HealthPop
By

Michelle Castillo /

CBS News/ May 24, 2012, 12:30 PM

Unplanned pregnancies 20 times more likely on birth control pill than IUD, study finds

CBS
(CBS News) A new study shows that women who use birth control pills, the patch or vaginal ring are 20 times more likely to have an unintended pregnancy than those who use an intrauterine device (IUD) or implant.

The statistics are especially concerning for women under 21, for whom the risk of unplanned pregnancy when using birth control pills, the patch or ring was almost twice as high as the risk for older women.

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CDC: More teen girls using contraception, waiting longer

"This study is the best evidence we have that long-acting reversible methods are far superior to the birth control pill, patch and ring," study author Dr. Jeffrey Peipert, a professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis, said according to the press release. "IUDs and implants are more effective because women can forget about them after clinicians put the devices in place."

According to the study authors, 3 million pregnancies a year - or about half of all pregnancies - in the U.S. are unplanned.

The Centers for Disease Control and Prevention says 99 percent of women having sex had used at least one method of birth control between 2006 and 2008. The most popular form was the birth control pill, which was used by 10.7 million women in the U.S. While birth control pills may be a preferred choice for many women, it is often hard for women to remember to take the pill today and have readily available access to refills.

IUDs are inserted into the uterus by a physician.  There are two forms: Hormonal IUDs are approved for 5 years, and the copper IUD can be used for as long as 10 years. IUDs work by preventing sperm from fertilizing an egg. Hormonal implants are inserted under the skin of the upper arm and are typically effective for three years and work by preventing the ovaries from releasing eggs. All these implants can be costly - more than $500 - and not covered by insurance.

The study, which was published in the May 24 New England Journal of Medicine, involved almost 7,500 women between the ages of 14- 45 who were sexually active or planned to be sexually active in the next six months, but did not want to get pregnant in the next year. They were each instructed about the benefits and side effects of IUDs, implant, birth control pills, patch, ring and contraceptive injection and then allowed to chose which one they wanted to use free of charge. They were allowed to switch from the different methods as frequently as they liked. Participants where then interviewed at three months, six months and then six month intervals during the study which could last for up to three years.

By study's end, 334 women became pregnant. Of these, 156 pregnancies were due to contraceptive failure. Overall, 133 (4.55 percent) of women using pills, the patch or ring had contraceptive failure, compared with 21 (0.27 percent) of women using IUDs and implants.

"If there were a drug for cancer, heart disease or diabetes that was 20 times more effective, we would recommend it first," Peipert says. "Unintended pregnancies can have negative effects on women's health and education and the health of newborns."

Using IUDs also comes with some risks. Women can have menstrual problems including increased bleeding and cramps as well as spotting between periods, according to WebMD. One out of 1,000 women may have their IUD get stuck in or puncture their uterus and up to 10 percent of IUDs are expelled from the uterus into the vagina during the first year, usually in the first months of use.

© 2012 CBS Interactive Inc. All Rights Reserved.
15 Comments Add a Comment
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yooperfem says:
The repercussions of unplanned pregnancy go beyond maternal and newborn health. The children suffer into adulthood from parents who are not able to parent effectively. This extends to adoptees as well. There is a particularly concentrated effort on the part of (mostly Republican) politicians to create barriers to access to prescription contraception and abortion in a medical setting. The anti-abortion politicians and organizations are not pro-life as they claim. They hold the view that women and children are chattels, just as they are in the Bible.
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KPeters_from_UK says:
by Jessi73 May 24, 2012 2:07 PM EDT
This is a good article -- I think one thing needs to be clarified. Michelle Castillo writes, "All these implants can be costly - more than $500 - and not covered by insurance."

I think this is misleading because some insurance policies DO cover IUDs. Of course each woman needs to check with her own insurance provider, because some probably do not cover IUDs, but in my case, Blue Shield in CA covered almost all of the cost of my copper IUD. I only had to pay $25.

Perhaps the article should be clarified so women don't write off the IUD idea due to cost, and the "lack of insurance coverage" comment.
_____________________________________

Ah, but wait...if the Church groups get their way then all contraceptions will not be covered by many insurance groups.

The women who really need 10 year IUD's can't afford $500 or even $800.
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Lerianis4 says:
Excuse me, but most times when birth control of ANY form 'fails', it actually hasn't.

It has either not been taken properly (missed a dosage here and there) OR it has been negated by some other drug that is known to interfere with birth control (some common antibiotics do this) and the doctors prescribing those drugs do not warn females of the risk.

In the past 30 years, I have never heard of birth control (save a condom) just 'failing'.
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AAnnie52 replies:
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Exactly - it's user non-compliance, not failure of the hormone. This is a big "no duh" study, btw, given the age group.
KPeters_from_UK replies:
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20 to 25% of unwanted pregnancies occur because of improper use and that doesn't exclude males who don't know hos to put a condom on correctly.
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nohater says:
what are the risks a female faces using either method? one might be more effective in stopping pregnancies but what are the physical, health risks for the female? researchers should provide a side by side comparison of risks so a female can decide how to proceed with her body. it is not enough to report that one method prevents pregnancy better than the other. if your a female, it's your body and your health that may or may not be at risk.
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Lerianis4 replies:
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nohater, there aren't any more 'health risks' than from taking any other medication on a long-term basis.
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DebbieCorona says:
IUD's may be more likely to prevent pregnancy but there are the costs and risks to weigh. Since standard BC pills are fairly reliable, cost less, and less risk they are generally the first choice.
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AAnnie52 replies:
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Costs and risks - every woman needs counseling as to her particular risk factors (e.g. family history of stroke, migraine with aura, endometriosis, etc.) before beginning any therapy, birth control or other. And upkeep as her situation changes over time. All of which requires women to have affordable, professional health care easily available for b/c AND other female-centric diseases and disorders - which is why definding planned parenthood and placing hoops for women to jump through to get ANY care is so short-sighted, not to mention mean-spirited.
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ChoiceProjectSTL says:
Thank you for featuring our research! For more information about our project, please visit our website: www.choiceproject.wustl.edu or join us on Facebook: www.facebook.com/choiceproject
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Jessi73 says:
This is a good article -- I think one thing needs to be clarified. Michelle Castillo writes, "All these implants can be costly - more than $500 - and not covered by insurance."

I think this is misleading because some insurance policies DO cover IUDs. Of course each woman needs to check with her own insurance provider, because some probably do not cover IUDs, but in my case, Blue Shield in CA covered almost all of the cost of my copper IUD. I only had to pay $25.

Perhaps the article should be clarified so women don't write off the IUD idea due to cost, and the "lack of insurance coverage" comment.
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slownewsday_5000 replies:
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We really need to get the birth control thing down pat.

We had 2 billion people on Earth only 90 years ago. Now it's almost 7 billion.

Anyone here who understands "natural growth curves" should be scared by that.
Lerianis4 replies:
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Not scared in the slightest, slow. Why? Because we are increasing our ability to feed/clothe/etc. all those people every single day.

We also waste a good 75%+ of our food in the world to spoilage/natural destruction, so.....

I think you get the point that our 'growth curve' is the last thing we should be worrying about. Only people who bring it up are borderline or actual eugenists.
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