Contraception failure rates per method

[REP]

From the CDC:

Copper T intrauterine device (IUD) — Typical use failure rate: 0.8%.

Levonorgestrel intrauterine system (LNG IUD)— Typical use failure rate: 0.2%.

Implant— Typical use failure rate: 0.05%.

Injection or "shot"— Typical use failure rate: 6%.

Combined oral contraceptives— Typical use failure rate: 9%.

Patch— Typical use failure rate: 9%.

Diaphragm or cervical cap— Typical use failure rate: 12%.

Male condom— Typical use failure rate: 18%.

Female condom— Typical use failure rate: 21%, and also may help prevent STDs.

Spermicides— Typical use failure rate: 28%.

http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm

The ones I have put in bold are among the most popular and result in 6-12 pregnancies per 100 women per year per method. (Condoms used alone result in 18 pregnancies per 100 women per year).

The problem with unwanted pregnancies isn't the lack of contraceptive use. If most sexually active women were not using one or more form of birth control, the birth and abortion rates would much, much higher. Instead, the abortion rate has held steady for years.

[idwiyo]

1. Thank you.

[REP]

3. There's always the misapprehension that "if these damn sluts would just use The Pill!"

that there'd be fewer abortions. Well, most women are using some form of contraception - unfortunately, they're not 100% effective, and some of the most popular ones used properly can still result in a pregnancy. Even surgical sterilization does not have a 100% effectiveness rate (the failure rate is less than 1%, but that failure rate is actual women receiving some very bad news).

[idwiyo]

23. I am wondering how long it will take before someone demands we use two methods at once.

You know, to make abortions even more "rare". And if THAT fails, carry to term and give it for adoption, because every foetus is sacred. And it will make forced-birthers happy. Or something like it.

[REP]

25. Adoption, not abortion, emotionally damages women.

Some studies on the long-term psychological sequelae to adoption:

J Obstet Gynecol Neonatal Nurs. 1999 Jul-Aug;28(4):395-400.
Related Articles, Links

Postadoptive reactions of the relinquishing mother: a review.

Askren HA, Bloom KC.

Deer Valley OB/GYN, Mesa, AZ, USA.

OBJECTIVE: To review the literature addressing the process of relinquishment as it relates to the birth mother. DATA SOURCES: Computerized searches in CINAHL; Article 1 st, PsycFIRST, and SocioAbs databases, using the keywords adoption and relinquishment; and ancestral bibliographies. STUDY SELECTION: Articles from indexed journals in the English language relevant to the keywords were evaluated. No studies were located before 1978. Studies that sampled only an adolescent population were excluded. Twelve studies met the inclusion criteria and were included in the analysis. DATA EXTRACTION: Data were extracted and information was organized under the following headings: grief reaction, long-term effects, efforts to resolve, and influences on the relinquishment experience. DATA SYNTHESIS: A grief reaction unique to the relinquishing mother was identified. Although this reaction consists of features characteristic of the normal grief reaction, these features persist and often lead to chronic, unresolved grief. CONCLUSIONS: The relinquishing mother is at risk for long-term physical, psychologic, and social repercussions. Although interventions have been proposed, little is known about their effectiveness in preventing or alleviating these repercussions.

Med J Aust. 1986 Feb 3;144(3):117-9.
Related Articles, Links

Psychological disability in women who relinquish a baby for adoption.

Condon JT.

During 1986, approximately 2000 women in Australia are likely to relinquish a baby for adoption. A study is presented of 20 relinquishing mothers that demonstrates a very high incidence of pathological grief reactions which have failed to resolve although many years have elapsed since the relinquishment. This group had abnormally high scores for depression and psychosomatic symptoms on the Middlesex Hospital questionnaire. Factors that militate against the resolution of grief after relinquishment are discussed. Guidelines for the medical profession that are aimed at preventing psychological disability in relinquishing mothers are outlined.

Community Health Stud. 1990;14(2):180-9.
Related Articles, Links

Erratum in:
• Community Health Stud 1990;14(3):314.

Social factors associated with the decision to relinquish a baby for adoption.

Najman JM, Morrison J, Keeping JD, Andersen MJ, Williams GM.

Department of Social and Preventive Medicine, University of Queensland.

