According to a new government report, American women, as a population, are not awesome at taking birth control. Okay, I'm not being fair — it's not American women in general who are bad, it's unmarried women who live with their significant others who are exceptionally not awesome at taking birth control. In fact, they fucking suck at it. What gives?
Over the last decades, keeping the VACANCY sign lit outside of your uterus has gotten progressively easier — now, in addition to the Pill (of which there are approximately a bajillion varieties for a bajillion different types of women), we've got The Ring, and The Patch, and The Shot and The Implant and The IUD. Some allow women to only have their period four times a year. Others may cause a woman's period to stop completely. Some occasionally end up hilariously around the end of your partner's penis after doing it, like a ringtoss. All are completely reversible and mostly safe and much more effective than the old "pull out n' pray" method . So why are 1/3 of births in the US still the result of unplanned pregnancies? Are women just really, terribly bad at reading and following directions?
The report highlights some stark contrasts between the birth control habits of married women, single women living with a partner, and single women living separately, in addition to differences between women's levels of education and age. And, as you might expect, the young, the poor, and the uneducated are much more likely to experience unplanned pregnancy than the older, the wealthier, and the more highly educated — as we've discussed, only about 23% of births to married women were the result of unplanned pregnancies, whereas half of births to unmarried women who (as my grandma would say) live in sin were the result of surprise pregnancies. And among women between the ages of 15 and 24, almost 79% of births were the result of unplanned pregnancies.
NBC refers to them as "oopsie babies," but the repercussions are much less cute than a thing a babysitter says when a toddler poops in the dog's dish. Unplanned pregnancies, as a general rule, occur when a family isn't prepared for a child — they're not planned. Additionally, women who plan their pregnancies are much less likely to accidentally harm their pregnancies by smoking, drinking, or engaging in other unhealthy activities because they're unaware that they're eating/smoking/drinking for two. Kids aren't cheap, either, and having an unplanned baby can have pretty dire financial effects on a family, especially if the child's mother is young, uneducated, and poor and the child's father is statistically unlikely to stick around. We're pregnanting ourselves right out of the middle class.
So, with all sorts of birth control available, what's keeping women from using it? A cocktail of ignorance, misinformation, and overblown concern. A full 35% of sexually active women who ended up unexpectedly pregnant say they didn't use birth control because they didn't think they could get pregnant, which means that there are hundreds of thousands of women in the US who have ovaries and uteruses and vaginas and vulvas who think that somehow they are Touched By An Angel that keeps those functioning body parts from doing what they're supposed to do. It's like sticking your hand in a garbage disposal, flipping the switch, and then acting all surprised when you lose a pinkie. Abstinence only education, y'all! Catch the spirit!
The second largest group of unplanned births came as the result of women who didn't use birth control because they didn't mind if they got pregnant, the third largest group reported that they didn't expect to have sex, and the fourth largest group said they were worried about the side effects of birth control. A full 13% of women who ended up having unplanned babies became pregnant because their partner didn't want to wear a condom, or their partner didn't want them on birth control. Ew.
On August 1st, a provision of the Affordable Care Act that will make copay-free birth control available to women will kick in, but it will only affect women who are already insured through their employers. Women who qualify for Medicaid are also able to access birth control without paying anything at the pharmacist. But for a third group, women who are neither insured by their employers nor qualified for Medicaid, no-copay birth control won't be available to them until 2014. It remains to be seen whether Obamacare will give women a better handle on their fertility, or if it will give women who don't understand contraception access to the information they need to make the right choice for themselves.
Image by Jim Cooke