Birth Control Effectiveness: Women Believe It Works Better Than It Does

The Huffington Post Canada  |  Posted: 05/01/2012 12:59 pm Updated: 05/01/2012 1:41 pm

Not interested in getting pregnant? Then perhaps you'll want to reconsider how much you rely on the Pill -- or condoms, birth control patches, vaginal rings and injections.

Reuters recently reported on a study in the American Journal of Obstetrics and Gynecology that found about 45 per cent of women overestimated the effectiveness of the Pill and condoms, which showed a nine per cent pregnancy rate with "typical use" of the Pill, and between 18 to 21 per cent with condoms.

Meanwhile, for the far less common intrauterine device (IUD), the unplanned pregnancy rate shoots down to between 0.2 per cent and 0.8 per cent. According to Planned Parenthood, that's on par with vasectomies, female sterilization and implants at less than 1 pregnancy per 100 women a year, though another birth control method is suggested for three months after a vasectomy.

SEE: There are ways to make your birth control more effective -- here are bad birth control habits you didn't realize you had. Story continues below:

Loading Slideshow...
  • Timing

    Pills work best if they're taken at the same time each day -- which is often difficult for women to remember.<br> (Photo courtesy of <a href="http://www.flickr.com/photos/duck/" target="_hplink">Flickr/canardo</a>)

  • Taking Antibiotics

    It's not as common as it once was, but antibiotics can occasionally affect the effectiveness of your birth control pill. Ask the doctor who prescribed the antibiotics about any potential interactions.<br> (Photo courtesy of <a href="http://www.flickr.com/photos/sheeppurple/" target="_hplink">Flickr/Sheep purple</a>)

  • Talking About It With Partner

    While it can be difficult with a new partner, avoiding the subject of birth control won't make it go away, particularly if you've already started having sex. Get past sexual histories, concerns and preferred methods out in the open as soon as possible to make this work for everyone.

  • Buying The Wrong Condoms

    Besides also being more comfortable for both partners, ensuring you have the right condom size can mean it's less slightly to break (if it's too tight) or slip off (if it's too small).<br> (Photo courtesy of <a href="http://www.flickr.com/photos/robertelyov/" target="_hplink">Flickr/robertelyov</a>)

  • Be Open To Change

    The Pill isn't the be all and end all of birth control options - investigate alternatives if you're not all that into the Pill, or if it's giving you some adverse side effects. Options like the intrauterine device (IUD) shown here are quite common, and could even be more effective.<br> (Photo courtesy of <a href="http://www.flickr.com/photos/stickypearls/" target="_hplink">Flickr/+mara</a>)

  • Consistency

    Forgetting to take their Pill is more common than most women would like to admit, and it can certainly impact the risk of pregnancy. Missing one day is generally believed to be fine, but you should probably opt for back-up for a week after just in case.<br> (Photo courtesy of <a href="http://www.flickr.com/photos/shimrit/" target="_hplink">Flickr/Shemer</a>)

  • Adding On Protection

    Similarly, the first week -- and more cautious people say even month -- of starting the Pill, use a condom, as the hormones won't yet be as effective as they could be. <br>(Photo courtesy of <a href="http://www.flickr.com/photos/jennyleesilver/" target="_hplink">Flickr/Jenny Lee Silver</a>)

  • Using The Wrong Tools

    Oil-based lubricants shouldn't be used with condoms, as they can break down the latex and therefore increase the risk of pregnancy. Always opt for water-based lubricants.

  • You Take It Out Too Soon

    For birth control methods like sponges and diaphragms that require removal, women can make the mistake of taking them out too soon -- each should be removed six hours after sex, but shouldn't be kept in any longer than 30 hours.<br> (Photo courtesy of <a href="http://www.flickr.com/photos/ideonexus/" target="_hplink">Flickr/Ryan Somma</a>)

CLICK HERE FOR SLIDESHOW TEXT

Study leader Dr. David L. Eisenberg told Reuters Health that information is key to prevent unwanted pregnancies.

"We need to do a better job of educating the public -- women and men -- on the failure rates with typical use," he said.

Birth control patches have been found to have approximately the same efficacy as the Pill, as does the vaginal ring -- only a 1 in 100 chance of an unplanned pregnancy if used properly, and a 1 in 9 chance if used improperly.

Last year, The Society of Obstetricians and Gynaecologists of Canada (SOGC) released a game, Birth Control Brigade, with that very intention.

“Our hope is that adopting a game format will allow messages about the array of hormonal contraceptive options and the importance of responsible and healthy sexuality to have a positive impact on the contraception choices they make,” said the SOGC's Dr. Edith Guilbert in the press release.

SLIDESHOW TEXT

Timing
Pills work best if they're taken at the same time each day -- which is often difficult for women to remember.

