There are 61 million U.S. women of reproductive age (15–44).1 About 43 million of them (70%) are at risk of unintended pregnancy—that is, they are sexually active and do not want to become pregnant, but could become pregnant if they and their partners fail to use a contraceptive method correctly and consistently.2
Couples who do not use any method of contraception have approximately an 85% chance of experiencing a pregnancy over the course of a year.3
In the United States, the average desired family size is two children. To achieve this family size, a woman must use contraceptives for roughly three decades.4
WHO USES CONTRACEPTIVES?
More than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method.5
Some 60% of all women of reproductive age are currently using a contraceptive method.6
Ten percent of women at risk of unintended pregnancy are not currently using any contraceptive method.6
The proportion of women at risk of unintended pregnancy who are not using a method is highest among those aged 15–19 (18%) and lowest among those aged 40–44 (9%).2
Eighty-three percent of black women at risk of unintended pregnancy are currently using a contraceptive method, compared with 91% of their Hispanic and white peers, and 90% of their Asian peers.2
Among women at risk of unintended pregnancy, 92% of those with an income of at least 300% of the federal poverty level and 89% of those living at 0–149% of poverty are currently using a contraceptive method.2
A much higher proportion of married women than of never-married women use a contraceptive method (77% vs. 42%), largely because married women are more likely to be sexually active. But even among those at risk of unintended pregnancy, contraceptive use is higher among currently married women than among never-married women (93% vs. 83%).2
Unmarried women who are cohabiting fall between married women and unmarried women who are not cohabiting: Some 90% of at-risk women living with a partner use a method.2
Contraceptive use is common among women of all religious denominations. For example, eighty-nine percent of at-risk Catholics and 90% of at-risk Protestants currently use a method. Among sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception.7
WHICH METHODS DO WOMEN USE?
Seventy-two percent of women who practice contraception currently use nonpermanent methods—primarily hormonal methods (i.e., the pill, patch, implant, injectable and vaginal ring), IUDs and condoms. The rest rely on female (22%) or male (7%) sterilization.6
The pill and female sterilization have been the two most commonly used methods since 1982.6,8,9
Four out of five sexually experienced women have used the pill.5
The pill is the method most widely used by white women, women in their teens and 20s, never-married and cohabiting women, childless women and college graduates.2
The use of hormonal methods other than the pill has increased with the advent of new options. The proportion of women who have ever used the injectable increased from 5% in 1995 to 23% in 2006–2010. Ever-use of the contraceptive patch increased from less than 1% in 2002 to 10% in 2006–2010. Six percent of women had used the contraceptive ring in 2006–2010, the first time this method was included in surveys.5
Reliance on female sterilization varies among subgroups of women. It is most common among blacks and Hispanics, women aged 35 or older, ever-married women, women with two or more children, women living below 150% of the federal poverty level, women with less than a college education, women living outside of a metropolitan area, and those with public or no health insurance.2
Some 68% of Catholics, 73% of Mainline Protestants and 74% of Evangelicals who are at risk of unintended pregnancy use a highly effective method (i.e., sterilization, the pill or another hormonal method, or the IUD).7
Only 2% of at-risk Catholic women rely on natural family planning; the proportion is the same even among those who attend church at least once a month.7
In 2014, about 14% of women using a contraceptive relied on a long-acting reversible contraceptive method, or LARC (12% used the IUD and 3% used the implant).6 This follows a trend in increasing proportions of women using LARCs, from 2% in 2002 to 6% in 2007 and 9% in 2009.10,11
Among contraceptive users, the groups of women who most commonly use an IUD or implant are 25–34-year-olds, those born outside of the United States, those living in a Western state, those who report their religious affiliation as “other” and those who have ever stopped using a non-LARC hormonal method. At least 16% of women in these groups use a LARC method.10
Among female contraceptive users in the United States, those most likely to use a LARC method are women who have had a child and those who have ever stopped using a non-LARC hormonal method.10
Some 5.5 million women rely on the male condom. Condom use is most common (i.e., at least 25% greater than the national average of 15%) among 15–19-year-olds, those who report their religious affiliation as “other,” those born outside of the United States, college graduates, those who are uninsured and those who are nulliparous or are expecting at least one (more) child.6
Ever-use of the male condom increased from 52% in 1982 to 93% in 2006–2010.5
Dual method use offers protection against both pregnancy and STIs. Some 8% of women of reproductive age simultaneously use multiple contraceptive methods (most often the condom combined with another method).12
The proportion of all sexually experienced women who have ever used withdrawal increased from 25% in 1982 to 60% in 2006–2010.5
Seven percent of men aged 15–44 have had a vasectomy; this proportion increases with age, reaching 16% among men aged 36–45.13
PROVIDING FREE BIRTH CONTROL DOES REDUCE ABORTION RATES
Colorado provides a real-life experiment on whether providing safe, effective, long-acting birth control can reduce unwanted pregnancies and abortions. The state’s Department of Public Health and Environment got private funding in 2008 for a program to provide long-acting reversible contraceptives (LARCs), such as IUDs and hormone implants, to low-income women for little or no cost.