Little is known about the characteristics, social circumstances and mental health of women who give a child up for adoption. This paper reports data from a longitudinal study of 8556 women interviewed initially at their first obstetrical visit. In total, 7668 proceeded to give birth to a live singleton baby, of which 64 then relinquished the baby for adoption. Relinquishing mothers were predominantly 18 years of age or younger, in the lowest family income group, single, having an unplanned and/or unwanted baby and reported that they were not living with a partner. These women were somewhat more likely to manifest symptoms of anxiety and depression both prior, and subsequent to, the adoption, but the majority of relinquishing mothers were of 'normal' mental health. The decision to relinquish a baby appears to be a consequence of an unwanted pregnancy experienced by an economically deprived single mother rather than the result of emotional or psychological/psychiatric considerations. These findings document a particular dimension of the impact of poverty on health.

[kestrel91316]

2. Oral contraceptives were 100% effective for me over the course of 30 years.

[REP]

5. That's nice.

Is your name Legion and are you 100 women?

[idwiyo]

6. Good for you. Unfortunately it doesn't work like that for everyone.

[REP]

11. It might have worked for me if

I wanted to use, "Not ever, honey, I'm blind from unending migraines" as my BC method ...

[idwiyo]

12. ...

[laundry_queen]

8. The key words here are

'typical use'

Lots of women forget to take a pill here and there quite often and they don't follow the package instructions to use another method of birth control until the next pack. Also, I cannot tell you how many times I went on a powerful antibiotic that was known to affect the effectiveness of the pill and the doctor AND pharmacist neglected to tell me - luckily I knew but omg, why are they not telling people? (I had a friend become pregnant this way). I actually had one doctor deny it even though it was right there on the package insert.

[OwnedByCats]

67. When I was 17

I went on the pill. About 6 months later I was put on antibiotics for strep throat. Nobody warned me and suggested I use something else in the meantime, and being only 17, coupled with not having been on the pill long, I didn't know any better. Then I found out a month later that they confused me with another patient with the same name as mine who was not on the pill, hence why I had not been told. Thankfully nothing happened, but I now research medication incompatibilities myself, just in case!

[NoOneMan]

7. The abortion rate has fallen from ~29 per 1000 females aged 15-44 in the 80s to 15.1

In any case, condoms should not be disregarded due to failure rates due to protection against disease as well. Different subject for a different time.

[idwiyo]

15. Never mind that access to abortion got severely restricted since 80'

[Donald Ian Rankin]

9. Note that these are for typical use, not correct use or even consistent use.

If you consistently use them correctly, most of these methods will be significantly more reliable than these numbers suggest, I believe.

[idwiyo]

16. Unfortunately we don't live in a perfect world.

[REP]

19. These studies show they are used correctly more often than not

As one poster mentioned above, antibiotics that lessen the effectiveness of oral BC are often dispensed without the patient being advised to use a back-up method during therapy - this isn't really "user error" unless the user is a pharmacist. Cervical caps, sponges, etc have different effective rates in women who given birth and women who haven't due to the changes in the cervix - this is more of a product design error (they should come in two sizes at least). The Depo shot stays in the system for 10 months after the last one (it takes that before normal endometrial function resumes), so being a day or week late with a shot really won't cause a disruption in the protection.

But aside from that, as the saying goes, "there was one perfect person and he died 2,000 years ago ..."

[surrealAmerican]

10. You would think implants would be more popular ...

... given their impressively low failure rate.

[REP]

13. Access, side-effects, and difficulties in removing them

Let's hope the ACA removes the "access" barrier for women who want it and can tolerate it.

[Glassunion]

14. Two reasons why my wife does not use the implant

she is allergic to the metals in the one brand, and the hormones in the other caused tumors. They are not for everyone, especially the brands with hormones if you have a family history of certain cancers. That is also why she does not use the pill.

[Small Accumulates]

17. Upfront costs are fairly high

Even though over time implants are very cost effective. But it can be tough to gather the funds for that investment.

[liberal_at_heart]

36. my daughter just got implenon. It's an implant they put in your arm. She is having some

side effects. She is not feeling well and is having some cramping, but she has a bad memory and has had a few times where she has forgotten to take the pill. So, she is hoping she won't have to worry as much about forgetting and getting pregnant.

[LeftyMom]

53. As with injectibles, the side effects can be terrible.

And if you're one of the unlucky ones getting back to normal takes a long time.

[valerief]

18. Where's the religious method of rhythm? nt

[REP]

21. I didn't include that, though it's at the link.

I don't consider that to be contraception. As the old joke goes, "What do you call people who practice the Rhythm Method?" "Parents."

[valerief]

22. Ha! I see it. 24%. Thanks.

[dsc]

28. actually that isn't all that much worse than condoms

and better than spermicide. That is quite surprising to be honest.

[jeff47]

59. That's 'cause "typical use" for a condom

includes all sorts of ways of doing it wrong. Not stopping for tears and "I'll put it on before I finish" being the most common.

