The pill is the most common birth control in America, and was used by 9.5 million women in 2014 (1). But now it is facing tough competition from more effective, longer-acting birth control methods, namely the Copper IUD, the Hormonal IUD and the implant. In 2002, only 2.4% of women used an IUD or an implant for their birth control (2). By 2014, 14.4% (3) used one, or just over 5.4 million women (4) . This rate of adoption is viral in the birth control world. I have used both the pill and a Hormonal IUD. Here are my opinions about why the increasing popularity of IUDs and the implant is a good thing.
The only reason why the pill is still the most common birth control is because our information about birth control is stagnant. You can’t find 5,000 detailed customer reviews about each method on Amazon like you can for chairs or flashlights. Instead, the information we trust comes through word of mouth from our family and friends. Studies have documented that friends strongly influence a person’s decision to get birth control (5) (6), and found that when choosing a method people “tended to try whatever their friends were using” (7) . The problem is that we don’t talk enough about birth control with our friends, because we still associate needing birth control with having sex, and sex is uncomfortable to talk about.
If we can’t learn about birth control from those closest to us, we have to rely on cues from society. Right now, society still favors the pill. The pill has been around since 1960 (8) , so not even our mothers or our grandmothers can deny that it exists. The pill is also more socially acceptable because its non-contraceptive benefits are widely known about. You can pretend that you’re taking the pill to “improve your skin” or “regulate your periods” (9) so people don’t probe you about your sex life 😳 . However, the Hormonal IUD and the implant also have significant non-contraceptive benefits. I got the Hormonal IUD because I suffered from terrible period cramps. Mine contains 52mg of levonorgestrel hormone, and is said to decrease overall period blood loss by 90% (10) for most people. The implant also helps with periods, as 82% of people with an implant reported lighter and less crampy periods (11). Yet these methods are almost invisible in our culture. We need to tell more people about their non-contraceptive benefits so that people won’t only associate them with having sex (and there’s nothing wrong with having sex, anyway 😋)
Luckily, far more teenagers aged 15-19 are choosing IUDs and implants. In 2005, only 0.4% of teenage girls who used birth control had an IUD or an implant (12) . By 2013, it was 7.1% (13) , an increase of almost 18x. When I got birth control for the first time in 2010, my doctor suggested I go on the pill because IUDs were only for older women who had given birth. Doctors now know it is safe to offer these more effective methods to teenagers. Instead, I was part of the 31% of women who miss one or more pills per month (14) , which put me at serious risk of pregnancy 😣 . I took a pregnancy test twice on the pill; once for a food baby, and once when I randomly skipped my period 🤷🏽♀️. Taking a pill at the same time everyday sounds like an easy thing to do, but it is basically impossible. It set me up for failure because if I missed it by an hour, I had failed. Even if I didn’t want to be pregnant in the next 5 years, I had to worry about taking it for 1,826 days to get there. For me, dealing with birth control every 24 hours was not freedom. With no male birth control available apart from condoms, us people with vaginas carry this burden. Getting a Hormonal IUD was a short, uncomfortable, one-and-done procedure that has given me 5 years of freedom from worrying about getting pregnancy.
Despite its popularity, the pill is far less effective than these methods for preventing pregnancy. About 1 in 11 couples who use the pill as their only method of birth control can expect a pregnancy within a year (15) . This represents a typical failure rate of 9% (16) . However, only 1 in 125 couples using a Copper IUD, 1 in 500 couples using a Hormonal IUD and 1 in 2000 couples using an implant can expect a pregnancy within a year (17) . People using the pill had 116,400 abortions in 2014, representing 13% of all abortion patients (18). If you are the kind of person who forgets to take the pill, the best time to switch to a more effective method is before you become part of that statistic 🙏🏽.
At the end of the day, we need to talk to each other more about birth control. If you’re deciding on a method, ask as many people as you can about their personal experiences with it. If you’re having a positive experience with your birth control, tell the younger women in your life about it. A one-minute conversation can save them years of not knowing the answer from being too afraid to ask ⏱. To avoid pregnancy, we need to play the long game, and each find a method that we like and can use correctly and consistently. For me, a quick, one-and-done procedure to get an IUD was the easiest way to do that.
The End 💕
(1) Guttmacher Institute. (2019, November 13). Contraceptive Use in the United States. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states
(2) Guttmacher Institute. (2019, November 13). Use of Long-Acting Reversible Contraceptive Methods Continues to Increase in the United States. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/news-release/2015/use-long-acting-reversible-contraceptive-methods-continues-increase-united-states
(3) Guttmacher Institute. (2019, November 13). Contraceptive Use in the United States. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states
(4) Guttmacher Institute. (2019, November 13). Contraceptive Use in the United States. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states
(5) Institute of Medicine (US) Committee on Unintended Pregnancy; Brown SS, Eisenberg L, editors. The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington (DC): National Academies Press (US); 1995
(6) Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social Organization of Sexuality: Sexual Practices in the United States. Chicago, IL: University of Chicago Press; 1994.
(7) Heise, L. (1997). Beyond acceptability: Reorienting research on contraceptive choice. Reproductive Health Matters, (SUPPL.), 5-14.
(8) Wikipedia contributors. (2019, November 13). Combined oral contraceptive pill. In Wikipedia, The Free Encyclopedia. Retrieved 01:14, November 16, 2019, from https://en.wikipedia.org/w/index.php?title=Combined_oral_contraceptive_pill&oldid=925912765
(9) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 118
(10) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 165
(11) Hatcher RA et al., eds., Contraceptive Technology, 21th ed., New York: Ayer Company Publishers, 2018; p 137
(12) Romero L, Pazol K, Warner L, et al. Vital signs: trends in use of long-acting reversible contraception among teens aged 15-19 years seeking contraceptive services—United States, 2005-2013. MMWR Morb Mortal Wkly Rep. 2015;64(13):363–369.
(13) Romero L, Pazol K, Warner L, et al. Vital signs: trends in use of long-acting reversible contraception among teens aged 15-19 years seeking contraceptive services—United States, 2005-2013. MMWR Morb Mortal Wkly Rep. 2015;64(13):363–369.
(14) QuickStats: Percentage of Women Who Missed Taking Oral Contraceptive Pills Among Women Aged 15–44 Years Who Used Oral Contraceptive Pills and Had Sexual Intercourse, Overall and by Age and Number of Pills Missed — National Survey Of Family Growth, United States, 2013–2015. MMWR Morb Mortal Wkly Rep 2017;66:965. DOI: http://dx.doi.org/10.15585/mmwr.mm6636a10
(15) Guttmacher Institute. (2019, November 13). Proportion of women who will become pregnant over one year of us, by method. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/sites/default/files/462-403.png
(16) Guttmacher Institute. (2019, November 13). Proportion of women who will become pregnant over one year of us, by method. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/sites/default/files/462-403.png
(17) Guttmacher Institute. (2019, November 13). Proportion of women who will become pregnant over one year of us, by method. In Guttmacher.org. Retrieved 01:14, November 16, 2019, from https://www.guttmacher.org/sites/default/files/462-403.png
(18) Reported contraceptive use in the month of becoming pregnant among U.S. abortion patients in 2000 and 20, Jones, Rachel K. Contraception, Volume 97, Issue 4, 309 - 312
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