Contraception Fraud

Americans now believe that care-free sex is an entitlement. Contraception can prevent unwanted pregnancies. In the unlikely event of contraceptive failure, abortion can end a pregnancy. The belief that pregnancy is unlikely induces women to have sex in relationships that can not possibly support a pregnancy.

But is contraceptive failure all that unlikely? The most recently available statistics suggest that the young, the unmarried and the poor are more apt to get pregnant than they supposed.

Contraception advocates frequently offer statistics to convince young women that they can safely engage in sex. The overall failure rate is 12.9%, meaning that 13 out of a hundred sexually active, contracepting women will be pregnant within 12 months. The "reversible" methods have failure rates ranging from 8% for the pill and 27% for withdrawal. Women absorb this kind of information, and conclude that pills or condoms protect them.

Advocates of contraception seldom provide information that shows contraceptive failure rates, broken down by relationship type, age and broad income categories. If they did, a woman would be able to see the failure rate most applicable to her own situation. It isn't as if this information doesn't exist. A 1999 study published by the Alan Guttmacher Institute, the research arm of Planned Parenthood, breaks down contraceptive failure rates by demographic characteristics.

If a poor cohabiting teenager, for instance, looked at this data, she would find that for her, the Pill has a failure rate of 48.4%. You read that correctly: nearly half of poor cohabiting teenagers get pregnant during their first year using the Pill. If she kicked her boyfriend out of the house, or if she married him, her probability of pregnancy drops to 12.9%. At the other extreme, a middle-aged, middle-class married woman has a 3% chance of getting pregnant after a year on the Pill.

The results for the condom are even more dramatic. Over 70% of poor, cohabiting teenagers using the male condom will be pregnant within a year. By contrast, the middle-aged, middle-class married woman has a 6% chance of pregnancy after a year of condom use.

What is going on here? You wouldn't think that the hormones in the pill could "know" whether a woman is married or not. Several factors are driving the differences in failure rates: fertility, maturity, commitment and amount of sexual activity.

Young women are more fertile than older women. Therefore, young women are more likely to get pregnant from any given act of intercourse, no matter what contraceptive method they use. The less mature, and possibly less stable individuals may not be using their contraception correctly or regularly. The commitment of married couples to each other makes it easier for married women to negotiate regular condom use. Finally, cohabiting women have sex more frequently than single women, so they have a greater chance of getting pregnant.

The government promotes contraception most heavily among the poor, the young, and the single, because their children are the most likely to become dependent on state support. Yet these targeted groups are the ones most likely to experience contraceptive failure. The commonly quoted failure rates of 8% for the Pill and 15% for the condom are inflated by the highly successful use by middle-aged, middle-class married couples. The "overall failure rates" are simply not relevant to this target population.

The false sense of security created by these inflated success rates of contraception may very well be seducing women to be sexually active in situations that can't sustain the care of a child. These women would be far better off postponing sexual activity, or developing a healthy relationship, or finishing high school. Yet the federal government spends approximately $12 on contraceptive education for every dollar it spends on abstinence education.

The government should insist that their programs provide demographically relevant information.

Otherwise, the rest of us should insist that the government get out of the sex ed business altogether.

"Contraceptive Failure Rates: New Estimates From the 1995 National Survey of Family Growth," Haisahn Fu, Jacqueline E. Darroch, Taylor Haas, and Nalini Ranjit, Family Planning Perspectives, Vol 31, No. 2. March/April 1999, pp. 56-63.