E-mail updates
Follow on Twitter
Subscribe to RSSBy Cari Nierenberg
MyHealthNewsDaily Contributor
Women who use long-acting methods of birth control are less likely to wind up pregnant than women who use shorter-term methods, which require daily or monthly remembering, a new analysis says.
The results showed that women using birth control pills, skin patches or vaginal rings were 20 times more likely to have an unplanned pregnancy than women who used intrauterine devices (IUDs) or implants placed under the skin of the upper arm.
"We were surprised at the magnitude of the difference between the contraceptive methods," said study author Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at the Washington University School of Medicine, in St. Louis.
The study, which appears Thursday (May 24) in the New England Journal of Medicine, is one of the largest ever done in the U.S. to compare birth control failure rates over a three-year period, Peipert said. It's also one of the few to include a large number of women using IUDs and implants. Previous studies were based on surveys and depended on women's recall of contraceptive failure, he noted.
Given the findings, Peipert said women and health professionals should consider this question: Would we use a medication that was 20 times less effective for cancer or heart disease?
Unplanned pregnancies
Half of the roughly 6 million pregnancies in the United States each year are unplanned. And of those 3 million, about half are attributed to the incorrect or inconsistent use of birth control.
The unintended-pregnancy rate in the U.S. is higher than in other developed countries, including France and the United Kingdom, where use of IUDs is much higher, the researchers said. The pill remains the most commonly used contraceptive method in the United States.
In the new study, researchers tracked almost 7,500 women ages 14 to 45 considered at risk for an unplanned pregnancy. All women were given the contraceptive of their choice free of charge, and they also received counseling about each method's risks, benefits and effectiveness.
The largest group, nearly 5,800, chose IUDs or implants. Slightly more than 1,500 women selected pills, patches or vaginal rings, and the smallest group, 176 women, chose an injectable form of birth control known as DMPA, short for depot medroxyprogesterone acetate.
During the study 334 unplanned pregnancies occurred. Of these, 156 were attributed to contraceptive failure (improper or inconsistent use), The remaining 178 pregnancies were due to other reasons, including the non-use of contraceptives.
The highest failure rate was seen in women using birth control pills, patches or rings. There were 133 pregnancies among women using these methods, which means the failure rate was 4.5 percent. There were 21 women who became pregnant while using IUDs and implants, and two women while using DMPA.
While a woman's method of birth control mattered, her age also made a difference.
Researchers found that women younger than 21 who relied on oral contraceptives, patches or rings had almost twice the rate of unintended pregnancies as older women who used the same contraceptives. That's because younger woman are more likely to forget to take their pills or to change a patch or ring, the researchers said.
Less mental effort is needed for IUDs, which can stay in the uterus for five to 10 years, depending on the type. Implants are effective for up to three years. It's estimated that 5.5 percent of U.S. women who use birth control currently use IUDs.
Making decisions
"This is an extremely well-done study, and I really applaud that the researchers did it," says Dr. Lynn Goltra, an OB/GYN who is director of family planning at Massachusetts General Hospital in Boston. "It shows that the failure rate is 20 times higher for labor-free birth control methods than labor-intensive ones."
In other words, the more effort a woman has to put into a birth control method, the more likely it is to fail.
Goltra, who was not involved in the research, said women under-utilize IUDs. "They're hassle-free, incredibly safe, and as effective as sterilization," she said.
Some women don't like the idea of placing something foreign inside their body or under their skin, Goltra said. There are also risks to using IUDs, she noted; for example, there's a very small risk of introducing an infection into the uterus that might affect fertility, and skin implants may cause unpredictable bleeding.
It also may be that women are less familiar with long-acting birth control methods, and they hear less information about them from their friends.
"If a woman's goal is to prevent pregnancy, she should be using the most effective method of birth control," Goltra said. "Long-acting reversible contraceptives are the most effective."
Follow MyHealthNewsDaily on Twitter @MyHealth_MHND. Find us onFacebook.
