Friday, June 27, 2008

Now You Tell Us....

The advocates of contraception have finally admitted in public what some of us have known for a while: The Pill doesn't work very well. James Trussell of Princeton is one of the leading experts on failure rates of various forms of contraception. Speaking at a conference in the UK, he said:
One in 12 women taking the Pill get pregnant each year because they miss so many tablets, Prof James Trussell, of Princeton University in America warned. ...

Half of all pregnancies in America are unintended and half of those happen because contraception failed or was not taken properly, the rest were not using any contraception.

He also admitted:
Increasing access to emergency contraception - the “morning after” pill - would also not have a significant effect on rates of unwanted pregnancy and abortions, he will tell the British Pregnancy Advisory Service conference in London today.

What is their proposed solution? Longer acting hormonal contraceptives, like injectables, and IUD's:
Speakers at the conference on the future of abortion will say that women should use longer-lasting methods such as hormonal implants or intrauterine devices (IUDs) that can be “fitted and forgotten”, but later removed if a woman wants a baby.

As it happens, I was just at a conference in which I showed the participants the failure rates of the Pill, broken down by demographic groups. It turns out that poor, cohabiting teenagers have a failure rate of almost 50%: 48.4% to be exact. That means, out of 100 girls with income under twice the poverty line, and who are under the age of 20 and living with their boyfriends, 48 of them will have a pregnancy within 12 months. Usually, people gasp when I show that chart. (Last year I did an article on the subject. The lefty netroots went nuts.) But a little thought will tell you why the failure rates are so high: the women aren't using their contraception correctly. James Trussel confirms this point:
He said studies have shown women miss three times as many pills as they say they do. Computerised pill packs have revealed that where as about half of women say they did not miss any pills, less than a third actually did. And where as between 10 per cent and 14 per cent admitted missing more than three pills in a month, actually between 30 per cent and 50 per cent missed that many.

The age-related failure rates suggest that the younger women are more likely to miss pills than older women. Do we really think we can come up with an educational program that will make poor cohabiting teenagers behave like married, middle-class, middle-aged women? I don't think so.
Evidently, neither does Dr. Trussell, because his solution is the long-acting contraception methods that you can just put in and forget.
But there is one other solution: unmarried women, especially teenagers, could have less sex. The failure rates for single women and married women are pretty similar, about 13% for poor women and 8% for the higher-income women.
If these girls really want to avoid pregnancy, they should kick their boyfriends out of the house. I wonder why no one from the British Pregnancy Advisory Service suggests that....

Hat tip to Ruben Obregon!


Peter Brown said...

I'm sorry; I don't understand the failure rate (presumably rate of unintended pregnancy) of "hav[ing] less sex". Surely that rate would depend crucially on just how much less sex we're talking about.

There's got to be a definition here that I missed!


Roland said...

I would assume that, given the author's normal committments, she is advocating abstinence...

And the reason that they cannot propose that solution is because the majority of people they're dealing with do not have the pre-requisite belief sets necessary to seriously suggest the solution.

Peter Brown said...

I'm sorry, I do get it now. The 8% and 13% figures cited by Dr. Morse in her next-to-last paragraph are for the Pill, not for having less sex. She doesn't give an unplanned-pregnancy rate for having less sex (by which she likely does mean abstinence, Roland, although complete abstinence isn't logically entailed in her argument here).

Apologies for my earlier thick-headedness.