I know of several people who have had unwanted pregnancies, yet I cannot think of anyone who had one while properly using at least one form of effective birth control. Rather, every case involved immense (and sometimes monumental) stupidity. Case in point: the couple that got pregnant while using the rhythm method but had reversed it so they were only having sex during her most fertile times.
So, does anyone know of any kind of study that compares the frequency of unwanted pregnancies through failure of the birth control method to unwanted pregnancies where there was no method used/ineffective method used/effective method improperly used. Examples of an ineffective method would be withdrawal and improper used would be taking birth control pills irregularly.
Note that I am not looking for personal anecdotes of birth control method failure, as I am sure it happens on occasion, but rather a picture of relative frequency. Thanks.
Such statistics are gathered on all birth control methods. They are called “typical use” or “actual failure” rates, as opposed to “perfect use” or “theoretical failure” rates.
I am assuming those are “% pregnant after a year of self-reported use”, correct? Based on my experience of how people *actually * use birth control when they claim to do so, those numbers seem fairly reasonable. However, I would expect that if you specifically isolate people who every single time used the method correctly, the practical numbers would be lower than theoretical not higher. I understand the difficulty of conducting a double-blind study on something like this ( ) but have there been studies with professional supervision that are normalized to # of acts of intercourse rather than time period?
Heck, I know two women who became pregnant after having tubal ligations! ANYTHING can fail, other than surgical removal of either both ovaries or the uterus.
I had a friend who got pregnant on Depo, which is about as fail-safe as you can get assuming you get your shots on time. And yes, she was getting hers on time.
The only way to be completely safe is to either never have sex or not have a uterus. Any of us could be in that small percentage (depending on method) who get pregnant anyway. Apparently the biology of reproduction is rather strong.
I looked there but didn’t find anything. Thanks though.
Nope, that is not what I am talking about. That kind of information is easy to find. What I am looking for is something that would look like this:
Of unplanned pregnancies in XXXX:
Y% were due to lack of use of birth control
Z% were due to use of ineffective birth control methods (withdrawal, etc)
Q% were due to failure of generally effective birth control methods (pill, condoms, etc)
In other words, we know that all birth control methods have failure rates but I am wondering how many pregnancies result from those failure rates versus not using anything at all. MLS and whiterabbit:
Let me get at some of the reasons I am asking and it may help people understand what I am looking for better.
If it turns out that the vast majority of unwanted pregnancies occur because people do not use any form of birth control (most likely I believe), then our efforts as a society to reduce that number would be best spent towards providing easy access to them and convincing people of their need (also removing the idiotic fallacies such as not being able to get pregnant your first time).
If most come from use of useless methods (probably comes in second), then we need to concentrate on instruction in what works and what doesn’t work.
If it is in failure of generally effective methods, then it is a more simple matter of better instruction in use, or perhaps we might have to accept that we are close to as good as we are going to get in reduction of unwanted pregnancies. I think this last possibility is not even close to the truth, but I want to be able to confirm or deny my hypothesis.
Not using anything at all gets you about a 85% annual “failure” rate. Anything other than that is due to some contraceptive effect, or individual fertility problems (or, of course, just the way statistics work). Those actual failure rates are the, well, actual failure rates. The difference between the theoretical and actual failure rates are those pregnancies caused by user error, which includes not actually using the method claimed. So in any given year, about 14 babies are conceived for each 100 couples using condoms. Since we can assume that 3 “condom babies” would be conceived just due to the limitations of the condom system (aka “theoretical failure rate”), that means 11 babies are due to user error (or lying about use). You can’t really separate out the “Uh, I guess leaving the condom on the hot windowsill made it break” from the “We said we used a condom so our parents wouldn’t kill us, but we didn’t really.” Liars, of which I agree there are many, are hard to tabulate. 'Cause, you see, they lie.
