Estimates of contraceptive failure from the 2002 National Survey of Family Growth



      In 2001, the US government's ���Healthy People 2010��� initiative set a goal of reducing contraceptive failure during the first year of use from 13% in 1995 to 7% by 2010. We provide updated estimates of contraceptive failure for the most commonly used reversible methods in the United States, as well as an assessment of changes in failure rates from 1995 to 2002.

      Study Design

      Estimates are obtained using the 2002 National Survey of Family Growth (NSFG), a nationally representative sample of US women containing information on their characteristics, pregnancies and contraceptive use. We also use the 2001 Abortion Patient Survey to correct for underreporting of abortion in the NSFG. We measure trends in contraceptive failure between 1995 and 2002, provide new estimates for several population subgroups, examine changes in subgroup differences since 1995 and identify socioeconomic characteristics associated with elevated risks of failure for three commonly used reversible contraceptive methods in the United States: the pill, male condom and withdrawal.


      In 2002, 12.4% of all episodes of contraceptive use ended with a failure within 12 months after initiation of use. Injectable and oral contraceptives remain the most effective reversible methods used by women in the United States, with probabilities of failure during the first 12 months of use of 7% and 9%, respectively. The probabilities of failure for withdrawal (18%) and the condom (17%) are similar. Reliance on fertility-awareness-based methods results in the highest probability of failure (25%). Population subgroups experience different probabilities of failure, but the characteristics of users that may predict elevated risks are not the same for all methods.


      There was no clear improvement in contraceptive effectiveness between 1995 and 2002. Failure rates remain high for users of the condom, withdrawal and fertility-awareness methods, but for all methods, the risk of failure is greatly affected by socioeconomic characteristics of the users.


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        • Finer L.B.
        • Henshaw S.K.
        Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.
        Perspect Sex Reprod Health. 2006; 38: 90-96
        • Fu H.
        • Darroch J.E.
        • Haas T.
        • Ranjit N.
        Contraceptive failure rates: new estimates from the 1995 National Survey of Family Growth.
        Fam Plann Perspect. 1999; 31: 56-63
      1. Trussell J, Vaughan B. Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth. Fam Plann Perspect, 1999;31(2):64���72, 93.

        • Ranjit N.
        • Bankole A.
        • Darroch J.E.
        • Singh S.
        Contraceptive failure in the first two years of use: differences across socioeconomic subgroups.
        Fam Plann Perspect. 2001; 33: 19-27
        • U.S. Department of Health and Human Services
        Healthy People 2010.
        With understanding and improving health and objectives for improving health, vol 1. 2nd ed. U.S. Government Printing Office, Washington, DC2000
        • Jones E.F.
        • Forrest J.D.
        Contraceptive failure rates based on the 1988 NSFG.
        Fam Plann Perspect. 1992; 24: 12-19
        • Finer L.B.
        • Henshaw S.K.
        Abortion incidence and services in the United States in 2000.
        Perspect Sex Reprod Health. 2003; 35: 6-15
        • Jones R.K.
        • Kost K.
        Underreporting of induced and spontaneous abortion in the United States: an analysis of the 2002 National Survey of Family Growth.
        Stud Fam Plann. 2007; 38: 187-197
        • Jones R.K.
        • Darroch J.E.
        • Henshaw S.K.
        Contraceptive use among U.S. women having abortions in 2000���2001.
        Perspect Sex Reprod Health. 2002; 34: 294-303
      2. Fu H, Darroch JE, Henshaw SK, Kolb E. Measuring the extent of abortion underreporting in the 1995 National Survey of Family Growth. Fam Plann Perspect, 1998;30(3):128���33,138.

        • Jones E.F.
        • Forrest J.D.
        Underreporting of abortion in surveys of U.S. women: 1976 to 1988.
        Demography. 1992; 29: 113-125
      3. Vaughan B, Trussell J, Menken J, Jones EF, Grady W. Contraceptive efficacy among married women aged 15--44 years: United States. National Center for Health Statistics, Vital Health Stat, Series 23, No. 5, 70 pages.

        • Peto R.
        • Pike M.C.
        • Armitage P.
        • et al.
        Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and examples.
        Br J Cancer. 1977; 35: 1-39
      4. SAS Institute Inc. SAS, computer programming package for statistical analysis.
      5. Lepkowski JM, Mosher WD, Davis KE, Groves RM, van Hoewyk J, Willem J. National Survey of Family Growth, Cycle 6: sample design, weighting, imputation, and variance estimation. National Center for Health Statistics, Vital Health Stat, 2006, Series 2, No.142, 92 pages.

        • Mosher W.D.
        • Martinez G.M.
        • Chandra A.
        • Abma J.C.
        • Wilson S.J.
        Use of contraception and use of family planning services in the United States: 1982���2002. Advance data from vital and health statistics; no. 350.
        National Center for Health Statistics, Hyattsville, Maryland2004
        • Frost J.J.
        • Singh S.
        • Finer L.B.
        U.S. women's one-year contraceptive use patterns, 2004.
        Perspect Sex Reprod Health. 2007; 39: 48-55
        • Frost J.J.
        • Singh S.
        • Finer L.B.
        Factors associated with contraceptive use and nonuse United States, 2004.
        Perspect Sex Reprod Health. 2007; 39: 90-99
      6. Frost JJ, Darroc JE. Factors associated with contraceptive choice and inconsistent method use, United States, 2004. Perspect Sex Reprod Health 2008; forthcoming.

        • Trussell J.
        • Grummer-Strawn L.
        • Rodriguez G.
        • Van Landingham M.
        Trends and differentials in breastfeeding behavior: evidence from the WFS and DHS.
        Popul Stud. 1992; 46: 285-307
        • Hatcher R.A.
        • Trussell J.
        • Nelson A.L.
        • Cates W.
        • Stewart F.H.
        • Kowal D.
        Contraceptive technology.
        19th ed. Ardent Media, New York, NY2007