You may hear us talk a lot about annual typical-use pregnancy rates when we refer to contraceptives like the condom or Pill. What we’re talking about here are the annual pregnancy rates for everyone that uses a particular method.
Typical use means everyone, including people that use the method perfectly and those who are inconsistent. The way we know these numbers is through the National Survey on Family Growth. And it’s just been updated.
Here are the changes for the annual, typical-use pregnancy rates by contraceptive:
Condoms 18% -> 13%
Withdrawal 22% -> 20%
Pill 9% -> 7%
Injectable 7% -> 4%
The nice part about these rates is that they all went downward. Since there’s been no real change in the contraceptives themselves, that means that folks have been doing better about using contraceptives correctly and consistently.
As a note of caution, these rates have naturally fluctuated over the years. Check back ten years from now and we may be looking at higher rates. Since these rates are lower than usual, a higher rate later on may be what we expect due to a phenomenon called regression to the mean. But these current numbers give us a reasonable snapshot of where we’re at for now. Indeed, the National Survey on Family Growth is the source for how we estimate typical-use pregnancy rates.
You can find an earlier article on exactly how contraceptive pregnancy rates work. But here’s a quick look at how you can use this information.
First, what kind of typical-user are you? Say you use a condom as your primary method of birth control. Do you use it correctly? That is, have you squeezed the air out and left space at the tip, did you roll it on right the first try, did you avoid biting open the package, did you store it properly, did you check the expiration, did you put it on before insertion, did you avoid an oil-based lubricant, did you hold the base of your penis when you withdrew, and most importantly of all did you use the condom consistently whenever you had sex? Those are a lot of details.
Now that you’ve got an idea of where you are, start off at the base rate, which now is 13%. Then you’d ask yourself whether you were more likely or less likely to make mistakes. To the extent that you’re more likely to make these mistakes, your estimated pregnancy rate would be higher than 13% over a year. To the extent you’re less likely to make these mistakes, your estimated pregnancy rate is lower than 13%. And if you are flawless and use a condom consistently and properly every time, then you can estimate your annual pregnancy rate risk near 2%, the perfect-use rate.
You can take this same idea and apply it to other contraceptives that involve potential user error. Think of contraceptives like the Pill, an injectable, or withdrawal.
If you’re looking at these numbers and nervously shaking your head, then it may be time to double up methods. If you or your partner are comfortable with a method that doesn’t involve user error, that tends to be a safer route. Here’ we’re talking about methods like an intrauterine device, implant, or sterilization (if you’ve made a final decision).
You may also find yourself in a special category. The survey analysis indicated that those below the poverty line experienced pregnancy rates at three times the rate compared to those at more than 200% the poverty line. Those in public schools experience a wide range of depth in sex education from medically accurate contraceptive information to no contraceptive information at all. It’s possible that the range of opportunity for sex education influences the discrepancy in contraceptive failure rates between economic classes.
Another unique category was for partners who lived together. Unmarried partners who lived together experienced pregnancy rates 50% higher than those who didn’t live together or were married. If this is you, this is something to factor in when estimating your risk and considering the contraceptive(s) that work for you and your partner.
Overall, it’s great that the contraceptive pregnancy rates went down. But just remember. Sloppy contraceptive use is still risky and has serious consequences. So don’t go getting overconfident.