So here it goes: When you’re considering which type of contraception to use, it’s helpful to look at the typical-use rate. Then, try to be honest with yourself and decide whether you should move closer to the perfect-use rate or further away.
It might also help to look at pregnancy rates beyond one year — after all, we’re not limited to one year of sex. Unfortunately, we don’t have good data on long-term pregnancy rates, but we can get an idea of what happens over longer periods of time.
Let’s say you’re an average condom user, and your odds of experiencing a pregnancy in one year are 18 percent. But you aspire to be a better user (good for you!). Over the next five years, you follow through, using a condom more consistently and correctly each year. As an improving condom user, you lower your pregnancy risk by 4 percent each year until you hit the perfect-use pregnancy rate of 2 percent — 18 percent rate the first year, then 14 percent, then 10 percent, then 6 percent, then 2 percent.
Over this five-year span, the risk of encountering at least one pregnancy — even though you’re improving usage each year — is just over 40 percent.
Dealing with the Numbers
This 40 percent risk explains why half of women between the ages of 15 and 44 in the United States experienced an unplanned pregnancy.
Note that 90 percent of women at risk for an unplanned pregnancy really do use contraception. And while the majority of contraceptive users aren’t perfect, even perfect users still account for 5 percent of unplanned pregnancies.
What can you do to reduce your numbers? It’s easy to just say that you should become a perfect user. That will certainly make a big difference, but it’s not a realistic option for everyone.
Using more effective methods is one approach. As mentioned, a long-acting reversible contraceptive, such as an implant or IUD, has a great pregnancy-rate track record. Further, more than 75 percent of users keep using those methods after a year. That’s a better continuing-use rate than condoms or the pill.
Let’s say both you and your partner are not perfect users, and long-acting methods are not an option. Another route is to use at least two methods simultaneously, an approach taken by 15 percent of men and women. By using two methods simultaneously, both methods have to fail at the same time in order for pregnancy to occur.
The most common example would be using the pill and condom together. But you could do other combinations, such as the pill and withdrawal, condom and rhythm method, or diaphragm and the pill. Any combination will be better than using one of the methods alone, though the lack of contraceptive options for men limits the combinations.
This is yet another reason why we need more contraceptive options — especially for men.