intercourse and kept inside the vagina for 6–8 hours after intercourse. The failure rate is 21%. In the fertility awareness-based method a woman who has a predictable and consistent menstrual cycle tracks the days that she is fertile. The typical woman has approximately 9 fertile days a month and either avoids intercourse on those days or uses an alternative birth control method for that period of time. The failure rate is between 2-23%. Lactational amenorrhea (LAM) is an option for women who have had a baby within the past 6 months and are breastfeeding. This method is only successful if it has been less than 6 months since the birth of the baby, they must be fully breastfeeding their baby, and not having any periods. The method is almost as effective as an oral contraceptive if the 3 conditions are strictly followed. The 'pull out method' or coitus interruptus is a method where the male will remove his penis from the vagina before ejaculating; this prevents sperm from reaching the egg and can prevent pregnancy. This method has to be done correctly every time and is best if used in addition to other forms of birth control in order to prevent pregnancy. It has a failure rate of approximately 22%. Emergency contraceptives A copper IUD can be used as an emergency contraceptive as long as it is inserted within 5 days of intercourse. There are two different types of emergency contraceptive pills, one contains ulipristal acetate and can prevent pregnancy if taken within 5 days of intercourse. The other contains levonorgestrel and can prevent pregnancy if taken within 3 days of intercourse. This option can be used if other birth control methods fail. Surgical methods Tubal ligation is also known as 'tying tubes', this is the surgical process that a medical professional performs. This is done by closing or tying the fallopian tubes in order to prevent sperm from reaching the eggs. This is often done as an outpatient surgical procedure and is effective immediately after it is performed. The failure rate is 0.5%. A vasectomy is a minor surgical procedure where a doctor will cut the vas deferens and seal the ends to prevent sperm from reaching the penis and ultimately the egg. The method is usually successful after 12 weeks post-procedure or until the sperm count is zero. The failure rate is 0.15%. User dependence Different methods require