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Contraceptive Failure in the United States: Estimates from the 2006–2010 National Survey of Family Growth
Author(s) -
Sundaram Aparna,
Vaughan Barbara,
Kost Kathryn,
Bankole Akinrinola,
Finer Lawrence,
Singh Susheela,
Trussell James
Publication year - 2017
Publication title -
perspectives on sexual and reproductive health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.818
H-Index - 93
eISSN - 1931-2393
pISSN - 1538-6341
DOI - 10.1363/psrh.12017
Subject(s) - national survey of family growth , medicine , family planning , abortion , context (archaeology) , condom , demography , developed country , population , research methodology , family medicine , pregnancy , environmental health , geography , human immunodeficiency virus (hiv) , archaeology , sociology , biology , genetics , syphilis
CONTEXT Contraceptive failure rates measure a woman's probability of becoming pregnant while using a contraceptive. Information about these rates enables couples to make informed contraceptive choices. Failure rates were last estimated for 2002, and social and economic changes that have occurred since then necessitate a reestimation. METHODS To estimate failure rates for the most commonly used reversible methods in the United States, data from the 2006–2010 National Survey of Family Growth were used; some 15,728 contraceptive use intervals, contributed by 6,683 women, were analyzed. Data from the Guttmacher Institute's 2008 Abortion Patient Survey were used to adjust for abortion underreporting. Kaplan‐Meier methods were used to estimate the associated single‐decrement probability of failure by duration of use. Failure rates were compared with those from 1995 and 2002. RESULTS Long‐acting reversible contraceptives (the IUD and the implant) had the lowest failure rates of all methods (1%), while condoms and withdrawal carried the highest probabilities of failure (13% and 20%, respectively). However, the failure rate for the condom had declined significantly since 1995 (from 18%), as had the failure rate for all hormonal methods combined (from 8% to 6%). The failure rate for all reversible methods combined declined from 12% in 2002 to 10% in 2006–2010. CONCLUSIONS These broad‐based declines in failure rates reverse a long‐term pattern of minimal change. Future research should explore what lies behind these trends, as well as possibilities for further improvements.