I'd recommend the book Taking Charge of Your Fertility, the info in it got me through all of my 20's and early 30's baby free.

When birth control was needed during fertile times I loved, loved, loved my cervical cap. It can be worn for 48 hours (which means you can put it in ahead of time if you start to feel randy around ovulation), and it relies more on suction than spermicide for pregnancy prevention so you can make your own with ky or corn starch paste and a little lemon juice if you are sensitive to chemicals in commercial spermicide.

I also got an ovulation detection kit where you put your saliva on a piece of glass, and then look through the little microscope that comes with it. If it creates a little feather patterns when it dries that means you're ovulating and precautions should be taken. Only detects current ovulation though, and does not warn you if it is about to happen, so maybe a better tool for trying to make babies than to prevent them.

Also, if she is with a guy who respects her and has some degree of self control, withdrawal method, though not perfect is still 80+% effective, some say it rivals condoms when done faithfully.

No now the new IUD - non copper and very low progesterone are recommended for woman of child bearing age. They can have it taken out and fall pg the next cycle - lower dose hormones makes it safer than the OC - but it still has hormones - its said to protect the Uterus because you often had lighter periods - its not as good as nothing but its better than getting pg when you dont want to!

Coitus interruptus*

*Results not guaranteed.

The copper IUD would be a good non-hormonal (but well functioning) method of birth control. I am actually getting it put in next month, and they recommend having it put in WHILE your on your period..something about the uterine wall being softer and more flexible. They will also give you 2 pills of misoprostal to take the morning of your IUD procedure to further relax the uterine walls. The doctor I spoke with yesterday at the IUD consultation said it's fine for women who haven't given birth yet...

It's true that doctors here in the US don't like to give the IUD to a woman who hasn't given birth, but they will try it if the lady really wants to. And there are IUDs that are hormone-free.

The problem with giving the IUD is that it's harder to adapt to if you haven't given birth. For the first few months there can be cramps and pains that are worse than one's regular menstrual cramps; these and other adjustment symptoms can sometimes be excruciatingly intolerable for women who don't have the, erm, elasticity that come with a full-term pregnancy and birth.

And at $300+ before insurance, the IUD can be an expensive item to discover you can't handle. (Although in some states the public health clinics offer IUDs for a sliding scale fee.)

So she would need to look into it carefully before going the IUD route.

Some of the other suggestions here are good ones, but NOT the "early withdrawal/coitus interruptus"! It's possible for a woman to get pregnant just by rubbing genitals, with no penile insertion. She doesn't need to gamble with that.

I know the answer that is recommending withdrawal is getting downvoted, but consider that it is shown to be pretty much as effective as condoms, which to me doesn't mean that withdrawal is a good method, it just demonstrates how terrible condoms are. And I've known women who have gotten pregnant because of them. I might be one of them if I hadn't noticed one broke and took the morning after pill, which was an extremely unpleasant experience. The birth control pill is the single BEST method. The pill has some issues, but honestly, in the modern world they pale in comparison to the consequences of an unwanted pregnancy. A modern lifestyle that involves wanting to have non-reproductive heterosexual sex requires modern tools like the BCP. The IUD is very foolproof, but it's hard to get a doctor to give it to you if you haven't ever given birth before for the reasons Frugal Jen mentioned. And honestly, I found the potential side effects kind of scary.

Methods like Taking Charge of Your Fertility are primarily designed for women who are already in a long-term relationship or marriage where getting pregnant might be a little annoying, but not completely unwanted.

Now a woman who truly doesn't want to take the pill can be in relationships that don't involve intercourse, or with a man who is snipped. But few young women are going to chose to do this.

Also, here is the recent Mark's Daily Apple article on it which has some more info and the comments are pretty good.

Well, the 'paleo' solution is to get pregnant when you are fertile.

Our society is so completely artificial. If earlier generations of females had spent their 20s doing everything but having children, the species would no longer exist.

I got a copper IUD inserted about two months ago, and I really love it so far. (I am 26 and have never been pregnant). I think a lot of people are biased against the copper IUD because of the idea that it "increases cramps and bleeding," but in my experience (which, admittedly, is rather short-term) an anti-inflammatory diet will decrease menstrual cramps/PMS symptoms to the point where they're hardly noticeable. I had never been on hormonal birth control before I got the IUD placed, and my periods were VERY painful (while not eating paleo). There were entire days every month where I could barely stand because I was in so much pain. I had to load up on NSAIDS (not realizing how bad they are for you) and my mood swings were crazy. I had days when I cried for hours and hours straight for no reason. In contrast, I've had one period since getting the IUD inserted + adhering to a paleo diet, and I've had no real issues. I didn't have any mood swings, no cramping, didn't have to take any NSAIDS, and I experienced very little water retention. I think the "downsides" to a copper IUD are nothing that can't be managed with a healthy paleo diet.

