make at Kokopelli OB/GYN. We offer a variety of contraceptives to meet almost any need – from the pill to the patch to IUD’s to more permanent measures. Or, if you’re interested in starting a family, the ideas and resources we offer are, well, very fertile.



Oral Contraceptives

Oral Contraceptives

Your birth control pills will prevent pregnancy and provide many health benefits. This information will help you understand their use.

Health Benefits: The birth control pill will reduce the amount of pain and cramping that you experience with a period. You will bleed less and sometimes not bleed at all during your period.

Women also experience fewer problems with their ovaries and enjoy being able to predict their periods weeks in advance. Pills will not cause weight gain. Acne will improve or resolve.

And, of course, the pill can prevent pregnancy now, but not interfere with your ability to get pregnant in the future.

Starting the Pill: Start the pill on the first day of your period. Use back-up birth control for 2 weeks. New pill users can be nauseated on their first pack. Take the pill with food.

Taking the Pill: Because the pill contains such a low dose of hormones, you must take it every day at about the same time for it to be effective in preventing pregnancy and irregular bleeding. Irregular bleeding is common in the first 3 packs and will resolve with continued daily use.

You may take the pill with other medicines such as cold remedies, vitamins, calcium. The use of antibiotics reduces the effectiveness of your pill in preventing pregnancy. Use condoms while on antibiotics.

Missing a Pill: If you miss one pill, then take one as soon as you remember and then take one pill at the regular time. If you miss two pills, then take two when you remember and one pill at the regular time. You must use back-up birth control (condoms) for one week to prevent pregnancy.  If you miss the first pill of the pack, you must start the pack as soon as possible and then use back-up birth control for 2 weeks!!. This is a common reason for unplanned pregnancy. Always keep a pack of your pills on hand and monitor your refill number at the pharmacy. You must return to the office yearly to get a refill.

Call Dr. Stevens for:

  • Irregular bleeding after 3 months
  • Worsening acne or headaches
  • Chest, leg or calf pain
  • Unusual abdominal pain

More Information: The pill will not work if you do not take it daily. The drug is gone 24 hours after your last dose. The pill is safe and beneficial for long term use. You do not have to take a “break” from the pill.

Health Benefits: The birth control pill often reduces the amount of pain and cramping that you experience with a period. You will bleed less and sometimes not bleed at all during. The pill will not cause birth defects or cancer. The pill will not protect you against sexually transmitted diseases.

Some women have a very light or absent period on the pill. This is okay. The pill is working as long as you have not missed a dose.

Smoking increases the risk of heart attack and stroke in pill users. You should stop smoking to protect your health or use another method of birth control.

Vaginal Contraceptives

Vaginal Contraceptives

NuvaRing – click here for more information

Birth Control Patch

Birth Control Patch

How Does It Work?

There are many drugs which can be delivered thru the skin and achieve the same or better benefit to the body. The birth control patch is one of these products.

The patch, which contains the active ingredients in a birth control pill (estrogen and progestin), delivers continuous levels of hormones to your system through your skin. The patch works exactly like a birth control pill to prevent pregnancy: thickens mucus in the genital tract, prevents the formation of eggs and prevents ovulation.

In some women who find taking the birth control pill daily difficult, the patch can offer more effective pregnancy prevention and menstrual control. The patch can be 97-99% effective in preventing pregnancy.

Where do I put it?

You have 4 choices: the lower abdomen, buttocks, upper, outer arm or back of the shoulder. The patch should never be applied to the chest or breasts

To ensure the effectiveness of ORTHO EVRA®, do not place the Patch on areas of your skin where makeup, lotions, creams, powders or other products are or will be applied. In addition, do not place ORTHO EVRA® on skin that is red, irritated or cut.

Women change the location of the patch weekly to avoid skin irritation and enable you to remove the adhesive from the old site.

When removing your used patch, simply lift one corner and quickly peel it back. If a small ring of adhesive is left on your skin, remove it by rubbing a small amount of baby oil on the area.

The Patch adheres well to the skin, allowing you to perform your daily activities such as bathing, showering, swimming and exercising without interruption. If the sticky surface of the Patch becomes wet, discard it and apply a new patch.

Once you have prepared the skin and applied the patch you will not be able to remove it and place it in a new location. The adhesive is unlikely to adhere adequately. You will have to use another patch. Patches cannot be altered or cut. Modifying the patch will decrease the effectiveness in preventing pregnancy and controlling your periods.