[dsc]

62. I realize why the condom numbers are high

though I do think the 18% is likely an over estimate. I had always read more like 10%. But I am still quite surprised at how effective the rythum method is. I would have guessed a failure rate much closer to 50%.

[jeff47]

70. If it's done properly, rhythm works well.

But it's very, very hard to do properly.

[gollygee]

74. Let's see.

A contraceptive practice where I can have sex any time except when my body especially wants to have sex.

I'll pass.

[REP]

75. And even harder if the woman has an irregular cycle

[pnwmom]

20. Also, you can make some of the methods more effective

by combining them -- for example, a diaphragm and a condom, or a condom and a spermicide.

[B2G]

24. Regarding failure rates for the pill/shot

They are very effective is used correctly.

For the pill, it's typically because they are skipped or not taken at the same team each day. For the shot, it results from not getting them 3 months to the day.

[REP]

26. It's every 13 weeks, actually, but it takes 10 months for fertility to return once discontinued

[giftedgirl77]

27. The pull out method doesn't work...

My youngest sister found out the hard way (no pun intended) her senior year. My mom had 3 daughters within 34 mths in age, within a year she became a grandmother 3 times (we were 20, 19, 18). Needless to say she had a bit of an adjustment period.

I was on depo for two years between my sons with zero side effects, when I came off I got pregnant within 2 mths. I have my tubes tied now & have for about 8 years & nothing is getting past that.

[GreenStormCloud]

29. How about vascetomy?

Soft vascetomy - Done in a manner to be reversible, can sometimes reverse itself. Failure rate, about 1%.

Hard vascetomy - Done in a manner to be absolutely, positively, permenant. Failure rate. ZERO.

[REP]

30. Surgical vasectomy - .15%; Tubal ligation - .5% - not "ZERO"

I myself had a tubal fulguration (my Fallopian tubes were burnt out, a procedure much more extreme than a ligation). This procedure still has a failure rate (.15%).

[Zorra]

31. Vasectomy appears to be the most effective form of birth control

(on edit) after implants.

[REP]

32. Tubal ligation/fulguration is portable and permanent, though

The failure rate for tubal fulguration is comparable to that of surgical vasectomy, and the woman gets to take it from partner to partner (if she so desires).

[Zorra]

56. True, it's a top option if you're sure you don't want children, or more children.

And a real drawback of vasectomy is that it involves a good degree of trust.

[REP]

58. Especially in your doctor!

[GreenStormCloud]

66. I assume you mean the woman trusting the man. There is a simple solution.

A vasectomy leaves a scar on each side of the scrotum, a little bit towards the rear, about an inch long. She can search for the scar during foreplay. She doesn't even have to tell him what she is doing.

[cynatnite]

49. My doctor said he cut 'em, banded 'em, and burned 'em...

He still warned me about the failure rate and that they could still grow back together. That was 15 years ago. Not sure if I should uncross my fingers yet.

[REP]

51. That's why my doc did a fulguration - my healing powers are freakish

She didn't feel at all confident about banding and burning me - mine are completely burnt off, just to be sure! Then I had an ablation. So I think I'm really at 100% babyproof

[GreenStormCloud]

65. I had my vasectomy fail.

Fortunately my girl friend missed her period due to stress. I was really surprised when my doctor said I had a sperm count of 30%. He did a new vasectomy at no charge. This time he cut out an inch of tube, folded the ends back over themselves, and sutured them.

[GreenStormCloud]

64. There are TWO methods of vasectomy.

One method does have a .15% failure rate. The other method has ZERO failure rate. Didn't you notice that in my post.

[gollygee]

33. Surgical sterilization is a great choice for some people

And that's the route I've taken at this point.

However, it isn't 100%, and more importantly (since this thread is about abortion) most abortions are by women who are young enough that they might not want to cut off the possibility of having a baby ever. It's often an issue of not wanting a baby at that moment or in that relationship than just not wanting a baby ever.

[REP]

38. Sterilizations are often denied to young women who absolutely want one

Yeah, anecdote is not the plural of data, but I'm one of them. I also know quite a few women like me who were denied sterilizations for various paternalistic reasons and had at least one abortion (and most of us finally got sterilized, yay, and remain childfree).

[cynatnite]

50. It wasn't that long ago that women had to get their husband's permission...

It's still difficult as you said. I knew plenty of doctors who were hesitant for young women who never had children. My daughter was young when she got hers, but she had her 3 kids back to back and was tired.

[REP]

52. I know. It shouldn't be.

The CREST study shows low levels of "regret" in young nullaparas who received sterilizations. I'm one who showed high levels of "YIPPEE!!!!"

