My latest Town hall article is HERE. The contraceptive failure rates commonly reported are very misleading. I cited a couple of articles from Family Planning Perspectives, published by the Allan Guttmacher Institute, which is the research arm of Planned Parenthood. Those articles show that contraceptive failure rates depend not only on the method of contraception used. The probability of failure also depends on the demographic characteristics of the user.
Some of my critics in the blogsphere seem to think I made these numbers up, just for meaness. These are Planned Parenthood's numbers. The question is: what do we make up them? What do they mean? There are 3 demographically relevant factors: age, poverty and marital status. I think there are probably several big issues behind these demographics: fertility, maturity, commitment and amount of sexual activity.
First, age is a proxy for both maturity and fertility. For any contraceptive method, young women are more likely to get pregnant than older women. This is a function of the fact that fertility naturally declines with age. Think about people you know: among the middle-aged, middle-class married women, you probably know some who are more worried about infertility than contraception. That is what the data are picking up when they show an overall failure rate of 15.2% for women aged 20-24 and 9% for women over 30. (table 4 of Ranjit et. al.)
Maturity matters because some of the younger, and possibly less stable individuals are probably not using their contraception consistently or correctly.
Commitment is very interesting: cohabiting women have twice the contraceptive failure rate of married women overall: 21% versus 10%. And even looking at comparable age groups and poverty status, cohabiting women have much greater failure rates than married women. See Tale 2 of Fu et. al. Cohabiting teenaged poor women have a 70% failure rate for condoms, compared with only a 23% failure rate for married poor teenagers. What does this mean? I suspect that the married couples have less difficulty negotiating consistent condom use. They have a shared future, which the cohabiting couples may not.
Finally, cohabiting couples have sex frequently than single people. This may account for the relative success of singles vs. cohabiting women of comparable age and income. Again, see Table 2 of Fu et. al.: the failure rate for the PILL is 48% for cohabiting poor teens, but only 13% for single poor teens.
Of course both these rates are higher than the officially published statistics of 8% for the pill, and 15% for the condom, which was my point.
Sex ed programs should be focusing on the failure rates that are relevant to the target demographic group, not the general population. If a middle-class, middle-aged married woman has a contraceptive failure, that is a private problem for her and her family. It has no social significance whatsoever, and is frankly none of the government's business one way or the other. Contraception failure among the poor and the young and the unmarried has become a public problem because the public is likely to end up supporting their offspring. That is why the government has taken it upon itself to teach sex ed in the first place. If the government is going to get involved, it should focus on demographically relevant contraceptive failure rates, not on some failure rates, theoretically obtainable in a world of perfect use. The point of the tables in these studies is exactly to show that perfect use is not the same as theoretically perfect use.
By the way, I am certainly prepared to believe that improved education can improve the consistency of contraceptive use. I'm not prepared to believe that there is any education program that will make a 13 year old behave like a 30 year old.
By the way, the shouting and screaming in the blogsophere, complete with commentary about my likely sex life, confirms what I believe is our new social norm about sex: Sex is a essentially a private recreational activity, with no moral or social consequences. We believe sex is essentially a sterile activity, and babies are an after-thought, an optional consumer life-style extra, if you happen to like that sort of thing. Many of the discussants at Pandagon seem to feel themselves cheated if they don't obtain the results that perfectly functioning contraception would create. I'm just the messenger: contraception doesn't always work. Shoot the messenger if you must, but that doesn't negate the message.