Leave a Comment:
Having a vasectomy and sterilization is a solution for guys and gals that need to limit their family size. The complete procedure can be done for free provided the lovers fall under the federal poverty line. Some concerned citizens are even offering cash rewards for participating couples.
This article was discussing reversable birth control methods, even though it didn't say so specifically. Of course the most effective forms are surgical, used when someone doesn't want any children now or in the future.
Also, some women choose birth control pills for their other benefits: regulate periods (or to eliminate all periods), prevent menstrual migraines or PMDD, treat uterine disorders, control acne, help depression, etc.
I have the 10 year IUD....non-hormonal. Never had a problem with it & come 2015 will have it replaced with a new one! There's no accidents or oh, I forgot. When I went to get it, I was in my mid-twenty's had my 2 kids & really wanted my tubes tied.....my marriage was failing. My OBGYN recommended the IUD instead....as she put it "life changes & you never know what tomorrow will bring". She was right. I met a wonderful man over 4 years ago who someday soon wants children.......although today is not that day.....for me, I'm really happy I didn't completely eliminate that option. All it takes is a doctors appointment to remove it. I wouldn't use anything else!
10 year non-hormonal IUD is the way to go. Cost effective, reliable, no worries at all.
I had to have an IUD removed because it caused irritation and discomfort during sex. The day it was out, no further problem. I'm sure my situation was not the norm. Naturally, I went back on the pill ASAP without any issues. At least there are choices based on what each woman needs. Hopefully, we will still be able to keep those choices. The current political stage is scary.
The 10-year isn't for everyone though. They can cause heavy bleeding and for those of us who already have monthly anemia issues that's a very bad thing.
Also, id rather use something that I would know it isnt going to randomly fall out, without you realizing it..
I had the IUD, and it fell out somewhere between 4-6wks. I had heavy bleeding the WHOLE time, and was considering going with something else anyhow, but scary to think I wasnt protected as well as I thought I was, and If I werent having other medical issues, I may have never known...
I prefer pills because I'm "blessed" with terrible hormonal acne otherwise. For me, the birth control aspect is nothing but a beneficial side effect!
Totally agree with you!
IUD's are safer now, but after that spate of issues in the 70's (wow-does that date me!) they never seem to have caught back on in the US. I never used one, but the Pill wasn't just birth control for me...so it was more like killing two birds with one stone....
The article makes sense......if you're not planning or ready to have a family soon, why take chances?
My OBGYN did tell me....if you're NOT in a monogamous relationship it is very important you use protection because your risk of PID (Pelvic Inflammatory Disease) goes way up!
@RocklinResident
This is actually a fairly common misinterpreted risk. The risk of PID does increase in the first few weeks after insertion, and is normally due to a woman having a pre-existing infection such as Chlamydia or Gonnorhea. The reason the risk increases "for a few weeks" is because that's generally how long it takes to get STD results back. STD testing is a must before an IUD isnertion so if your provider doesn't offer it make sure you ask. After your results come back normal you risk of PID goes back to what it is without an IUD.
OF COURSE it is always a good idea to use condoms anyway if you're not in a monogamous relationship or if your partner hasn't been tested. Cheers!
www.choiceproject.wustl.edu/
I had an IUD for between 4 and 6 wks... It fell out during that time, and I did not know. I refuse to use it again, because I dont want it to randomly fall out w/o my knowledge...
I cant stand the implant, because I would sit there and pick at where its located... Wont turn out well...
Me and hubby use the pill, with the hope and pray method... I already got pregnant on the pill before, hopefully it wont happen again anytime soon (and no, I did not mess up)
The only person I know that had an IUD was a married friend of mine that end up in the hospital with an extremely painful infection. It took the doctors days to figure out what was wrong with her, while wasting part of their time accusing her of making the pain up. Doesn't make me want to run out and get one.
Before you leave the office, your doc should show you how to check yourself to make sure the implant is where it's supposed to be.
I couldnt check it myself (couldnt reach it, I think they cut the strings to short), and my husband never felt it the few times we had sex after I had it in.
If someone is not in a monogamous relationship then they should be using protection anyways.
I thought a "no brainer" too, for some I guess it's not.
