The pharmacist my surgeon had me meet with prior to my RNY said that BC pills are not as effective after RNY. People will say that they take the pill and they work fine, but just because they havn't gotten pregnant on the pill doesn't mean they work fine. It's like BC pills aren't as effective if you are taking antibiotics, but not everyone who takes antibiotics on the pill automaticly get pregnent. I would rather be safe than sorry. I used the nuvaring for a while. RIght now I use a BC patch that I like. You put a new one on your hip each week for three weeks, and then no patch for one week. I haven't had any issues with it.