Contraceptive Failure in the United States: The Impact of Social, Economic and Demographic Factors

Abstract

Applying a new multivariate life table technique and information for currently married women from the 1973 and 1976 cycles of the National Survey of Family Growth the authors analyze 1st year contraceptive use failure rates for small population subgroups. When pregnancy intention family income and age are controlled the pill is by far the most effective method with a 1st year failure rate of 2.4% followed by the IUD (4.6%) the condom (9.6%) spermicides (17.9%) the diaphragm (18.6%) and rhythm (23.7%). In general effectiveness increases with age and income. Among women older than 25 those who want no more children are more successful than those who wish only to delay a pregnancy. However among younger women delayers are more successful than preventers--probably because women who have had all the children they want at an early age are more likely to have already had contraceptive failures. Failures for pill users are generally low for women in all population subgroups. The highest failure rate for the pill is equivalent to the lowest failure rate reported for rhythm (8%). For women under age 22 failure rates for the diaphragm are extremely high (up to 52%). For women who are both young and poor failure rates are high with all methods except the pill and IUD. (authors modified)