Why Aren’t Women Using More Effective Birth Control?

A new study published in the New England Journal of Medicine found that the most popular methods of contraception – the pill, the patch, or the vaginal ring – are 20 times less effective than long-term birth control methods. Intrauterine devices (IUDs) and contraceptive implants are designed to stay in the body anywhere from 2-10 years, and provide continuous protection against pregnancy.

The study’s authors compared the rates of failure in various birth control methods in 7,500 women. Over the course of a year, 4.55 out of 100 participants on hormonal birth control became pregnant, compared to only 0.27 with a long-term contraceptive. Even more interesting – women under 21 had twice the risk of becoming pregnant on the pill.

Why? Mostly because it can be hard to remember to take a pill at the same time every day – and some hormonal methods aren’t very forgiving. Dr. Jeffrey Peipert explained his results to the Huffington Post, saying, “It’s the human factor. We just make mistakes sometimes. The long-acting reversible contraception methods are forgettable. You put them in place and they work very well.”

Still, the Guttmacher Institute has found that only 5.5% of women using contraception are using the IUD. (Even less have the implant.) Part of this is because of the faulty Dalkon Shield model in the 60s and 70s which caused infections and uterine perforations at an alarmingly high rate. It wasn’t very effective at preventing pregnancy, either. While this was the only brand of IUD plagued with these problems, the devices were wildly considered unsafe and fell out of favor for decades.

Now that newer, safer IUDs are available on the market, there’s another problem – many doctors simply don’t know how to insert them. And many doctors erroneously believe they are unsafe for use in women who haven’t had children.

Implants and IUDs are also expensive – while an $800 price tag spread over 10 years is less costly in the long run, it may be harder for women to come up with than $20 for a month of the pill. Women without insurance, or with only partial coverage, will usually find the cost prohibitive.

Dr. Sarah Bedstadt, an assistant professor in the department of obstetrics and gynecology at the University of Rochester, told the Huffington Post, “In this country, the default birth control has always been birth control pills. This study really shows that there are much more effective methods. That’s not to say that all women should be using these methods. But women should have the information they need chose what’s right for them.”

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Photo credit: Beatrice Murch


Lika S.
Lika P5 years ago

And it's also a proven fact that these devices can mess up hormones and long term use can affect if you can become pregnant in the future or not.

So, why are we preaching about birth control for women's use, when it can mess up women's health, in so many ways such as high blood pressure, allergies, and more? My cousin has to go through treatments to force ovulation or she'll have an aneurism in her ovaries, and this is due to long term use of the pill.

Condoms with proper use is just as effective as anything else in preventing pregnancy AND its also good for staying safe from most STD's. Yet no one wants to talk about that. And if you have an "oops", you don't have to run to the doctor to take the device out or suffer the consequences.

Jennifer Walsh
Jennifer Walsh5 years ago

thanks for the info

Amber Beasley
Amber Beasley5 years ago

Natural Family Planning. it works, you don't have to pay for it, and it doesn't screw up your hormones.

Corey Mondello
Corey Mondello5 years ago

woman arent even paid the same as men, and still expected to work full time and raise a family if they want to be considered "successful" TV, Movies, Books, etc, all still teach that a woman is a second clas citizen and add to this, all the Conservative Christians in the Republican Party who are trying to legally take away their rights. Young girls are still taught being pretty is more important than anything else, and most of their moms tell them to be succesful and go to school at the same time, and then their daughters look at their moms who have dropped everything to be stay at home moms. what kind of message are we sending out girls? u dont have to live in Iran or some other place where stoning is still legal to be a culture that teaches females that they are not as good as men. When Abrahamic religions are the basis of teaching, (Judaism, Christianity and Islam) woman are always considered second class citizens, seeing as conservative Christians have taken over the Republican Party, you can see just how horrible this is for woman in America,

Phillipa W.
Phillipa W5 years ago

I wouldn't ever use these "more effective" ones for one simply reason - their safety. One single shot of depo provera left me bleeding out solidly for a full 8 months. Then I discovered it feeds cancer cells, causes hair loss, thyroid damage, osteoporosis, and the list goes on and I personally was left feeling angry and betrayed that it was legal after discovering just how bad it can be and the genuine rates of side-effects. I looked into implanon and discovered it's very similar in composition. An IUD? No way. Never, ever ever. Nuvaring? Same ingredients as depo - which is very different to the pill, although I was lead to believe it was similar by the information leaflets. Only to discover these new hormonal contraceptives are nothing like the ones I was using effectively for years (the pill).