Mine was covered by my insurance, but I would have gotten it even if it hadn't been -- the upfront cost is expensive, but i's good for 12 years, and after it's put in, it requires no maintenance. My boyfriend has felt the strings once or twice, but he says it's not painful, and he just moves them out of the way. I enthusiastically recommend it. I also have friends who have them and love them.

I'm pretty skeptical about artificial hormones. I have a lot of friends who've had terrible experiences on hormonal birth control.

There are plenty of methods. Charting a cycle works if one is dedicated enough to ensure not to be sexually active around ovulation - ironic that we're most horny then though :-/

There's diaphragms, but I think they're a bit of spontaneity killer.

The IUD is a non-hormonal method which any female can use, pre or post birth. I'm in the UK, so docs in the states might have a suffering opinion, but that's all it is... Opinion.

The IUD is the most effective form of birth control out there right now. The minera is supposed to make periods lighter and easier, while the copper IUD increases cramping and bleeding. I just got the minera put in last month, and my doctor mentioned that they are becoming more popular (at least in Canada). I had no issues getting it despite being in my 20's and childless.

I'm 29, never had a baby, and got a copper IUD almost a year ago. My husband and I are planning on having a baby soonish, so it was a tough call with going through getting an IUD that I might only have for a year or two.

It was inspired by my paleo journey, which also included avoiding as many substances/chemicals as possible. I had considered a technology-assisted rhythm method, but decided that having to potentially avoid sex or use a backup method when I most wanted it was a deal-breaker :P

I'm very happy with the decision. Yes, it was expensive and it hurt a lot for a second, but I squeezed my husband's hand and it was over quick. I was barely sore an hour later. My first couple of periods were definitely worse and I had random spotting for a while, but it got better over a few months.

I have a copper IUD. I'm in Canada, and have a similar one to paraguard (it's called Flexi-T here). Mine lasts 5 years, and was ~100$ Canadian. They come in two sizes, one for women pre-baby, and one slightly larger for post-baby. I'm in my mid 20s, and doctors here actually like giving us IUDs.

In fact, young 20 somethings should get an IUD instead of hormonal birth control, since it's more fail-proof, low or no hormones, and lasts for years!

If you look at the IUD usage in Europe, half of women who use birth control are using IUDs, compared to very low % of women in North America. North American old school doctors don't think young women should be getting them, but they are wrong. If you really want one, then try to get a doctor who is more knowledgeable on the subject, or a referral to a OBGYN.

The main gyno schools in the US have decided that there are no enhanced risks for having an IUD pre-baby.

As for the side effects of the copper IUD, my cycle was a bit shorter, and my flow heavy (as heavy as with BC though), so I'm being treated by a naturopath for liver function and B vitamins, which is working very well so far! Also being paleo cuts out all the soy products, so yay for us :)

Isn't it interesting that we do so many things to try to prevent pregnancy, when in reality no method is 100%. Its like if a baby wants to come they will come, and it is just the way our modern society is that makes this a problem. Both of my children were conceived after just one time not using anything. With the 2nd I was on my period. I feel blessed to have them both but at the time it was like oh shit. I a married and much older so it was OK, but still. If we lived in a paleolithic time all babies would be welcome and the tribe would raise the baby together rather than a teenager all by themselves.

With that being said I know a lot of women who have had problems with the pill messing with their hormones and making the crazy. I too would recommend the IUD but caution for her to be very careful in checking the string regularly. In a woman who has not had natural child birth it can shift positions and be ineffective. If she finds that does not work for her she can try something else. There are 2 types the Mirena(small low dose only local hormone and the Paraguard(no hormone but made of copper) I had problems with the copper, because I have a nickel allergy and there is some nickel that is not disclosed on the box. I switched to the mirena and cant be happier.

Finally it is really important that she protect herself from STD's as well as pregnancy. This is perhaps a bigger problem that pregnancy. Condoms are the best way to protect against this. If she is in a relationship and they both have been tested and are clean after 6 months then stop using a condom. They should both continue to get tested once a year, because things can show up later or people do cheat it is just a fact of life.

I would keep track of your ovulation. Pregnancy usually occurs during a specific time (in the middle) of your cycle. If you are careful not to have intercourse during this time period, the chances of becoming pregnant are significantly reduced (about 95%). This is about as natural as you can get.