Taking Antibiotics
It's not as common as it once was, but antibiotics can occasionally affect the effectiveness of your birth control pill. Ask the doctor who prescribed the antibiotics about any potential interactions.

Talking About It With Your Partner
While it can be difficult with a new partner, avoiding the subject of birth control won't make it go away, particularly if you've already started having sex. Get past sexual histories, concerns and preferred methods out in the open as soon as possible to make this work for everyone.

Buying The Wrong Condoms
Besides also being more comfortable for both partners, ensuring you have the right condom size can mean it's less slightly to break (if it's too tight) or slip off (if it's too small).

Be Open To Change
The Pill isn't the be all and end all of birth control options - investigate alternatives if you're not all that into the Pill, or if it's giving you some adverse side effects. Options like the intrauterine device (IUD) shown here are quite common, and could even be more effective.

Consistency
Forgetting to take their Pill is more common than most women would like to admit, and it can certainly impact the risk of pregnancy. Missing one day is generally believed to be fine, but you should probably opt for back-up for a week after just in case.

Adding On Protection
Similarly, the first week -- and more cautious people say even month -- of starting the Pill, use a condom, as the hormones won't yet be as effective as they could be.

Using The Wrong Tools
Oil-based lubricants shouldn't be used with condoms, as they can break down the latex and therefore increase the risk of pregnancy. Always opt for water-based lubricants.

You Take It Out Too Soon
For birth control methods like sponges and diaphragms that require removal, women can make the mistake of taking them out too soon -- each should be removed six hours after sex, but shouldn't be kept in any longer than 30 hours.

FOLLOW CANADA LIVING

Not interested in getting pregnant? Then perhaps you'll want to reconsider how much you rely on the Pill -- or condoms, birth control patches, vaginal rings and injections. Reuters recently report...
Not interested in getting pregnant? Then perhaps you'll want to reconsider how much you rely on the Pill -- or condoms, birth control patches, vaginal rings and injections. Reuters recently report...
 
 
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02:12 AM on 05/09/2012
Speaking of errors, someone needs to proofread and edit 2 out of the caption for photo 4. It's unslightly. Get it? I guess when it comes to penises, thinking 'too small' is more common than 'too big' but condoms that slip-off are not too small.
03:17 PM on 05/03/2012
Just call me 0.2 to 0.8 percent. Love my baby though, no regrets!
01:59 PM on 05/03/2012
i wonder if the same is true about expectations for preventing diseases in the cases of the various barrier methods....
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mrportman
01:57 PM on 05/03/2012
"We need to do a better job of educating the public -- women and men -- on the failure rates with typical use," he said.

How about a better job of educating people on how to use contraceptives? In this day and age, a pregnancy should never be a surprise.

My wife has issues with migraines and aura, which is a big red flag for hormonal contraceptives, and we decided to give the "heat" method for men a try. Luckily, we're almost ready to have children so it'll be a welcomed surprise if our experiment.
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zmfts
Whatever doesn't kill you makes you walk funny.
01:19 PM on 05/03/2012
Clearly, "birth control" is not the correct term for today's contraceptives. I propose the term "birth discouragement."
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mrportman
01:58 PM on 05/03/2012
As usual, it's human error that is the issue and very rarely the product itself.
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01:24 AM on 05/04/2012
Truly. I really dislike how this article just brushed over that fact. "Typical use" is not the same as "proper use." And you know what, there are very clear and simple directions that come with every pack of birth control pills.

I'm surrounded by girls on the pill and they seem to "woops missed a pill!" ALL the time. Really? It's not that complicated. It's within your control. If you use a medication improperly and it does not work, that is not the medications fault. The medication didn't fail. You did. At the very least people need to be taking accountability for that.
06:28 AM on 05/03/2012
Firstly, you truly do only need to use back-up for a week after missing a pill (and even then it depends where in your cycle the missed pill was and how many you missed as to whether you need back up at all). Secondly, used perfectly, the pill fails in 1 in every 3,000 users. We aren't talking about birth control failure here, we're talking user error. Thirdly, the only antibiotics that effects serum levels of the pill to the point that it would be ineffective are those used to treat TB.
02:40 AM on 05/03/2012
I adore my copper IUD. I had tried several different pills, which raised my blood pressure. Depo Provera, which caused weight gain and depression. Nuva Ring-- that one was pretty good, but the insurance company stopped paying for it and it is $80/month. Getting off hormones was very good for me, both physically and emotionally. It helped my marriage, if you know what I mean. We have a tiny chance of an unplanned pregnancy. And when we do want to get pregnant, I will be fertile right away. Oh, and the wonderful organization Planned Parenthood did the whole insertion for $240, a fraction of the $1000 my OB/GYN was going to charge. And my IUD is effective for a decade.

