The accidental pregnancy

The most famous unplanned pregnancy

A new poll conducted by Contraception in America found that accidental pregnancies remain common despite the availability of contraception.

One of the main goals of  reproductive health organizations is to increase the availability and accessibility of effective contraception, both in the United States and around the world.  Unintended pregnancy happens, this line of thinking goes, because women don’t have access to reliable birth control. If they did, the assumption is that they’d use it which would lead to a lower  number of unintended pregnancies.

But maybe accessibility is not the problem.  According to these data:

Nearly two in five (40%) women of reproductive age reported currently using no form of birth control.

Forty percent of American women don’t use birth control? No wonder almost half of all pregnancies in the US are unplanned.

Researchers (including these ones) and reproductive health advocates generally give the same explanations for these numbers:

  • Women aren’t using the methods properly.
  • Women underestimate their risk of pregnancy or believe they are infertile.
  • Women don’t know how emergency contraception works, so they don’t have an effective backup plan.
  • There isn’t enough emphasis on prescribing what’s known as long acting reversible contraception (LARC) like IUDs, implants and injectables.

How to solve this? The answer provided by the experts is usually a call for more education.

There is a need for further education and training of healthcare providers in order to raise patient awareness of effective birth control choices, including long acting reversible contraception for all women of reproductive age.

But what are the real reasons that women don’t use birth control? Here are some highly unscientific answers to that question:

  • It can make you fat, irritable, blotchy, bloated, itchy. It can make your hair fall out, give you hives, or make your face puffy.
  • It does weird things to your menstrual cycle. It makes you bleed every day, or bleed really heavily, or stop bleeding altogether. It gives you bad cramps, or headaches, or just makes you feel strange.
  • The birth control patch looks like a giant Band-Aid. It doesn’t come in a variety of shades. It turn your skin strange colors
  • Female condoms are ugly and unwieldy.
  • Taking a pill every day is  annoying.
  • Sticking plastic rods, unknown quantities of hormones, or other foreign objects into your body just doesn’t seem right.

The female condom in all its glory

Maybe it’s not ignorance that makes 40 percent of US  women not want to use these types of contraception.

I’m a major advocate of birth control. Women must be able to control their fertility, it’s a fundamental requirement for gender equality. However, many of the existing methods are problematic. They are  unacceptable to lots and lots of women. If women truly don’t know that there are lots of birth control options out there, then by all means, educate away. But it’s important not to dismiss the very real concerns many women have about hormonal contraception.

So how about trying to develop a user controlled method that is really acceptable?  Or creating hormonal shot for men for a change? Or encouraging women to use diaphragms or contraceptive sponges  as enthusiastically as we tend to encourage hormonal methods? Maybe 40% of American women aren’t  idiots who don’t know how the reproductive system works or can’t figure out how to use these methods correctly or mistakenly believe they are infertile.

What do you think?

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