PRB

The oral contraceptive pill and female sterilization are the most widely used birth control methods in the United States, according to the most recent data available from the U.S. Centers for Disease Control and Prevention (CDC).¹ Together, the pill and female sterilization are the choice of more than half of U.S. women ages 15 to 44 who use contraception (see figure). These two methods have been the leading contraceptives in the country since 1982. Male condom, vasectomy, and intrauterine devices (IUD) round out the top five contraceptive methods used.

The 2010 Affordable Care Act requires insurance companies to cover all Food and Drug Administration-approved contraceptive methods and sterilization procedures without co-pays or deductibles beginning August 2012 on new policies.² Group health plans sponsored by certain religious employers are exempt. These new requirements are expected to have the biggest impact on the use of long-acting reversible methods such as the IUD and implants, which though shown to be extremely effective in preventing pregnancy, have high up-front costs.³

Contraception to control pregnancy is “virtually universal” among women of reproductive age, report demographers William Mosher and Jo Jones of the CDC’s National Center for Health Statistics. Their analysis of the 2006 to 2008 nationally representative National Survey of Family Growth finds that 99 percent of all women who had ever had intercourse had used at least one contraceptive method.⁴

Among sexually experienced women ages 15 to 44, they find 93 percent had ever had a partner who used the male condom, 82 percent had ever used the oral contraceptive pill, 59 percent had ever had a partner who used withdrawal, and 22 percent had ever used the three-month injectable contraceptive DepoProvera. Nineteen percent of women reported ever using periodic abstinence based on the calendar (rhythm method), while 5 percent reported ever using natural family planning.

Current Contraceptive Method Used by U.S. Women Ages 15 to 44 Who Are Using Contraception, 2006-2008

*Includes emergency contraception, female condom or vaginal pouch, foam, cervical cap, Today sponge, suppository or insert, jelly or cream (without diaphragm), and other methods.
†Data do not meet standards of reliability or precision.

Source: William D. Mosher and Jo Jones, “Use of Contraception in the United States: 1982–2008,” Vital and Health Statistics 23, no. 29 (2010).

Findings from the CDC report provide a comprehensive picture of U.S. contraceptive use:

• Between 2002 and the two-year period from 2006 to 2008, the percentage of women who had ever used emergency contraception rose from 4 percent to 10 percent. Over that same time frame, the share who had ever used the contraceptive patch rose from 1 percent to 10 percent.
• Hispanic, black, and Asian women were less likely to have ever used the oral contraceptive pill than non-Hispanic white women. Black women were more likely than white women to have used the three-month injectable contraceptive, DepoProvera.
• The proportion of women who used a method of contraception at their first premarital intercourse has risen steadily, from 56 percent before 1985, to 76 percent between 2000 and 2004, and to 84 percent between 2005 and 2008. Most of this increase was due to a greater use of the male condom at first premarital intercourse, from 34 percent to 72 percent.
• About 62 percent of the 62 million women ages 15 to 44 were currently using contraception on the day they were interviewed between 2006 and 2008. The remaining 38 percent were not using contraception for a variety of reasons. These included women who were “not at risk of unintended pregnancy” because they were currently pregnant or postpartum, trying to become pregnant, sterile for medical (noncontraceptive) reasons, unable to conceive, or had not had intercourse recently or ever.
• The 7 percent of women “at risk of unintended pregnancy” because they had intercourse in the previous three months and were not using contraception account for a large proportion of all unintended pregnancies; the remaining unintended pregnancies occurred to the 38 million contraceptive users, primarily because of inconsistent or incorrect contraceptive use.
• Non-Hispanic black women were more likely to use female sterilization as a method of contraception than non-Hispanic white women, and less likely to rely on male sterilization. However, considering male and female sterilization together, about the same percentage of white, black, and Hispanic women were using sterilization: 23 percent for each group.
• Among women at risk of unintended pregnancy, 9 percent of Hispanic, white, and Asian women were not currently using contraception compared with 16 percent of at-risk black women. This finding may be related to higher rates of unintended pregnancy among black women than white women.
• Female sterilization is the leading contraceptive method among contraceptive users ages 30 to 44. By ages 40 to 44, in fact, half of contraceptive users were using female sterilization.
• About 9 percent of unmarried women had a partner who was using male condoms as their most effective method of contraception between 2006 and 2008. Another 5 percent, however, were using condoms along with a more effective method (such as the pill or an injectable contraceptive), meaning that a total of 14 percent were using the condom. Among married women, however, this kind of combination use was much less common.
• Half of all pregnancies in the United States are unintended, and the average probability of an unintended pregnancy in 12 months of contraceptive use is 12 percent, which is about the same as in 1995. Most pregnancies among contraceptive users are caused by inconsistent or incorrect use, not by a failure of the method itself.

Paola Scommegna is a senior writer/editor at the Population Reference Bureau.

References

1. William D. Mosher and Jo Jones, “Use of Contraception in the United States: 1982-2008,” Vital and Health Statistics 23, no. 29 (2010).
2. U.S. Department of Health and Human Services, “Required Women’s Preventive Services: Required Health Plan Coverage Guidelines,” accessed at www.hrsa.gov/womensguidelines/, on Feb. 27, 2012.
3. Guttmacher Institute, “New Federal Protections Expand Coverage Without Cost-Sharing of Contraceptives and Other Women’s Preventive Services,” Guttmacher Policy Review 14, no. 3 (2011).
4. Mosher and Jones, “Use of Contraception in the United States: 1982-2008.”