Women Don’t Know Everything They Should About Contraception

A new survey suggests that women are not as well informed about birth control methods—even the ones they are using—as they should be. The study was sponsored by Teva Women’s Health, a manufacturer of contraceptive methods. A nationally representative sample of 1,000 women ages 18 to 44 were asked about their birth control choices and pregnancy experiences, as well as their knowledge and attitudes about certain methods. The survey also asked questions of 200 physicians, including Obstetricians/Gynecologists and family practitioners. It found:

• 31 percent of all women ages 18 to 49 report having experienced an unintended pregnancy.
• 47 percent of all women who have experienced an unintended pregnancy blame birth control failure.
• Among women currently using birth control, 31 percent of women ages 18 to 24 reported birth control failure, as did 7 percent of women ages 25 to 39, and 4 percent of women ages 40 to 49.
• Only 7 percent of sexually active women who were not trying to get pregnant and not sterilized say that they are at high risk for an unintended pregnancy.
• Among women at risk of pregnancy (which excludes women who are currently pregnant, trying to get pregnant, sterilized, had a hysterectomy, or whose partner has been sterilized), 31 percent of those ages 25 to 29, 48 percent of those ages 35 to 39, 49 percent of those ages 40 to 44, and 64 percent of those ages 45 to 49 are not using a form of contraception.
• 91 percent of women had heard of emergency contraception (EC), but among those many did not know how it worked. For example, 40 percent of women who had heard of EC incorrectly believed that it worked by terminating an existing pregnancy.
• While most women reported talking to their physician about contraception, 61 percent of women who had talked to their health care provider said they had to start the conversation.

The survey confirms what we’ve known for a long time—there are many gaps in women’s knowledge and understanding of birth control, and health care providers are missing opportunities to discuss these topics. As the authors note: “Overall, women do not understand the mechanisms through which various forms of contraception work and are also under-informed about contraceptive methods.” The study shows that women are not only underestimating their own risk of pregnancy, they are also underestimating their own role in contraceptive failure. For example, many women suggested they experienced birth control failure of the pill, but admitted that they often or sometimes forgot to take their pill. As the authors point out: “Incorrect usage of birth control methods may lead to birth control failures and accidental pregnancy.”

This study makes it clear that we need to provide more education about how birth control methods work and what steps women (and men) need to take in order to make sure that their method of contraception is as effective as possible. Moreover, it suggests that we need to remind women that, with few exceptions, if you don’t want to get pregnant you have to use birth control. It still amazes me how many grown women are willing to just take their chances when it comes to pregnancy.

Why We Don’t Notice that Sex is Kind of Gross

On television and in movies, sex is beautiful; two people with perfect bodies, wearing fabulous lingerie, fall gently onto a well-made bed, then, lit by a soothing blue glow and surrounded by quiet music, they glide around each other gracefully until the “after shot” when they are glistening, smiling, and neatly wrapped in a sheet. In contrast, real-life sex is kind of messy. People sweat, they smell, they fart, they burp, and that’s even before the body fluids (which are sticky and have their own distinct scents) get involved.  And yet, almost all of us not only do it, we seek it out. It does make one wonder, why don’t we think sex is gross?

Researchers in the Netherlands attempted to answer this question in a study of 90 women. The women were randomly assigned to three groups and shown different videos; a “female-friendly” erotic video, a high-adrenaline sports video that depicted activities like skydiving or rafting, or a clip of a train. The researchers then asked women to perform tasks that would be considered gross, like drinking from a cup with a (fake) bug in it, wiping their hands with a used tissue, eating a cookie that was next to a live worm, or putting their finger in a tray of “used” condoms. It turned out that women who had watched the erotic video were more likely to complete these tasks and to rate them as less disgusting than those who watched either of the other videos.

The researchers concluded that “…both the impact of heightened sexual arousal on subjective disgust and also on disgust-induced avoidance … act in a way to facilitate the engagement in pleasurable sex.” They go on to suggest that these findings could explain some sexual dysfunction because if women are not sufficiently aroused they might find sex disgusting and then begin to avoid it in the future.

The researchers recommend a large-scale study on this issue.

School Systems in Texas Expanding Sex Ed

When it comes to sex education, Texas is usually thought of as being pretty strict in its abstinence-only-until-marriage approach. In fact, it was one of the first to have a state-wide abstinence-only program. Called the Lone Star Leaders, the program was started by then-Governor George W. Bush to “help young people make right choices about drugs and alcohol, tobacco, sex, crime, civic involvement and school.” The State Board of Education has also engaged in bitter debates over textbooks in an effort to make sure the books were exclusively focused on abstinence and contained no information about other methods of protection against STDs or unintended pregnancy.

Now, though, many school systems in Texas are steering away from this strict abstinence-until-marriage approach and adopting broader sexuality education curricula. This week, the Spring Branch and Cypress-Fairbanks Independent School District, which is in the Houston area, adopted an “abstinence-plus” program created by the University of Texas Prevention Research Center which includes 12 lessons designed to teach seventh graders about contraception, unplanned pregnancy, and condom use.

The director of the University of Texas (UT) program who developed the lessons explained: “The misperception is that by talking about condoms and contraception and talking about sex, kids are going to increase their sexual activity; we know definitely that is not true.” UT received a $15 million grant from the U.S. Department of Health and Human Services to develop and test the curriculum. Thus far it has been used in five Houston schools and been taught to about 20,000 students.

Not all parents, however, welcomed the change. At an information session for parents in the Cypress-Fairbanks ISD some said the new program was “against their ‘moral fiber’ and a ‘bad choice’ for students and school districts.” That said, according to a district administrator, 200 parents attended the meeting and fewer than 10 had doubts about the program.

The district joins 10 schools in Harris County, the KIPP charter school system, and districts in Austin, Corpus Christi, San Antonio, and Plano in having broader sex- education programs.