Contraceptive Effectiveness

Fifty-three percent of unplanned pregnancies occur in women who are using contraceptives. When choosing a method of birth control women often consider the published success/ failure rates for the method they are considering. However, these rates are based on "perfect use" by women--that means using the method exactly as prescribed during every act of sexual intercourse.

The failure rates for a given method of birth control may actually be much higher during "typical use" than you might expect: Implants and injectables
2-4% Oral contraceptives
9% Diaphragm and cervical cap
13% Male condom
15% Periodic abstinence
22% Withdrawal
26% Spermicides
28% Cohabiting women. Unmarried women. Women who live below 200% of the poverty level. Black women. Hispanic women. Adolescents. Women in their 20's.

The success or failure of various methods of birth control vary according to several factors. An example can be seen in a recent article in the Journal of the American Medical Association (JAMA) that said "...adolescent women who are not married but are cohabiting experience a failure rate of about 47% during the first year of contraceptive use, while the 12-month failure rate among married women aged 30 and over is only 8%."

The failure rate for Black women is about 20% and apparently does not vary with income, while Hispanic women experience a 12-month failure rate of 16% and white women about 11%--rates that do vary by income and which are significantly higher among poorer women and lower among financially secure women.

The reasons for contraceptive failure are complex and vary according to method:

Oral contraceptives may fail if a woman forgets to take them every day at the same time or if 2 or more pills are missed during a cycle and an alternative method of birth control is not used.

Diaphragms and cervical caps can be moved out of place by the penis thrusting against the cervix.

Condoms can break and/ or semen can leak from them: Period abstinence, or natural family planning, can fail if a woman does not accurately predict her fertile period: IUDs can be dislodged.

Withdrawal can fail if pre-ejaculatory semen enters the cervix or if the man is unable to withdraw his penis before ejaculation. Practice your chosen birth control method consistently. Carefully follow instructions for the use of your birth control method. Use alternative method of contraception such as a condom, if you forget 2 or more birth control pills during your cycle. Certain antibiotics and other drugs can reduce the effectiveness of oral contraceptives--ask your pharmacist if this is a concern for you whenever you fill a prescription. Take oral contraceptives at the same time each day. Using a condom and spermicide with a diaphragm or cervical cap during your fertile period can result in almost 100% contraceptive success. If you use an IUD, check for the string extending from your cervix monthly, if you can't feel it use alternative contraception and call your physician. Call your physician immediately for emergency contraceptives after unprotected sex. If you have any questions about the use of your birth control method--contact your healthcare provider--clearly understanding the proper use of your contraceptive will increase your chance of successful pregnancy prevention.

Remember, even one act of unprotected sexual intercourse can result in an unplanned pregnancy.

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Contraceptive Myths - Contr...

During the last hundred years, women were led to believe much about reproductive health that was simply untrue. Young girls were taught that menstruation was unmentionable -- a curse. Pregnant women in labor were often told to put a knife under their bed to "cut the pain." In the early 1900s, birth control was illegal. Great controversy and debate over contraceptive use, even in marriage, existed. Learn about these 10 contraceptive myths.Many women believe that having unprotected sex during menstruation or during the first or last part of their menstrual cycle will keep them from becoming pregnant. While many women may be more likely to become pregnant mid-cycle, the chance of conceiving may be higher than previously thought at any time of the month. Another fact to know: Sperm can live up to 5 days in a woman's body. zSB(3,3)While ovulation and menstruation are not likely to happen while you are regularly breastfeeding your baby, eventually menstruation will return and you may ovulate without knowing it. So, yes it is possible to become pregnant while still breastfeeding your child. This is one of the biggest falsehoods that women believe. Yes, you can get pregnant even if your boyfriend or husband pulls out before ejaculation. Before ejaculation occurs, a small amount of lubricating fluid, which contains sperm, is released. Any vaginal penetration by the penis can result in pregnancy, even if he always pulls out before ejaculation. Vaginal douching, or taking baths or showers after sexual intercourse, will do nothing to help prevent pregnancy. That's because the sperm has already traveled up towards the egg. If you have started your period, you can get pregnant. Generally, younger girls are more fertile than older women and can get pregnant very easily. Don't believe anyone who tells you that you won't get pregnant "just this one time." Insist on protection! Yes, it's true that the Pill is an effective method of birth control when used properly; however, the Pill does not protect against HIV or other sexually transmitted diseases. The only 100 percent foolproof method of preventing an unwanted pregnancy or STDs is abstinence. One time is all it takes to get pregnant or to get a STD. Don't let anyone talk you into having unprotected sex even once, or you may pay for a lifetime through an unplanned pregnancy and the resulting consequences. Take care of yourself and your body and refuse unprotected sex. As long as you are having periods, you can become pregnant. While it is true that the older you get the less fertile you are, you must consider yourself fertile and able to get pregnant until you have been without periods for at least one full year.

After one year without periods, you can forget about birth control and enjoy unprotected sex as long as you are in a monogamous relationship.

zSB(1,2)If it is hard to know when you are going to need to use birth control, try using condoms or the Today Sponge. Both can be saved for use when needed. The Sponge offers the benefit of 24-hour protection, so you can insert it in the morning and be protected all day.

If you use condoms, do not carry them around in your pocket or purse. In addition, using a spermicide with condoms increases their effectiveness.

Unless your doctor has told you that you cannot get pregnant, you need protection. Even if your doctor has told you that you "probably won't get pregnant" without surgery or treatment, use birth control -- my only grandchild was conceived under such circumstances. Other Related Resources & Guide Picksif(zSbL

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