Condoms and the Pill: Not as effective as you think

April 27, 2012, 3:58 p.m.

A survey of over 4,000 women revealed that nearly half have too much faith in the Pill and condoms as contraception. (Credit: Hilary Thomas/Flickr Creative Commons)

Women overestimate the effectiveness of the condom and the Pill as birth control methods, says a new study.

Reuters reports a new study indicates that nearly half of women who seek birth control have too much faith in the Pill and condoms.

It also found that there were "significant knowledge gaps" regarding the effectiveness of hormonal birth control patches, vaginal rings and injections.

Researchers looked at 4,144 women from the St. Louis area who were surveyed before getting contraceptive counseling. They were asked to rate the effectiveness of different methods of birth control, and that's when they indicated they overestimated certain methods. Afterward, when women were counseled on all of the options that were available to them, 71 percent chose intrauterine devices (IUDs) or contraceptive implants, generally considered the most effective forms of birth control.

The study appeared in the American Journal of Obstetrics and Gynecology.

According to Reuters, the Pill and condoms are the most popular reversible forms of birth control, even though they aren't the most effective. ("Reversible" meaning "not permanent.") Unplanned pregnancies occur in about nine percent of Pill-users per year, and between 18 and 21 percent of condom-users.

Part of the reason for the high pregnancy rate is that those methods of birth control rely on "perfect use" – in other words, certain conditions have to be in place for these methods to be as effective as advertised but, inevitably, condoms break and women forget to take the Pill.

Neither IUDs nor implants rely on perfect use, though, and their pregnancy rates reflect that: between 0.2 and 0.8 percent of IUD-users every year, and 0.05 percent of those using a contraceptive implant.

Despite the numbers, only five to six percent of women choose to use IUDs or implants, which may be due to a lack of knowledge about them – both on their part and on the part of doctors.

The Centers for Disease Control and Prevention reports that questions were raised in 1974 about one IUD in particular due "an excess risk of complicated pregnancies." That IUD was taken off the market, and improvements since then have led to a pregnancy rate of less than one percent, with low side effects to boot.

Another recent study found that nearly 30 percent of doctors still mistakenly believe IUDs to be dangerous, which affects their prescription of them to women seeking birth control.

"We need to do a better job of educating the public – women and men – on the failure rates with typical use," David Eisenberg, the study's lead author, told Reuters.

That's true for South L.A. in particular. The area already has an "unmet need for reproductive healthcare," according to Serena Josel, Planned Parenthood Los Angeles' director of public affairs. Part of that unmet need is because of the associated costs, which Josel also told OnCentral "serve as very real barriers to care."

One glance at the numbers and that becomes clear: About 74 out of every 1,000 births on the southside is to a girl between the ages of 15-19 years old.

But the price tag of those more effective forms of birth control makes them an unrealistic option for many of South L.A.'s teenage girls – U.S. News and World Report says IUDs will cost between $500 and $1,000 up front, even though that's usually good for about 12 years. Implants can cost between $450 and $540, depending on income – and that's not including the removal fee, which will be between $490 and $580, and a little bit more if you want to get a new rod reinserted.

The cost of the most popular methods can quickly add up, though, even if they're not as effective – birth control pills can cost between $160 and $600 annually, and couples who use condoms, say, twice a week will pay around $150 every year.

Photo by Hilary Thomas via Flickr Creative Commons.

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