As for the difference between ineffective methods and failure of generally effective methods, that’s gets into sticky definitions of “ineffective”. Even the worst on the chart (which, while not specified well on this chart, would be the calender method of NFP aka “The Rhythm Method”) is better than nothing at all - so it is literally “effective”. Not effective enough for me to choose it, personally! We each have our own dividing line, I guess. But for a person who isn’t all that worried about pregnancy, it might be effective enough for his/her purposes. As for your last question, if a high number of babies were concieved because of failure of generally effective methods, then they wouldn’t be generally effective, would they?
I have a stake in this thought exercise as well: not only am I one of those anecdotes you don’t want to hear about (sponge, extra spermicide and unbroken condom on my first time), I’m (now) a proponent of symptothermal FAM. It’s theoretically a very, very effective method of birth control with absolutely NO side effects, but between confusion as to what it is and isn’t (it’s NOT rhythm) and people dicking around who don’t follow the procedure properly or get “caught in the moment” and have unprotected sex during their fertile time when they KNOW they’re fertile, it gets a bad rap. It’s down there on the theoretical 1% part of the FDA chart, but even there it gets crammed in with other, far less effective, forms of natural family planning.
Probably not ever going to get a good hard real number unless you sort out unprotected extra-marital encounters. IIRC Several numbers between 3% and 7% have been tossed around as to children not being fathered by who most people would expect.
WhyNot, this is still not quite what I was asking. I have found lists of relative effectiveness all over the place, both theoretical and in practice. What I am looking for is number of actual unwanted pregnancies (or percentage of the whole) that came from these different methods. Here is a result that would be in the form I am looking for (completely made up numbers):
In 2007 there were 1 million unwanted pregnancies:
500,000 (50%) were due to a lack of use of birth control
300,000 (30%) were due to use of an ineffective birth control method (e.g. Coca-Cola douche)
200,000 (20%) were due to failure of a commonly accepted birth control method
There is of course disagreement over what constitutes effective birth control, but this is just an example, I’ll take the data however I can get it. whiterabbit, not yet, but I am trying to make myself more clear. drachillix, I realize that it will be difficult to get good numbers, but there are much higher sources of error than marital infidelity. How would people record unwanted pregnancies that result in miscarriage? How do you even get the data in the first place? I was just hoping that someone had enough information somewhere to get a relative order of magnitude.
How can you even find that? Unwanted pregnancies aren’t reported in any way, so I don’t how that data could be compiled. Chill out, people are just trying to help you.
of the reported pregnancies in 1980, 1 occurred while using a rubber - it broke.
of the reported pregnancies in 1983 1 occurred while using a rubber - it broke and ortho-novum tricyclin [used properly, not missed and not on any other med.]
of the reported pregnancies in 1996 1 occurred to a person who had her tubes tied in 1984.
After spending an hour looking through soc/anthro/etc. papers on the subject, I have found that the numbers tossed around the academia as to misattributed paternity are in the range of 1% to 30% with something like ~10% worldwide and 3% US averages. I have the citations at home if anybody wants them, but I’d hardly call that an insignificant source of error.
If I understand this correctly, then the information WhyNot gave as to theoretical and practical effectiveness would be sufficient, if combined with statistics on how often each method was used (including the null method), and the total number of unwanted pregnancies. Does this sound correct?
Wow, the 30% number is a lot higher than I would have thought. If we are using US data, though I think it would be very optimistic to think that we could get near 3% accuracy. As other posters and I have mentioned, I don’t even know how we could get the data.
[edit]Oh, and thanks for spending so much time looking into this. I appreciate the effort.[/edit]
Yes, I think it might. I had considered trying something like this, but I was not able to find numbers on relative use and was hesitant that combined factors of error might become large enough to wash out any real statistical result. I think you might be right that is the only way we could get an estimate though.
[quote=enigm4tic]
Excellent! I will go through those and see if I can find anything. Thanks.
) but have there been studies with professional supervision that are normalized to # of acts of intercourse rather than time period?