When do I start the patch?

Apply your first patch on the first day of your period. The patch will be effective in two weeks. Apply a patch every 7 days for 3 weeks. Remove the patch for one week while you have your period and then refill your prescription and re-apply the patch for the next cycle.

You can delay your periods or have fewer periods by using your patch for more than 3 weeks. Ask your health care provider about this option.

Helpful Reminders:

You will need to change the patch every 7 days to maintain effective period control and pregnancy prevention. Although you using the patch means that you will not have to take a daily birth control pill, you must still remember to change the patch weekly. Try these ideas to remind you:

  • Set the alarm on your cell phone for a weekly reminder
  • Make it part of your routine to change your patch before your first class on Monday morning
  • Add a weekly reminder to the calendar on your work and/or personal e-mail
  • Keep a weekly “to do” list, and add a Patch reminder to that agenda
  • Put a yellow sticky note on the bathroom mirror: “TUESDAY!” Only you will understand the meaning.
  • Keep a calendar on your refrigerator and circle all “Patch Change Days” for the year

In clinical trials, less than 2% of birth control patches had to be replaced because of complete detachment, and less than 3% had to be replaced because of partial detachment. Proper preparation of the skin will ensure that your patch will stick for a week thru exercise, swimming and bathing. Still, you should ask your provider for an extra prescription that allows you to obtain just one patch at the pharmacy in case you need to replace one.

See this web site for further information:

Progesterone-only Birth Control

Progesterone-only Birth Control

Depo  Provera

Depo provera (Depo) is an injectable form of birth control that is 99.7% effective in preventing pregnancy.

Depo works to prevent pregnancy by preventing ovulation in some women. The drug also thickens mucus in the genital tract obstructing the forward movement of sperm and reduces the ability of the uterine lining to be receptive to pregnancy.

The first dose of Depo must be injected during the first five days of the menstrual cycle.

Subsequent doses of Depo will be administered every 12 weeks or 84 days. Doses of Depo can be given earlier than 12 weeks, but no later than 13 weeks or 91 days without a lapse in birth control.

If a subsequent Depo dose is not obtained by 91 days, then it will not be administered unless you are on your menses or have abstained from intercourse for two weeks and have a negative pregnancy test. If you are late for your injection then your new injection will not be effective birth control for up to two weeks. Remember: emergency birth control is available over-the-counter at your pharmacy and is safe and effective.

Recommended injection site is the buttocks. Although the site will be sore , resist massaging it. This will disperse the medication too fast.

Common side effects of Depo include: irregular bleeding, breast tenderness, bloating, weight gain (5 pounds the first year, 0 – 3 pounds every year after), acne, headache, worsening depressive symptoms.

If irregular bleeding bothers you, you may obtain a Depo injection sooner than 12 weeks. Ask your doctor about this option.

After the fourth injection, most women do not menstruate anymore. This is not permanent but after discontinuing Depo regular menstruation may not resume for 3 – 12 months.

Depo effectively prevents pregnancy two weeks after the first injection. Birth control is continuous provided you obtain subsequent injections of Depo when you are due.

Depo does not protect you from sexually transmitted infections.

Because Depo decreases your estrogen levels, the drug can also reduce your bone strength. We recommend that you take a daily vitamin and calcium supplement. Your calcium goal is 1200 mg daily.

If you are over 40 Depo may lead to irreversible bone loss. Ask your health care provider about other options for birth control that have no impact on your bone health.


Nexplanon – Click here for more information

Implanon – Click here for more information

Oral Progesterone

Progesterone-only birth control pills (POPs), also called the “mini pill”, contain only half of the ingredients found in a regular birth control pill.

Regular birth control pills contain both estrogen and progesterone. Estrogen-containing pills can increase the risk of clotting in women with high blood pressure, diabetes, migraine, clotting disorders and smokers. These women are encouraged to use products without estrogen. Estrogen can also decrease the production of milk in breastfeeding women. Women who want to continue to breast feed should avoid products containing estrogen.

A regular birth control pill is 93-99% effective in the first year of use and 97-99% in subsequent years of use. A progesterone-only birth control pill is as effective: 97-99%. With all birth control pills, effective pregnancy prevention relies upon the regular, daily use of the product.

