How does birth control work in Star Trek?

Question

According to Memory-alpha, Contraception injection:

In The Making of Star Trek, it is stated that the birth control
  practiced on board the USS Enterprise was never discussed in any
  episode of The Original Series because the censors would not have
  allowed it. But if it were to have been discussed, they would have
  explained contraception to be based on monthly injections mandatory
  for unmarried women and voluntary for married women. If a member of
  the crew became pregnant, she would have a choice between medical
  discharge or rotation to a shore base for the duration of the
  pregnancy. (pages 206, 207)

Yet, when Benjamin Sisko and Kasidy Yates become pregnant they are surprised. Sisko forgot to renew his injection.

Why would Kasidy Yates have relied exclusively on Sisko's injections? Has the responsibility shifted from women to men since TOS time? Are civilians not allowed access to birth control?

Why haven't they developed something more reliable?

How exactly does birth control work in Star Trek?

revenant · Answer

Birth control works quite well in the Star Trek universe, thank you for asking!

It seems that you are asking three separate questions:

Why Sisko was getting birth control injections could be explained simply that Yates was allergic to whatever birth control medications are available in the Trek universe.
Should birth control of the future be more reliable than the present?  In real life, if a woman is on the pill and a male uses condoms there is still a very small chance of pregnancy. 
You answered the question when you asked if birth control in the Star Trek universe is a renewable contraceptive injection, that in males presumably somehow inhibits sperm cell reproduction.  I would assume in females works about the same way that modern day birth control injections do.

Tronman · Answer

The simplest explanation based on dialog in the episode, and logic, is that both partners get monthly birth control injections. It may not be strictly required that both partners do, rather, it simply allows for maximum effectiveness.
Based on a quick google, injection-based birth control for women today has a 94-99% effective rate.
Presumably, a male birth control injection will cover the remaining percentage. Meaning if both partners are keeping up to date on their monthly injections, chances of getting pregnant is pretty much 0.
Even with Sisko forgetting his injection, pregnancy was probably still unlikely, but not impossible. Luck just wasn't on their side.
Out of universe, it seems clear that the writers needed a way to get Kasidy pregnant in a realistic way. Given what we know of birth control technology today, a dual partner approach being even more effective (except for simple human error) seems realistic. Given that Sisko is fighting a war, it makes sense he would be the forgetful one.

How does birth control work in Star Trek?

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