If you have used any method of birth control, taken a health class, talked to a doctor about sex or even just picked up a box of condoms, you have no doubt been exposed to a general idea of how effective each method is (with regard to preventing pregnancy, which is the focus of this article. STD protection is another story).
If you have used any method of birth control, taken a health class, talked to a doctor about sex or even just picked up a box of condoms, you have no doubt been exposed to a general idea of how effective each method is (with regard to preventing pregnancy, which is the focus of this article. STD protection is another story). Listed in the information that comes with your pills or condoms or the literature from your doctor or (shudder) online, is usually the failure rate of that method expressed as a percentage. Simple enough, right? Well, actually (try to look surprised), it’s not.
The data listed is technically accurate, because it would be extremely illegal to misrepresent it, but it is framed in a way that could be inspiring quite a bit of misplaced confidence. The first bit of confusion arises from the fact that most people don’t understand that the rates expressed are not a representation of the lifetime of the product’s use; they only cover the first year of use. While the packages or literature do say that, it’s usually asterisked and in fine print somewhere in the sidelines.
The second problem is far more troublesome. Most of the packaging, literature and even informational websites about birth control’s effectiveness contain the dirty little phrase “perfect use.” What “perfect use” means is that the failure rate you are seeing is the percentage of unintended pregnancies during the first year of use under absolutely machine-like lab conditions with scientists controlling and ensuring absolute adherence to the use guidelines set by the manufacturer or medical community. What perfect use does not mean is that you used the method responsibly, but under real-world conditions. The term for that is “typical use.” The trouble with listing perfect use instead of typical use is the false trust it creates in the product, since the failure rates vary wildly and some methods prove more effective in real life than the ones that are just as good under lab conditions.
Since the lab that determined your contraceptive’s failure rate won’t be taking the baby you have when it fails despite what their data told you, it’s probably best to know exactly what the real-world failure rates are. That’s what I’m here for! (Note: In the interest of practical use, I have tried to stick with more commonly used methods. I haven’t listed the abstinence method since this is a scientific article, not an opinion piece, and I am not even justifying the “pulling out method” with a response. I have also left out vasectomies and tubal ligations since most college kids don’t get them and things like spermicidal foam, the sponge and cervical caps for their spectacularly high failure rates and extremely uncommon use).
Under perfect use conditions and during the first year of use, the three most effective methods are the subdermal implant (like Implanon) with 0.05 pregnancies in 100 users, the Mirena IUD with 0.2 pregnancies in 100, and the pill with 0.3 pregnancies in 100. The worst methods under perfect use are the female condom with 5 pregnancies in 100 and the male condom with 2. But what happens when your uterus stops being polite and starts getting real?
Under “typical use” conditions, the story is a little different. The top two most effective contraceptives are still the subdermal implant with 0.05 pregnancies per 100 users, the Mirena IUD with 0.2 pregnancies per 100, exactly what they were under perfect use. The pill, however, gets knocked definitively out. Why? Because under the real-world use conditions, the pill’s failure rate leaps to 160 times what it was in lab settings to eight pregnancies per 100 users in the first year of use. That’s a pretty spectacular change for manufacturers and their advertisers to roundly ignore. Ladies, that’s a one in 12 chance that you will get pregnant in one year on the pill.
It’s still twice as effective as our worst offenders, though. The female condom fails at a rate of 21 pregnancies per 100 users and the male condom fails at a rate of 15 pregnancies in 100. 21 out of 100 is pretty horrible, but the male condom is the most commonly used method of protection among college and high-school aged kids. Wrap your head around this: That’s a one-in-six chance to get knocked up using a condom. ONE IN SIX. Literally, the same odds as the most certain-death game known to man. You deserve better than to play genital Russian roulette. Be smart, know the risks, and
invest in more than one form of anti-pregnancy insurance. ?