Trends in abortion between 1997 and 2014Guttmacher Institute
“The Colorado Family Planning Initiative helped cut the abortion rate nearly in half for women aged 15-19 and by 18 percent for women aged 20-24,” the department said in a 2017 report. “Between 2009 and 2014, birth and abortion rates both declined by nearly 50 percent among teens aged 15-19 and by 20 percent among young women aged 20-24.”
ABORTION IS VERY COMMON IN THE U.S.
“In the United States, where one half of all pregnancies are unintended, almost one third of women will seek an abortion by age 45,” ACOG says.
A 2016 study in the New England Journal of Medicine found that 45 percent of all pregnancies among U.S. women in 2011 were unintended, and 42 percent of them these unintended pregnancies ended in abortion.
According to the Guttmacher Institute, 19 percent of pregnancies ended in abortion in 2014, a total of 926,200 abortions. That was down 12 percent from 2011. The 2014 abortion rate of 14.6 abortions per 1,000 women was the lowest rate ever measured. In 1973, the rate was 16.3 abortions per 1,000 women, aged 15 to 44.
I like the idea that men would have more power, and more accountability, when it comes to the prevention or the pursuit of pregnancy. I like the idea of a culture in which men can’t allege that a woman “trapped” them into fatherhood because they, too, had the ability to make an autonomous birth control choice beyond a condom. Where men also have to weigh whether their choice of birth control is worth the effect it could have on their physique, and whether that potential downside might make them a less desirable sexual partner.
A smaller share of the world’s people were hungry, impoverished or illiterate than at any time before. A smaller proportion of children died than ever before. The proportion disfigured by leprosy, blinded by diseases like trachoma or suffering from other ailments also fell.
.. Every day, the number of people around the world living in extreme poverty (less than about $2 a day) goes down by 217,000.
.. Every day, 325,000 more people gain access to electricity. And 300,000 more gain access to clean drinking water.
.. Readers often assume that because I cover war, poverty and human rights abuses, I must be gloomy, an Eeyore with a pen. But I’m actually upbeat, because I’ve witnessed transformational change.
.. As recently as the 1960s, a majority of humans had always been illiterate and lived in extreme poverty. Now fewer than 15 percent are illiterate, and fewer than 10 percent live in extreme poverty.
.. Just since 1990, the lives of more than 100 million children have been saved by vaccinations, diarrhea treatment, breast-feeding promotion and other simple steps.
.. “Intellectuals hate progress,”
.. President Trump rode this gloom to the White House. The idea “Make America Great Again” professes a nostalgia for a lost Eden. But really? If that was, say, the 1950s, the U.S. also had segregation, polio and bans on interracial marriage, gay sex and birth control. Most of the world lived under dictatorships, two-thirds of parents had a child die before age 5, and it was a time of nuclear standoffs, of pea soup smog, of frequent wars, of stifling limits on women and of the worst famine in history.
.. the ability to hold two contradictory thoughts at the same time. I suggest these: The world is registering important progress, but it also faces mortal threats.
.. there was never a headline saying, “The Industrial Revolution Is Happening,” even though that was the most important news of the last 250 years.