Christine Stewart
Christine S5 years ago

The older IUD's that had so many problems likely scare people off, and the hormone rods require minor surgery to implant AND take out at a great cost. Another reason for occasional birth control pill failures is antibiotic or alcohol use can render the pills less effective. one pharmacist told me keeping the pills in the bathroom was a no-no because the humidity from showering could affect the pills?..

Karen Howard
Karen H5 years ago

We have to accept the fact that not all methods of birth control work. I knew a woman who got pregnant with her first child while on the pill, her second child while using an IUD, and the third while using a diaphragm.
Like the brakes on a car--sometimes things don't work like they should, no matter what precautions we take.
With regard to the pill, IUD and surgical implant, think of the TV commercials from lawyers offering to handle your case if you suffered any side effects from any of these methods. (Most recently Yaz.)
If both parties want to have sex, both should take responsibility for contraception. If a man doesn't want to be a father, or if he thinks his partner might "trick" him, he should consider his options. Many men seem to be more concerned with Viagra than condoms.

MEGAN N5 years ago

Even if a pregnancy is accepted by both parties and both agree to be responsible for the child the man still is given a back seat in the child's life with practically no rights to his child. I am not anti woman or anti mother or anti abortion or anti anything like that but I do see an uneven distribution of rights between the TWO people involved with the creation of the fetus as soon as the fetus is discovered.

I am also not saying that there aren't bad guys out there but I just wish that every once in a while people would recognize the fact that men are not always the bad guys and sometimes they are feeling like a victim.

I have know more than one woman who has done this to a man and even bragged about it and I know of at least one man who had a girlfriend dump them because they were inconvenient (she wanted to move across the country and if he knew he was the father he would want to see the baby and arranging for visits was "too much work" so she decided not to tell him) only to reappear in their life years later with a child they never knew about and a label of dirt bag ready to stamp on his head for all the world to see. But thats ok right because men all suck and deserve what they get.

MEGAN N5 years ago

It is an issue for any and all people having sex who do not want children. You may get pregnant even if you are very careful about your birth control. The issue I see is that while women have a multitude of options for their birth control men only have 2 condoms or surgical sterilization. Also when a woman gets pregnant she is the only voice of import when deciding what to do about the fetus, even if she were to deliberately damage a mans condoms to get pregnant or on the other if she was careless with her birth control.

So basically if a woman wants to get pregnant and does so by treachery she gets to label the man who impregnated her as a dirt bag and gets money in support for up to 21 years while the man has almost no rights (2 weekends a month is not really going to provide a relationship with the child is it) and is labeled by the mother, the courts and society as a bad guy.

On the other hand if a woman gets pregnant by carelessness with her birth control and wants to abort the would be father has no right to an opinion at all and if he voices anything even sounding like regret over the loss of his potential child then he is a bastard and little better than a rapist in the eyes of society.

Even if a pregnancy is accepted by both parties and both agree to be responsible for the child the man still is given a back seat in the child's life with practically no rights to his child. I am not anti woman or anti mother or anti abortion or anti anything like that

Tierney G.
Tierney G5 years ago

David r says "the greatest injustice in the sex arena today centers on the army of men exploited and harnessed to child support payments over 18 years for a child he neither wants nor even gets a chance to see. no wonder men go over the hill, the injustice is monstrous and women are silent or compliscent in it"

My answer is simple keep your pants zipped or get snipped. Hey thats what we women have been told by men and you men don't even have to through the pregnancy the birth and then the 24 hrs a day care whether your sick or not for well over 18 years as well as pay pay pay!
I just can't relate to what men must have to go through (snark)