I'm 24 and have never been pregnant. I had some additional cramping and heavier bleeding the first few months. Love my IUD, seriously. Added bonus: occasionally pisses off social conservatives.
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Seattle Noir
I'm not a chocolate dipped white girl.
11:43 AM on 05/03/2012
Right there with ya I have the Mirena 5 years (second round) and most of my friends have them as well. No worries about pregnancy and no right wing wack job trying to keep it way from me, I think if more women used IUD's the coservatives would have a heck of a time trying to control womens bodies. And I am sorry you had to pay even $240, mine was a $20 copay with my insurance each time and I haven't looked back.
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mrportman
02:01 PM on 05/03/2012
IUDs have caught a bad wrap. Most don't realize that the safety profile has significantly increased over time.
03:14 PM on 05/03/2012
After 3 children my hubby and I decided no more. Neither of us wanted to have surgery to be steirlized so I got a copper iud. Wellll, call me .8%. When our son was a year old I found out I was pregnant. My OB told me most likely the pregnancy would expel aka miscarriage. Well, the iud expelled instead. We now have 4 beautiful perfect children! After baby #4 I had a tubal done, then had to have a hysterectomy (kept overies). Yeah if I get pregnant now there is a big problem! BTW Love the hysterectomy! Monthly things I don't have to deal with anymore!
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BrotherRog
author, Kissing Fish: christianity for people who
09:47 PM on 05/02/2012
One a related note, As I understand it, birth control pills also affect women's sense of smell and shifts the pheromones that they seek in a mate. Trouble is, when they marry, go off the pill, and get pregnant, etc... they revert to the original pheromones that they were originally looking for before they went on the pill, and many women lose attraction to their mate. This may well be part of why 50% of marriages end in divorce.

To the extent that this is true, condoms and IUDs may be a better way to go.
08:37 AM on 05/03/2012
Women go on BCPs for a lot of reasons other than to prevent pregnancy. It allows women to regulate their periods and in a lot of cases, skip them if they want. Menstruation is a burden. While I have read that before, what you are talking about, there simply is no proof of any cause or even correlation of what you speak. More to the point, when in committed relationships men seem less likely to want to wear condoms. Actually given the low failure rate of hormonal birth control we can pretty much assume unwanted pregnancies are caused more by not using condoms or using them incorrectly so a lot of guys simply arent wearing condoms in general.

In short, not a simple issue.
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mrportman
02:15 PM on 05/03/2012
There you go again - still harping about men and condoms. Yes, this post isn't as bad as some of your others, but you still only highlight the errors of men. In this case, you make no mention of significantly higher failure rate of hormonal contraceptives due to human error (9% vs the.3% if used properly). Condoms are significantly harder to use than remember to take a pill every day at the same time when one considers that we're not adequately taught how to determine the appropriate size, how to put one on, proper storage, etc.
That's not to say that I am of the opinion hormonal contraceptives are perfect.
Their use should be carefully thought about in terms of the long term effects of increase shbg levels (7x higher for women who have used hormonal contraception as compared to those who have not).
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03:49 PM on 05/03/2012
"While I have read that before, what you are talking about, there simply is no proof of any cause or even correlation of what you speak."

And that is why the word "may" was used in that hypothesis: speculation (which does not require evidence, just thought or a discussion of the possibility).
06:10 PM on 05/02/2012
I never understood the Diaphrams...they seem too big and are they effective?
11:23 PM on 05/02/2012
I tried the cervical cap once and hated it. It wasn't that difficult to insert but it sure was a pain to remove. What's worse is that it trapped secretions all the time it was in and they came gushing out when I got the cap out. My gynecologist at the time told me that if I hated this method, then I definitely would also hate the diaphragm because it works the same way.
09:57 AM on 05/03/2012
yikes. yay for new and innovative forms of birth control!
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Gilbert Albright
02:55 PM on 05/02/2012
THE PILL is responsible for the epidemic of breast cancer. Prior to the introduction of the The Pill, breast cancer was minimal. Since its introduction, breast cancer rates have skyrocketed and the it occurs earlier and earlier in each successive generation that uses it.

Of course the Government and Pharmaceutical companys will never admit it with billions of dollars at stake. They just poo poo the obvious and say there is no evidence of it.

