Abstract
Background
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.
Results
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.
Conclusion
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.
Keywords
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Article info
Publication history
Published online: December 03, 2007
Accepted:
September 27,
2007
Received in revised form:
September 27,
2007
Received:
September 19,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
