One out of four women become pregnant despite using birth control or family planning methods according to experts in the United Kingdom. In the UK alone, more than 14,000 women that attended family planning clinic became pregnant despite using reliable forms of birth control such as pills or long acting contraceptives.
The recent news of the failure rates of birth control or family planning methods would certainly be a source of concern to millions of women on contraceptives worldwide. In the United States where most families don’t have more than two children, women use contraceptives for about 30 years or more.
In many other countries such as Nigeria, the use of contraceptives is also on the rise. Apart from preventing unintended pregnancies in married and unmarried women, the relatively high prevalence of HIV and other sexually transmitted infections has led to an increased awareness of the use of contraception in several developing countries.
Nevertheless, improving our understanding of the options available and their effectiveness would help in making an informed choice. So, what should you know about contraceptives? Which is most effective? Why do birth control pills fail? Consider the answers to these important questions about contraceptives or family planning.
What are the different types of contraceptives available?
There are at least 15 different types of contraceptives or birth control methods worldwide. The various contraceptives and their mechanism of actions are:
Preventing eggs from being released or a fertilized egg from functioning
- Pills, vaginal rings, patches, implant, injections
Preventing sperm from reaching the eggs
- Natural methods, Female condom, male condom, diaphragm, intrauterine device, cervical cap (Femcap), contraceptive sponge, spermicides
Disrupting reproductive activities
- Sterilization usually by vasectomy (males) and tubal ligation (females)
Which contraceptive is most effective?
All contraceptives have different rates of effectiveness. Generally, the contraceptive implant and the IUD are the most effective reversible birth control methods available. Because these methods don’t rely on the user, mistakes are unlikely to occur.
Oral contraceptive pills, the hormonal patch and the vaginal ring are 99% effective. However, this drops to 91% on account of human errors e.g. forgetfulness.
The male condom is 98% effective. However, effectiveness drops significantly due to improper use. Overall, in making the right choice most couples consider the effectiveness, convenience, side effects and cost.
How can I prevent birth control pills from failing?
The failure rate of birth control pills can be reduced by adhering to some of the instructions that guide proper use such as:
Do not forget to take the pill daily and make sure you begin at the right time
Do not combine other medication with birth control without checking for drug interactions. For instance, medications for migraine, seizure and some infections (e.g. tuberculosis or meningitis) interfere with the pill making it less effective in preventing pregnancy.
Treat bowel problems promptly because this may affect absorption of the pill
Always take a mini-pill (progestron only pill) at exactly same time daily.
What is the most commonly used contraceptive?
Worldwide, female sterilization still remains the most widely used contraceptive or birth control method. Married women are more likely to use contraceptives than unmarried ones. Unlike developed countries where up to 75 percent of women use one form of birth control or the other, the use of contraceptives is quite low in Africa and other developing countries. As at 2015, female sterilization and the IUD are the two most common methods used by married or in-union women worldwide. The least common was rhythm or withdrawal method which is used by just 6 percent of married women. Nevertheless, permanent contraceptives such as female sterilization are very unpopular in Africa.
Which forms of contraceptives protect against HIV and other sexually transmitted infections?
The form of family planning that prevents pregnancy and offers the best protection against sexually transmitted infections is the male condom. Next are the female condom and the diaphragm which offers only limited protection against HIV and other sexually transmitted infections.
What are the possible issues associated with poor use of contraceptives?
The main concern is an increase in the number of unintended pregnancies. Unfortunately, unintended pregnancies may lead to an increase in induced abortions which may be unsafe. A doctor in Nigeria recently observed that contrary to popular thinking, several married women, who become pregnant ‘accidentally’ despite using recommended family planning methods often resort to induced abortions. Unintended pregnancy may be a huge burden on the finances, time and resources of families in resource constrained settings. For women in their early forties, such pregnancies may also be associated with shame and embarrassment. Nevertheless, with adequate support from their spouses, friends and relatives, they are better placed to create a loving atmosphere for the new born.
Kost K et al., Estimates of contraceptive failure from the 2002 National Survey of Family Growth, Contraception, 2008, 77(1):10–21.
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