I got a copper IUD put in a month ago, and so far, hey, not knocked up! It was rather painful to get put in- I'm 24 and have never had children- and I did have some kind of bad cramping, for the first time in my life. But it hasn't bothered me for the last couple of weeks at all. My insurance kind of sucks, but even it covered the cost 80%.

I had a Mirena for a while and I thought it was a great compromise. (I have a medical condition that benefits from some hormonal intervention, which annoys me to no end!) I've never given birth, so it was awkward to put in, but not impossible - and at least the hormones are very localized, unlike the various pills. I'm not so sure the copper IUD is all that less interventionist - you're still putting a foreign body somewhere it's not designed for, and it renders the uterus unfriendly.

Disclaimer: I am not posting here to hate on the pill. I am damn grateful for the existence of the pill. This is a first world problem. We're a privileged lot to even have this chat.

Oh, why do I think this is not going to be popular? Depo-Provera injections were a life-saver for me. I don't want to get into the personal reasons for why this is.

One of the main objections to Depo is regarding bone density loss, which is so far not conclusive. Women on a paleo lifeplan should not be worried about this as lifting and diet more than make up for the assumed risk.

The other side effect is no periods. And to that one, I say woohoo!

Is it an option for everyone? No. For a young woman with no plans to start a family in the next few years? I have been having the injections since I was in my early 20s, I'll be 40 next year, and my bone density scans are excellent.

There are online communities devoted to the evils of Depo-provera so I will let them speak for themselves, and only speak here for myself. It was the right choice for me then, it's the right choice for me now. Will it always be? Don't know. Time will tell.

As far as the IUD's go....oh hell no. Not again. I had the copper IUD (non-hormonal) placed about three years ago.

Now (I apologize for the TMI) excessive bleeding and cramps is an understatement. I was eating a paleo diet at the time, taking a lot of Omega-3's and I'm no stranger to both pain and heavy bleeding given I started my period at 9 and bled heavily. The IUD make it look like a walk in the park.

These cramps put me on my ass, I couldn't speak or think and I'd be crouched over holding onto something. I was bleeding measuring cups of blood (I have the Divacup lol, so I could do the millilitre counting, which at the end of seven days was about 380 mls---the average is 35 and anything over 80 is considered heavy). I was soaking through everything and had to change my cup every hour (extra-heavy super mondo tampons soaked through in 30 minutes). To boot, I had wicked sore breasts and acne. My pms (I've always been a little unbalanced) was extreme. I also developed discharge that wouldn't leave no matter what and had a chronically inflammed angry cervix (no STD's).

The last fricking straw for me was when it slipped and I got pregnant. I had the IUD removed ASAP and unfortunately miscarried at just about 10 weeks. For those not in the know, its not as rare as you think to conceive with an IUD in place. The other thing that they don't tell you is once conceived, there's a 1 in 2 chance of miscarriage and that rate increases when you have to remove it (obviously). But if you don't remove it and you miscarry with it in place, you have a high risk of a septic miscarriages...which isn't good.

Needless to say. Never again.

There is apparently new stats on IUD effectiveness----they're not so impressive.

Remember folks, just because it isn't hormonal doesn't mean it doesn't have effects on the body---excess copper and a foreign substance DO NOT make the body happy.

Condoms, fertility planning, sometimes withdrawal and a bit of prayer have served me well since then.

I can't believe this isn't on here: DIAPHRAGM. Plus spermicide. If you have a sensitivity to spermicide, you can use manuka honey or an aloe vera + lemon juice blend to act as a sperm blocker.

I've been using this method for 2 years with no problem. And I am a person who has gotten pregnant 5 times the FIRST attempt; and one of those 5 was even using a condom (correctly). It was recommended to me by my holistic-gyn who used this method for 20 years without getting pregnant.

And it's not a "spontaneity-killer" lol. Most women take a few minutes to freshen up if they think they might get frisky. Brush teeth, perfume, whatever. Slip it in then. Or put it in at the beginning of the evening. It's definitely no more trouble than remembering to take a darn pill every night!

If you have interest, there is a yahoo group called Diaphragms and Caps where you can get lots of good info, including recipes for natural spermicides to use. (Note: you MUST use some sort of sperm blocker to get the effectiveness of the diaphragm up where it needs to be). There are also 2 lactic-acid based spermicides available in Europe and Canada, but they are very hard to get here in the US (I've been blocked by customs a few times). Darn FDA strikes again. They are called Contragel and Cayagel.

I have used just about every other form of birth control out there, and this is by far my favorite. I did like fertility awareness before I had kids, but once you have a baby, extended breastfeeding really messes with your cycles and makes them hard to track.