We’ve got the latest numbers on contraceptive use and, perhaps unsurprisingly, birth control is pretty dang popular among U.S. women.
This week, the Centers for Disease Control and Prevention (CDC) released a report on the current state of contraception which found that nearly two out of three women of reproductive age in the United States use contraception.
The report is based on data from the 2015–2017 National Survey of Family Growth (NSFG), which asked 5,554 women about their birth control use in the previous month.
By extrapolating this data to the 72.2 million women of reproductive age in the country, we can get a pretty good idea of who is using birth control and how. "It’s an important report because it provides a descriptive portrait of women’s contraceptive use and non-use for women between 15 and 49 in the U.S.," study co-author Kimberly Daniels, Ph.D., tells SELF. The biggest finding was that 64.9 percent of women in that age group use contraception. This is a slight increase from the 61.6 percent of women (aged 15 to 44) from the last report, containing data for 2011 through 2015.
Female sterilization and birth control pills are the most popular contraceptive methods.
The report found that the most common contraceptive methods women use are female sterilization at 18.6 percent and the pill at 12.6 percent followed by long-acting reversible contraceptives (LARCs), which includes implants and intrauterine devices (IUDs), at 10.3 percent, and male condoms at 8.7 percent. "These four methods account for half of all contraceptive use, so that means 36 million women are relying on them," Daniels says. Other methods including the Depo-Provera shot, the contraceptive ring, and the patch, made up the remaining percentages.
Oh, and as for 35.1 percent of women who aren’t using contraception? They’re not all just having unsafe sex. About half of them (17 percent of the respondents) hadn’t had sex in the past three months while the rest were either pregnant, postpartum or trying to conceive (7.5 percent), or, indeed, sexually active but not using protection (7.9 percent).
Birth control use increases considerably with age, but other factors play a role in contraception preferences, too.
The report also looked at how the respondents’ age, race, and education level related to the method of birth control they were most likely to use. The clearest pattern is that overall contraceptive use increases considerably with age, from 37.2 percent among women between the ages of 15 and 19 to 73.7 percent of women aged 40 to 49. Although education level did not correlate with overall contraceptive use, it did impact the type of contraception women chose. As education level increased, the rate of female sterilization declined while use of the pill increased. Although the use of LARCs was unrelated to education level, it did correlate with age: 13.1 percent of women in their twenties and 11.7 percent of women in their thirties chose LARCs, compared to 6.7 percent of women in their forties.
One important caveat about the numbers we're talking about: This is the first report of its kind that includes women up to age 49 (previous years only included women up to 44), which, Daniels explains, makes directly comparing this report with the last one a little tricky. For instance, women in their mid-late forties are more likely to opt for female sterilization, making the apparent increase in this method—from 14.3 percent in the last report to 18.6 percent in this one—seem larger than it actually is. More women aren’t actually choosing sterilization; we just weren’t including these women in the survey before.
When you take out data for women aged 45 to 49, female sterilization rates remain flat: only 14.2 percent of women aged 15 to 44 chose this method in 2015 to 2017, according to the CDC.
Although the CDC report doesn’t tell us why we’re seeing these numbers, previous research indicates that greater access to contraception plays a role.
There's already a body of evidence suggesting that the success of the Affordable Care Act (ACA) in helping more women obtain access to affordable and effective contraception has a lot to do with these trends, as SELF reported last month. The law made health insurance in general easier and more accessible, and it instituted a birth control mandate (which requires employers to offer insurance plans that cover 100 percent of the cost of at least one form of FDA-approved birth control in each method category). “The ACA leveled the playing field in terms of cost for a lot of different types of birth control,” ob/gyn Kristyn Brandi, board member with Physicians for Reproductive Health, tells SELF.
For instance, we saw an increase in the amount of women aged women 15 to 44 choosing LARCs, from 8 percent during 2011 to 2015 to 11.3 percent in 2015 to 2017. We can deduce that this likely in part due to the ACA, because there is research demonstrating that the rate of women paying out of pocket for an IUD decreased dramatically in the years after the law’s implementation. And when money is not an issue, women are much more likely to choose previously pricey LARCs over other methods.
In addition to preventing unintended pregnancies, contraception has many different benefits for reproductive autonomy and health.
First of all, yes, it’s pretty awesome at helping women avoid pregnancy when that's not something they want. And that, in turn, reduces the need for abortions. Just last month, the CDC released a report showing we’ve hit historically low abortion rates, a trend that closely tracks with the uptick in contraceptive use, as SELF reported.
On top of that, contraception also has a multitude of other medical uses. Hormonal birth control can help control heavy or irregular menstrual bleeding, reduce period cramps, suppress ovulation that causes painful ovarian cysts, ease the pain of endometriosis, clear up acne, prevent menstrual migraines, manage menopausal symptoms, and lower the risk of endometrial, colon, and ovarian cancers.
Experts see the CDC report as more evidence that we need to protect reproductive rights going forward.
Any kind of legislation limiting birth control access or reproductive rights in general could slow down or reverse the progress we’ve made. “I can imagine that if people had less access to birth control, these numbers [on contraceptive use and abortion rates] could change drastically,” Dr. Brandi says. Right now, there are new ACA rules set forth by the Trump administration that could roll back birth control coverage, as well as pending amendments to state constitutions that could ban abortion if Roe v. Wade were overturned.
The latest threat came last week when a federal judge in Texas ruled the ACA unconstitutional. (Democrats are preparing to appeal the decision, which will likely make its way to the Supreme Court.)
The law remains in place for now, but the medical community is concerned. “A lot of people’s access to birth control is based on the ACA, so thinking about this act being overturned means millions of women’s health care could be affected,” Dr. Brandi says. “This report emphasizes even more so that we need to protect the ACA.”
Related:
