Here’s How the Most Common Forms of Birth Control Actually Work
One of the most important things to know when choosing a birth control method is how well it works. This is especially important in a country where childbirth is expensive , maternal mortality is incredibly high , and our options for abortion are limited and shrinking .
Of course, no method of contraception is perfect. The effectiveness of a birth control method is measured in two ways. One of them is the “ideal use” indicator, which reflects the chances of having a baby if you do everything right every time: for example, you never miss a pill or forget to use a condom. Everything works as intended. These calculations often reflect very low failure rates.
But there are also “typical usage” statistics that show the failure rate that people experience in the real world when trying to use this method. This includes all variables that the ideal usage does not cover. Maybe you forgot to use it or don’t bother to use it regularly; or maybe there are factors beyond your control, like a guy who removed a condom without telling you, or you were prescribed a drug you didn’t know could interfere with your birth control pills.
Abstinence advocates like to say that it is the only method of birth control with a zero failure rate. However, this is only an indication of ideal usage. In fact, people don’t always stick to it. (As far as I can tell, there is no generally accepted standard for abstinence, but abstinence-only educational programs certainly do not result in zero pregnancies among their students.)
So, let’s take a look at some of the most common methods of contraception and the actual success rates of each. The failure rate is determined by how many women using this method get pregnant in a year . So it’s not the number of refusals to use or intercourse; this is the chance to have a baby after a year of using this method.
The statistics here are from the CDC . We’ve ranked them from highest to lowest failure rate in typical use. Note that there is an 85% chance of “failing” with complete inactivity. This means that if you can get pregnant, are sexually active, and don’t use contraceptives at all, you have an 85% chance of getting pregnant within a year.
- Fertility awareness methods (not having sex on days you think you’re not fertile): range from 2% to 23%
- Withdrawal syndrome (“stretching” before ejaculation): 22% (CDC did not list this method as an option; statistics come from Planned Parenthood )
- Male condoms : 13% (21% for female condoms)
- Birth control pills : 7% for combined or progestin-only mini-pills.
- Patch or ring : 7%
- Depo-provera shot : 4%
- Copper Navy : 0.8%
- Female sterilization (“tubal ligation”): 0.5%
- Hormonal IUD : 0.1-0.4%
- Male sterilization (vasectomy) after a 12-week period that includes a sperm count check: 0.15%
- Implant (under the skin, usually hands): 0.1%
However, effectiveness is not the only consideration when deciding which form of contraception to use. You may have medical or personal reasons for choosing one method over another. But it’s good to know what numbers you’re dealing with.