I've been on the hormonal IUD for almost 4 years now and I love it! I honestly don't even think about it. I get tested on a regular basis to make sure everything is healthy and the IUD stays put.
I happened to fall into the group of those with the hormonal IUD that stopped getting a period, which I enjoy. I've got no desire to have children and if the "motherhood" bug happens to bite me, I'll remove it and try away. For now, I'll be sticking with the hormonal IUD for some time.
"50% of pregnancies in the US are accidental." Wow, we got to work on that.
"Work on that" how exactly? If adults aren't able to take responsiblity for their actions, who should force them to do so? Maybe the government ought to bring back Eugenics and enforce forced sterilizations and abortions...its the only way to ensure humanity doesn't breed itself to extinction.
I think with 'work on that' we should look at why 50% of pregnancies are unintented and how that can be adressed.As the article points out-the more reliable BC methods,in particular the IUD-are not commonly used.Is that because health professionals do not support their use?Because women do not know enough about them?Or may have heard too many negative things about the method?Implants or IUD's seem to be a much more practical and cheaper BC method for women who know they do not want children or additional children.
Yes. Personal responsibility is a dying virtue.
both my pregnancies would be considered "accidental" even though I did not screw up on my BC. IUD didnt work for me either. I refuse to get the implanon because Im one of those people who would pick it at it... If they put it deep enough I couldnt feel it, then itd be ok, but they dont. So, I use other forms of BC, combined with the hope and pray method...
Thank you for featuring our research! For more information on our project, please visit our website: www.choiceproject.wustl.edu or join us on Facebook: www.facebook.com/choiceproject
One got past spell check. It's "depo" not "depot". Also, it seems logical that something that you don't have to remember daily would work better than something you have to take every day. Too bad so many in this country are determined to take away a woman's choice of how or even if she uses birth control. Having a child should be a wanted and expected event.
I take BC and take it in the evening every day. After years of being on the pill I am happy with that choice. As for people getting pregnant while on the pill, sometimes it is because people forget and then do not use a backup method or abstain. If you really do not want to get pregnant then you have to think! I cannot use condoms so the few times when I forgot to take my pill or was on antibiotics that diminish the pills effectiveness my husband and I simply did not have sex. I have been married for 14 years and have never been pregnant, so we must be doing something right. I am glad there are so many options available and I hope that women continue to have a choice in what birth control method to use.
I did not miss a pill, nor was I on any meds, when I got pregnant on the pill...
The only thing not mentioned is that most doctors wont give you an IUD or implantable if you haven't had kids yet. So of course the unplanned pregnancies in younger women is more significant because they aren't allowed to have the longer term options. When I was 19 I asked for an IUD because I was a college student and KNEW I didn't want kids for at least another 5 years. Every doc I went to told me no. I was upset and thought it was ridiculous for them to decide for me what was right/wrong. Once this mindset is altered then I'm sure we'll see less unplanned pregnancies from teens and 20 somethings.
there is a reason they dont like giving IUD's to someone who never had kids... Its not because they are being mean or something... Most drs wont do so, because it is extremely difficult and painful to put in, if you did not have kids yet.
I don't know why birth control is a political issue. Doesn't belong in the political arena. It sad to think that some girls who will become woman in the future might have limited options in that regard. That doesn't have to happen to them. Whenever someone tries to do this (make birth control options limited), then they (women it affects as well as other women) need to speak out and they need to vote. It's less likely that laws would be passed limiting or banning birth control pills if those who are opposed to this speak out or go to the polls in numbers. Maybe when one of these politicians isn't elected again because of these archaic views, politicians will take notice.
No method is without its pros/cons.... My wife uses the copper IUD. Very effective and no hormones.
It's very easy these days to remember to take your pill. I have my phone set with a daily alarm that makes an ominous sounding noise (different from any other alarm that I use) to alert me it's time to take my pill. I keep my pack in my purse, so I always have it with me, and I never leave without my phone. The pills are small enough that if I don't have water with me, I can still manage to swallow it down ok. There really isn't any reason for the irresponsibility of it.