07 March 2010

Tons of people you know are clueless about birth control

UPDATE: Amanda has a good write-up of this study over at Slate's XX.

Seriously, thank you abstinence-only sex education. The National Campaign to Prevent Teen and Unplanned Pregnancy recently conducted a study attempting to find out why so many (about half) of pregnancies in the U.S. are reported as unplanned. Their major findings about the "range of factors that put unmarried young adults at risk of unplanned pregnancy:"
Even though most unmarried young adults say that it is important for them to avoid pregnancy right now, only about half of those who are sexually active use contraception every time. Some take a pass on birth control altogether, at least part of the time, and while others are more conscientious, they are often not careful or consistent enough. In addition, a significant portion expects to have unprotected sex in the near future.
As an unmarried adult who is scared shitless of getting pregnant, I find this odd. But then, I found that study that found that 50% of men in couples who claimed that not getting pregnant was important to them would be pleased if their girlfriend accidentally got pregnant just fucking bizarre. I am literally unable to comprehend how one can be so ambiguous about parenthood. The commenters at The Sexist were suggesting that perhaps men are just pleased that their sperm works; I am a little unwilling to think that men are so clueless about how much work and money a baby is to be more pleased about their functioning man parts than dismayed that they are now in charge of a tiny screaming bundle of joy for the rest of their lives. Amanda's theory makes more sense to me; it's true that misogynistic culture tells men that wanting marriage and babies is a feminine trait, and real men have to get roped into those things by their overwhelming desire for the pussy. It's a narrative that makes the man a hero, the-bestest-man-in-the-world, for marrying a pregnant woman, since that's such an unpleasant thing for him to do but oh so responsible. So he can get what he really wants through unplanned pregnancy--marriage and babies--without having to admit to himself or the world that that was what he wanted. I still find that ambiguity puzzling, but that's probably a signal of how terrifying I find pregnancy, rather than my perspicacious insight into human psychology. From the study again:
Many say they have little knowledge of even common contraceptive methods such as condoms and the pill, and most have not even heard of less common methods such as the implant.
Unsurprising, honestly. We still live in a country where people believe anti-choicers when they say birth control causes abortions. They do not teach about the pill or condoms in most sex ed programs in the U.S., except maybe to spread misinformation, like telling young people that condoms can't stop the spread of STDs, that condoms have a failure rate of 15% even when used correctly, and claiming that there is no such thing as safe sex.
To the extent they have heard of various methods, many express little confidence in their effectiveness and strong concerns about side effects. Many even claim, "it doesn't matter whether you use birth control or not; when it is your time to get pregnant it will happen."
Wow. Again, the effectiveness misunderstanding is understanding. Abstinence-only sex education programs tell young adults that birth control methods are ineffective all the time. And they're also not above suggesting that women who use the pill or other forms of hormonal contraception (which, by the way, is almost all American women between the ages of 15 and 44) have serious risk of dangerous side effects. There certainly are serious side effects to hormonal birth control, including blood clots and heart attacks, but the risk of getting these side effects is minimal. If abstinence-only programs teach about side effects of birth control, they are likely to exaggerate them (just like they exaggerate birth control failure rates). From a pamphlet opposing the Healthy Youth Act in Wisconsin: "Yet hormonal contraceptives have been proven dangerous to women's health." This is not an abnormal attitude toward female-controlled birth control options in the pro-life, pro-abstinence community.

However, the people who said that it doesn't matter if you're on birth control--I would not like to meet them in person. That sort of attitude is grossly irresponsible and fatalistic. And it's an attitude that can only be the result of superstitious or ignorant thinking; if you know the actual failure rates and risk of birth control options (which, this study showed, the majority of unmarried young adults simply don't), it's nearly impossible to think that it doesn't matter whether you're on birth control.

The study shows that most unmarried young adults feel strongly that pregnancies should be planned (94% of men and 86% of women) and most of them also find it important that they avoid pregnancy right now (86% of men and 88% of women). But half of them are not practicing birth control methods consistently or at all. The intentions are not matching their behavior. About 50% of young unmarried adults are "well protected against unplanned pregnancy." The study proposes that the explanation for this gap is that the majority of young unmarried adults are clueless about birth control methods and their efficacy and side effects. Some scary statistics:
Among those reporting they had relied on the rhythm method or natural family planning, 40% do not know when a typical woman's most fertile time of the month is.

Despite current clinical evidence suggesting otherwise:
27% of unmarried young women believe that it is extremely or quite likely that using birth control pills or other hormonal methods of contraception for a long period of time will lead to a serious health problem like cancer.
30% say it is extremely or quite likely that using an IUD will cause an infection.
36% say it is likely that the pill will cause them to gain weight and 40% say it will likely cause severe mood swings and that these concerns reduce the likelihood of their using the pill.

42% of men and 40% of women believe that the chance of getting pregnant within a year while using the birth control pill is 50% or greater [!].
Of young adults who have relied on the pill, 14% believe that the pill is effective even if a woman misses taking them 2 or 3 days in a row. 14% believe that after a woman stops taking birth control pills, she is unable to get pregnant for at least 2 months.

Of those who have used condoms, 24% believe that wearing 2 condoms provides extra protection. 11% don't believe it is important to leave a space at the tip of a condom when putting it on.

Despite all this, 90% believe they have all the knowledge they need to avoid an unplanned pregnancy.
I wouldn't place the blame for this problem solely on the steps of abstinence-only sex education programs, but those programs are clearly failing young adults. And pro-abstinence, pro-life, religious organizations also foster a social environment where young adults believe that birth control and abortion are ineffective, dangerous, and/or racist. That environment is clearly affecting young people's opinions about birth control, but their doctors, parents, peers, and larger social system are not doing enough to combat that environment.

I think part of the problem, too, is that most men figure that women should know more about birth control methods than they do, and thus place a lot of the responsibility for birth control on the shoulders of their female partners. But women don't get some sort of extra sex ed, people. I had no sex education in school, in fact. And when I did go on the pill, my doctor told me practically nothing about it. She didn't counsel me on my other options, of which I had many, and told me very little about the side effects (or lack thereof) of taking the pill. And I was young and embarassed, so I didn't ask a lot of questions. And my mother was irritated with me about having sex in the first place, so she sure wasn't available for questioning. There was a string of people who failed me: my school, my parents, my doctor. It's not just abstinence-only programs that are failing young people, but the entire system surrounding sexual health. And it's ridiculous.


Hatkey said...

I'm about a month late to the party on this, but thank you so much for this post. When I started looking into birth control, I did as much online research as I could before settling on the method that was right for me. When I started talking to my friends about their preferred methods, however, I was shocked and appalled... nobody seemed to know anything about contraception. And seeing as we were all around sixteen at the time, it worried me that much more. I had one friend in particular who said she and her boyfriend had sex in the shower because water "washed all the sperm away"... and that kind of thinking is not at all uncommon.

As dorky as it may be, I've started carrying little notecards with failure/success rates and birth control facts on them. Pregnancy, even if you intend to terminate it (though I'd say people are as ill-informed about abortions as they are about BC) can be life-changing, yet so few people are making an effort to teach others. That, coupled with the "Pfft, it won't happen to me" kind of mindset can be very dangerous...

I wish I could grab everyone and shake them and say, "Goddammit, what are you doing?! You need to examine the steps that you're taking to avoid unplanned pregnancy!" But instead I'll just forward them this article. Thanks much!