Well the statistics don't lie. The before and after numbers tell it all.
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Katie Wray
03:09 PM on 05/02/2012
correlation doesn't necessarily mean causation.
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Gilbert Albright
10:58 PM on 05/02/2012
But 2 plus 2 equals Four.
09:50 PM on 05/02/2012
Post Hoc argument.
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jf12
When I saw her I marveled greatly.
02:43 PM on 05/02/2012
Are women "out in the open" about past histories?
08:54 AM on 05/02/2012
i've taken levlin for four years and never had a scare, usually same time everyday and i think i've forgotten to take it twice? i'm just one person but i'd say it's very effective if used correctly. although i could only listen in horror when one work mate told me that she got pregnant 'cos she wasn't good at remembering to take the pill everyday, cos it's like a pain, you know?' 0_o

it's a magic pill that wards of unwanted pregnancies! pregnancy is pretty serious! you know?! *face palm*

theirs no getting through to some people.

i'm a big believer in using condoms the first couple of months on the pill. better to be safe than sorry. also carrying your little packet in your wallet has saved me from taking it later or missing it entirely so many times! most of us tend to take our wallets everywhere.
08:40 AM on 05/03/2012
"theirs no getting through to some people."

Dude, for real. I recommend always using condoms (even with the use of BCP or other hormonal birth control) unless youre in a committed relationship and know your partner has been tested.
09:48 AM on 05/03/2012
exactly. i'm in a committed relationship but for those who aren't until you've both been tested never ever ever ever ever (i really could go on forever) have sex without a condom. period. sometimes i think some avenues tend to emphasize pregnancy and condoms over the STD part.

i wish everyone had all the information and common sense to follow through with these measures every time.
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mrportman
02:32 PM on 05/03/2012
The wallet is not an ideal place to store a condom.
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GoldwaterKid
Vote Person, Not Party
01:19 AM on 05/02/2012
This is a very funny article. When the pill was in it's beginning stages in the 1960's, one of the things that was discussed among OB/GYN doctors was that if you don't take the pill at the same time, within even a two hour period, it isn't 100%. If you miss a pill, don't have sex for seven days.

Which is why the IUD was so popular to many, many women.
11:28 PM on 05/02/2012
The problem with IUDs was that they often led to pelvic inflammatory disease, which left many women permanently sterile. One model, the Dalkon shield, was taken off the market and doctors began to not recommend using them to their female patients. In the years since, they have made a comeback but a lot of doctors are still reluctant to use them on women who have never been pregnant.
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GoldwaterKid
Vote Person, Not Party
11:44 PM on 05/02/2012
Great to see a comment and reply.......

Yes, they were a little tricky in the beginning and they did have a recall as many products do at times. The IUD is so much better than the pill, because of the chemicals being put into womens bodies.

My parents had a best friend that was an OB/GYN during that time, and he was so interesting to talk to about birth control at the time. So much different than what kids actually knew at the time.
09:09 AM on 05/03/2012
Well, the Dalcon Shield was *one* IUD in the many we've had since then. And the main issues with it were, first, it's basic design - the doctor who designed it wanted to make sure the sucker stayed so he put multiple arms on it - which ended up digging into women's uterine walls and creating scar tissue. Second, because it was designed to STAY, the strings broke when trying to remove them, that's how the wicking thick string was introduced, which wicked infections from the vagina into the uterus. It was a HUGE mess, but exclusive to that one design.

It's a shame IUDs still have that reputation when the ones now don't resemble the DS at all. In the US only 2% of women use IUDs when it's more effective than sterilization. In Europe, the range is 10-26% of women use IUDs. I've never had children and I've had my IUD for 2 years - no complications - just angry I didn't get it sooner!
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08:45 PM on 05/01/2012
Read somewhere quite a while back that the drug companies were reducing the amount of the effective drug in each pill to minimize side effects; this could contribute to any problems with effectiveness?
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mrportman
02:38 PM on 05/03/2012
Not at all. When the pill first came out, the hormones levels in it were way too high (overkill) causiing significant side effects. Hormone levels have slowly been decreased without decreasing the failure rate.

Sadly, it's human error that is the issue here.
02:39 PM on 05/01/2012
So, it's not that birth control is less effective than women think, it's that they don't use it correctly. Big difference, and probably accounts for a lot of the "I got pregnant on the pill" stories.
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onionboy
Blessed are the Cheese Makers
03:14 PM on 05/01/2012
It's funny. I've heard that story from two friends. As the years have passed, the confessions have come out.
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inapickle
05:28 PM on 05/01/2012
I'd say it's both. Most people think they 100% will not get pregnant on the pill, when in reality 1 in 100 women who take it perfectly will get pregnant. If you don't take it perfectly, the rate rises. Most forms of birth control are believed to have higher efficiency than they do and many people don't use them perfectly on top of that.
08:49 AM on 05/03/2012
It's the same for any birth control. You wouldnt believe the number of guys who dont use the correct size of condoms or who dont know how to correctly use them, either of which can result in tearing.
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mrportman
02:44 PM on 05/03/2012
You post implies that it's difficult to use the pill "perfectly," when it's not. Take one pill at about the same time daily. It's one of most effective forms of contraception to date. The failure rate jumps at least 8x due to human error.

Don't get me wrong, I'm not saying guys are any better. People are just plain irresponsible.