Why Do So Many Women End Up On The Pill When It Fails Them?

Many don't know that nearly one in ten women taking it will get pregnant within the year.

Women overestimate the effectiveness of the Pill and condoms — the two most popular methods of birth control in this country — according to a new study in the American Journal of Obstetrics and Gynecology. After the study group of 4,100 women was counseled about other methods of birth control, such as IUDs, 71 percent chose to go on that or an implant. The findings suggest that many women choose the Pill because they don’t receive thorough counseling about their other birth control options or the true effectiveness of the Pill — which isn’t as great as pharmaceutical companies tell you it is.

This helps explain why the most popular methods of contraception in this country are the birth control Pill and condoms — if you don’t know all the information about all the methods of contraception available to you, why would you choose the one you know the least about? What many women don’t know about the Pill is that only if you take it exactly according to the manufacturer's instructions, including at the same time every day, that your chances of getting pregnant are 0.03 percent. But for whatever reason — business or forgetfulness — many women don't take the Pill exactly according to the instructions, bringing its real failure rate to a rather startling 9 percent, according to Dr. Nancy Stanwood, obstetrician/gynecologist and board member of Physicians for Reproductive Choice and Health. That means that nearly one out of 10 women will get pregnant while taking the Pill over the course of a year.

Given those statistics, it's probably not surprising that half of all pregnancies in the U.S. are unplanned. "It’s an embarrassingly high number for a developed nation," Dr. Stanwood says. "Amongst those [unplanned pregnancies], half were happening for women taking birth control. They’re trying to do the right thing. They’re using the method that is failing them."

That’s not the only reason the Pill is not the best form of birth control for many women. Many stop taking it due to side effects like depression, moodiness, and a decreased sex drive. And according to a November 2010 New York magazine piece, "infertility has become the Pill’s primary side effect" — a story that was sure to give some long-term Pill-takers pause about continued use.

So if it's so problematic, why is "going on the Pill" still perceived as something couples in committed monogamous relationships should work towards? Besides the perception of increased intimacy with condom-less sex, the Pill does have a better track record than condoms, which have an ideal failure rate of 2 percent and a real failure rate of 18 percent. And men often suggest their partners go on the Pill in the interest of avoiding desensitizing condoms.

Also, the other birth control options can seem unappealing — but that's probably more due to ignorance than anything else. The IUD — a matchstick-sized device that is inserted into the uterus that protects against pregnancy for five to 10 years — has a real failure rate of 0.10 percent. When I asked one straight guy if he would encourage a partner to get an IUD, he said probably not: "It's my understanding that IUDs aren't particularly common... It's also much easier to ask someone to take a Pill, than to stick something in their vagina." (Oh, is that so?)


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