Why Is Birth Control Use Declining in U.S. Women?

In late 2004, the National Center for Health Statistics released a report analyzing contraceptive usage in the United States from 1982-2002. The report discovered an interesting statistic — the percentage of adult women who had sex in the previous three months but did not use contraception rose from 5.4 percent in 1995 to 7.4 percent in 2002.

The increase was statistically significant and occurred only in adult women over the age of 20 — contraceptive use by teens was unchanged.

The Washington Post reported on the increase noting,

Because the survey is so large (more than 7,600 women) and known for its accuracy, “an increase of even two percentage points is worrisome,” said John S. Santelli, a professor of population and family health at the Mailman School of Public Health at Columbia University. Even as he cheered the news that a growing number of teenagers are using contraception, Santelli wondered whether doctors are neglecting women.

“Maybe we’re failing with women over 21,” Santelli said.

Much of the speculation about the increase centered around the possibility that women are finding the cost of birth control to be too expensive,

Jeffrey Jensen, director of the Women’s Health Research Unit at Oregon Health and Science University, said he regularly encounters patients who have trouble affording birth control, even if their private insurance covers it.

“It is absolutely unconscionable that women have a co-pay of $20 or $25 [month] for contraceptives and men are getting off scot-free,” Jensen said. Drug companies “have cut way back” on free samples and many women turn to less effective types of birth control because of cost, he said, “running a greater risk of pregnancy as a result.”

Not sure why Jensen feels the need to turn this into a men vs. women thing (men “get off scot-free”). The last time I checked, no major insurance company covers the primary male contraceptive — condoms.

Another speculation is that there was a decline in comprehensive sex education as the abstinence movement gained steam in the 1980s and 1990s. According to the Washington Post,

Several recent studies found that as the abstinence-until-marriage movement surged, there was a “considerable drop” in comprehensive sex education from 1988 to 2000, Santelli said. “Women in their twenties have probably gotten less effective information about contraception,” he said.

Or it could simply be a one-time outlier in the sample. After all, the difference between 1995 and 2002 women who had sex without using contraception was only 129 out of the 6,493 women 20 or over interviewed in the survey.

Sources:

More women opting against birth control, study finds. Ceci Connolly, Washington Post, January 4, 2005.

Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2002. Joyce C. Abma, PhD.; Gladys M. Martinez, PhD.; William D. Mosher, PhD.; and Brittany S. Dawson, M.P.P., Division of Vital Statistics. December 2004.

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