Two in five women of childbearing age in the U.S. didn't use any birth control in the month before they took a new survey on contraception.  

The main reasons why these women skip contraception is that they think they are infertile or are not currently sexually active. But some may be placing themselves at risk for unintended pregnancy.

The new Contraception in America survey polled 1,000 women aged 18 to 49 and 201 doctors about their contraceptive knowledge and preferences. Taken together, the polls provide a snapshot of contraceptive use in the U.S. The survey was sponsored by Teva Women's Heath, which manufactures several types of contraceptives.

Calling the results “surprising,” Jennifer Wider, MD, says that many women are not using contraception, and the ones that are don’t always use it properly. Wider is the medical advisor for the Society for Women's Health Research, the nonprofit group based in Washington, D.C. that conducted the survey.

Most commonly reported types of birth control included birth control pills, tubal ligation, male condoms, and IUDs.

Some women may miss taking birth control pills. And there is also confusion on how long an intrauterine device (IUD) lasts, even among users. One in three women says an IUD lasts less than five years, when it actually lasts five to 10 years, the poll showed.

“Many women just don’t fully understand their risk for getting pregnant,” she says. “Women need to be proactive and begin a conversation with their doctor at their annual visit and discuss their options.”

More Poll Results

According to the poll:

• 43% of women who had been pregnant had one or more accidental or unintended pregnancy.  
• About 50% of these women report that at least one of these pregnancies may have been caused by birth control failure, such as a broken condom.
• One in 10 women on birth control reported a perceived failure in the past year.

There are also some disconnects between women and their doctors, according to the polls. The majority of doctors said they routinely discuss contraception with women of reproductive age. But women said they bring this up more frequently than their doctors.

“This survey tells us that a tremendous amount of basic contraceptive education is still needed for women of all ages and their doctors,” says women's health expert Dominica Moore, MD. She is president of Sapphire Women's Health Group in Far Hills, N.J, and a board member of the Society for Women's Health Research.

Contraceptive Education Needed

Just because a woman has never gotten pregnant naturally doesn’t mean that she can’t.

“Your chance of conception is like the stock market. Past performance is no predictor of future performance,” Moore says. “It just takes one egg, one sperm, and one time.”

Contraception counts, she says. “The incidence of unintended pregnancy among women in their 40s is as high as unintended pregnancy in teenagers.” Men also have a role and need to take responsibility for contraceptive choices and use.

The new findings suggest that it is time to change how doctors talk to women about their birth control choices, says Colleen McNicholas, MD. She is a clinical fellow in family planning in the department of obstetrics and gynecology at Washington University School of Medicine in St. Louis.

“We need to start with the most effective methods that require the least amount of women's time, such as long-acting reversible contraceptives (LARC), and work our way down,” she says. LARCs include IUDs and implantable contraceptives and are basically hands-off for women.

As it stands, most doctors start with the pill, which involves some diligence on a woman’s part. “For women who do choose the pill, education is needed to teach them what to do if they miss one,” McNicholas says.

SOURCES: Colleen McNicholas, MD, clinical fellow, family planning, department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis.Donnica Moore, MD, president, Sapphire Women's Health Group in Far Hills, N.J.Contraception in America Poll.Jennifer Wider, MD, medical advisor, Society for Women's Health Research, Washington, D.C.

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