The brand name mini pill is called Micronor. Many generics are available. When you open the pack of Micronor you will immediately notice that every pill is the same color. This is because every pill has medicine in it. There is no break for your period. Therefore, the most common complaint of women using Micronor is irregular periods. Not heavy bleeding, but possibly unpredictable bleeding. Most women experience lighter periods over months of use and do develop some type of pattern to their periods. Some women will experience no period after many months of taking progesterone-only birth control pills. This is not harmful. Periods will return when the pill is discontinued.

Intrauterine Devices

Intrauterine Devices


Mirena is an intrauterine contraceptive that continuously delivers a small amount of hormone called progestin directly to the uterus. Made of soft, flexible plastic, it is put in place by your healthcare provider during an office visit. Mirena does the following: 

  • Offers birth control that is 99.7% effective
  • Prevents pregnancy for up to 5 years
  • Reduces menstrual flow
  • Returns you to fertility within one month of removal
  • Keeps hormone levels steadier and lower than the pill

Get more information online:


Paragard is an intrauterine contraceptive that is hormone free. Made of copper, it is put in place by your healthcare provider during an office visit. Paragard does the following: 

  • Offers birth control that is 99% effective
  • Prevents pregnancy for up to 10 years
  • Doesn’t interfere with your regular menstrual cycle
  • Returns you to fertility within one month of removal
  • Is hormone free

 Get more information online:

Permanent Birth Control

Permanent Birth Control

At some point in life you may decide that you would not like to be pregnant again. Some women will choose permanent sterilization to prevent pregnancy for the remainder of their reproductive years.

Your options for sterilization or permanent birth control are tubal ligation (tying your tubes) or Essure. A tubal ligation is performed in an out-patient surgical center and requires 2-5 days off of work for recovery. An Essure procedure is performed in the office under sedation using a scope or camera in the uterus to place plugs in the fallopian tubes. Most women recover from this procedure rapidly and return to work in 2 days.

Before making a decision to permanently remove the possibility of future pregnancy, your physician will want to discuss your decision to choose permanent birth control. Your doctor wants to be certain that you have examined your choice from all angles and considered all other reversible methods of birth control. You should understand that tubal ligation or Essure procedures are non-reversible or permanent. Advantages of permanent birth control are:

  • No future costs for birth control
  • It is permanent.
  • Eliminate daily pill use. Eliminate risks of pill use for women over 35, smokers, women with high blood pressure and diabetes.
  • No impact on sexual functioning. Perhaps improved function without the worry of pregnancy.
  • No change in menstrual function.
  • Possible decreased risk of ovarian cancer.
  • Can still take birth control pills or use IUDs if desired.

Modern sterilization procedures for women, although not 100% effective, are generally much more effective that typical birth control pill, depo-provera or condom use. Modern IUD’s are as effective as tubal ligation and may be an alternative method for you, offering 5-10 years of birth control without undergoing a surgical procedure.

An alternative to female sterilization is male sterilization, called vasectomy. A vasectomy is performed by a urologist and generally is felt to be safer, with less potential for complication than tubal ligation for women. A vasectomy is more effective than tubal ligation to prevent pregnancy providing the man submits two semen samples that are deemed to be absent of motile sperm. We can help with referral to urology if you need more information about this option.


Essure is an effective permanent birth control. Essure is a surgery-free and hormone-free permanent birth control procedure that places soft, flexible inserts in your fallopian tubes. These inserts work with your body to form a natural barrier that permanently prevents pregnancy. Essure can be done as an in-office procedure to reduce time and costs associated with hospital procedures.

Click on this link to learn more about Essure:

Tubal Ligation

Tubal ligation is a permanent sterilization procedure performed under general anesthesia at an out-patient surgical center.

Because reversible contraceptive methods such as birth control pills are less than perfect for pregnancy prevention, many women choose tubal ligation. In 2005 about 27% of women who had completed child bearing were relying upon tubal ligation for birth control. 9% of women relied upon their partner’s vasectomy for pregnancy prevention.

Surgical tubal ligation is 99.6 – 99.8% effective. By comparison, male vasectomy is 99.9% effective.



Experiencing infertility is difficult for any couple trying to conceive. Dr. Stevens and his staff will work with you to develop a fertility treatment plan designed to fit your lifestyle and unique needs.

Click here for more information. (American College of Obstetricians and Gynecologists)

Natural Family Planning

Natural Family Planning

Click here for more information. (American College of Obstetricians and Gynecologists)

Emergency Birth Control

Emergency Birth Control

Click here for more information. (American College of Obstetricians and Gynecologists)