Surprise! Contraception sometimes fails!

You might expect teenagers to become pregnant without planning on it, but did you know that many women in their 20’s and 30’s also have unintended pregnancies—while using contraception?  It’s hard to believe, but every year more than 1 million American women get pregnant while using birth control.  In our last blog entry, we listed contraception methods and their effective rates, and you may have noticed that most methods fall in the 94%-99% effective range.  So how are so many women on birth control getting pregnant? 

The answer is usually human error.  Many women either use their birth control incorrectly or they use it inconsistently. 

The good news is that you are in control and can minimize your risk of having an unplanned pregnancy while on birth control.  The table below shows the biggest mistakes to watch out for and tips to maximize effectiveness.    

Contraception Method	Biggest Mistakes	How to Maximize Effectiveness
The Pill	Forgetting to take the first pill in the pack Forgetting to take other pills in the pack Not taking pills at the same time each day, Taking medicine that reduces the effectiveness of the pill.	Make sure to take the first pill on the correct day.  Create a routine to help you take your pill at the same time each day.  If you miss a pill, use a backup method of birth control.  When you start taking the placebo pills, check to see whether you have another pill pack.  This gives you plenty of time to go to the pharmacy if you are out.  If you begin taking a new medication, make sure your doctor knows you are on the Pill.
The Patch	Forgetting to apply a new patch on the correct day.	Apply a new patch at the same time as something else you do weekly, like making a grocery list.  Apply the patch to dry skin that doesn’t have lotion or oil on it.  Make sure that your patch is in place after swimming or exercising, and always have an extra patch just in case one does fall off.
Intrauterine Device	Forgetting to check for the string once a month to make sure the IUD is correctly positioned.	Wait at least six weeks after having a baby before you get an IUD.  This makes it less likely to fall out.  Show up for your follow up visit so your doctor can make sure the IUD is in place.  Ask your doctor to teach you how to check for the string.  If you can’t find the string, use a backup method and make an appointment with your doctor.
Vaginal Ring	Forgetting to insert a new ring on the correct day.  For women who choose to take the ring out during sex, forgetting to reinsert the ring after sex.	Ask your doctor to watch you insert the ring to make sure you are doing it correctly.  Check for the ring after sex to make sure it’s still there and positioned correctly.
Subdermal Implant	Good news—you really can’t make a mistake.	Your doctor inserts it into your upper arm, and it’s effective for three years.  In rare cases, it may come out if it wasn’t placed properly or if you develop an infection in the area.
Depo-Provera	Forgetting to get your shot Not getting your shot in the correct timeframe.	Schedule your appointment with a few days to spare in case you have to reschedule.  To ensure accuracy, figure the timeframe you’re due for another shot by weeks instead of months.
Diaphragm / Cervical Cap	Forgetting to use it Failing to place it properly Not using spermicide with it Storing it incorrectly.	Ask your doctor to watch you insert it to make sure you know how to place it correctly.  Use fresh spermicide every time you have sex.  Clean it with soap and water Store it in a cool, dry place.  Keep it away from sun and heat because they can break down the material.  Have your doctor refit you every year, and get refitted if you gain or lose 10 pounds or more, or if you have a baby vaginally.
Spermicide	Forgetting to use it Inserting it more than an hour before sex Not using enough	Insert the recommended amount no more than an hour before having sex.  You can increase effectiveness by using with a barrier like a condom or diaphragm.  To be extra safe, avoid sex during days 10-18 of your cycle.
Condom	Forgetting to use it Applying improperly—too early on a non-erect penis which can cause it to slip, or too late after penetration has occurred.	Use a new condom every time you have sex Apply it to an erect penis.  Apply the condom before you begin to have sex—don’t wait until later on.  Make sure to open the package carefully so you don’t tear the condom.
Female Condom	Forgetting to use it Not inserting it correctly	Make sure to follow insertion instructions Use a new female condom every time you have sex.
Male Sterilization	Forgetting to use a backup method for the first three months.	Make sure to use a backup method for three months after the surgical procedure.  Sterilized men should follow up according to their doctor’s instructions to make sure they no longer ejaculate sperm.
Female Sterilization	Good news—you really can’t make a mistake.	This method is effective immediately.

Some surprises are great, but an unplanned pregnancy can be unsettling and stressful.  To avoid this type of surprise, make sure you always use your contraception method correctly and consistently.  Remember that mantra, and you will decrease your chances of having an unplanned pregnancy.