[GreenStormCloud]

68. Doctors have to protect themselves from lawsuits.

Sterilizing a young woman with no children has the potential of a future lawsuit, no matter what kind of forms the doctor may have her sign.

If I were a doctor, I would refuse to do it to. I would know the name of a doctor who would be willing to take that risk and would make the recommendation that she see him.

Sorry, but the U.S. is a sue-happy country.

[REP]

73. Informed consent makes the doctor sue-proof

Also, women aren't stupid ... well, most of them; I was in an informed consent class where one woman did not know that surgical sterilization is permanent and not considered reversible; however, due the informed consent process, she learned that and did not have the procedure. The other women - a number of whom were young nullaparas - could have given the damn class. Sterilization is something that the vast majority of women who seek it out do so because they know EXACTLY what it is.

At least one study has found extremely low levels of "regret" associated with female sterilizations, even amount very young women with no children.

[GreenStormCloud]

78. It only takes one lawsuit to be expensive for a doctor.

So you have 999 women who have no regrets and one who has regrets and blames the doctor, finds a greedy unethical lawyer (Example: John Edwards) and the doctor has an expensive lawsuit on his hands.

[liberal_at_heart]

34. the failure rate is not the issue. The issue is people either not having access to it, choosing not

to use it, or using it incorrectly. And unwanted pregnancy rates are the lowest they have been in decades because of birth control use, so the statement that abortion should be rare because birth control should make it rare does stand up.

[REP]

35. If birth control weren't being used, the abortion rate wouldn't hold steady/decline

It would increase each and every year.

Those judgeypants don't look good on you anyway.

[liberal_at_heart]

37. I don't give a damn what you think of me. You will not change my mind, since you are

wasting my time by being juvenile you can just go on my ignore list.

[REP]

39. But I wuvs you!!

[PeaceNikki]

40. lol @ "judgeypants"

Thanks, btw. I honestly was not expecting DU to be *this* far behind on this topic.

[liberal_at_heart]

41. I was not expecting so many on DU to be so backwards on preventing unwanted pregnancy and STI's.

[PeaceNikki]

43. whooooooosh

right over your head.

[REP]

44. STDs, no apostrophe. You're welcome.

[REP]

42. I knew it was, but my standards are super low

Look at this sub thread. "You won't change my mind with facts and I'm going to ignore you!!"

[PeaceNikki]

45. trashing thread

that's her/his other favorite.

[REP]

46. It's a her.

Reproductive issues set her OFF, due to some issues in her past.

[jeff47]

60. Pedantic: The number of abortions would go up, but the rate would remain unchanged

The rate corrects for population growth.

[REP]

61. Not necessarily

For example, the rate for a number of years was 16 per 1000 women; it has gone down to 15.1 per 1000 women. The reduced access to abortion services may be a partial explanation for the decline, but the abandonment of "abstinence only" sex ed as well as the availability of OTC emergency contraception may be another part of the picture.

[jeff47]

69. Right, but "increase every year" implies not correcting for population growth. (nt)

[cynatnite]

47. When I worked in OBGYN...

The doctors usually recommended that if a woman opted for the less reliable, to also use a secondary precaution. They usually told the patients what the failure rates were for things like spermicides and all that.

That's not to say all doctors did, but the ones I worked with made a point of it.

[REP]

48. And with the ACA, let's hope more women will be able to see a doctor

And get the best, most effective BC she can use!

[FreeState]

54. Condom failure rate if used correctly is 2-3%

The 12% figure is a bit misleading because 10% of that is inconsistent use or ineffective use. If condoms are used correctly 100% of the time the failure rate is 2%.

[REP]

55. Real-world numbers vs "perfect use"

These numbers come from the CDC. They don't have an agenda; that's why I used them as a source.

As Terry Allen said, "There's the radio ... And then there's Real Life."

[FreeState]

57. Education can fix a large portion of that 10%

But the same cannot be said of the other methods.

[lumberjack_jeff]

72. The demographics of people who have the experience to use condoms effectively

are not the demographics of people most likely to get pregnant accidentally.

[freshwest]

63. Wow! I was unaware of the oral contraceptives failure rate. The others run as I expected.

[jeff47]

77. That's a "real world" rate

which includes things like women forgetting to take the pill, or women who think they only need to take a pill on days when they are going to have sex or doctors not thinking about how other prescriptions affect birth control pills.

Taken as directed, the failure rate is way less than 1%.

[lumberjack_jeff]

71. It is long past time for a male birth control pill.

That's the "two or more" redundancy that is needed.

[Niceguy1]

76. yes!

and it would give men more control over the baby making decisions too