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Sex Without a Safety Net

Contraceptive Use Down Among Sexually Active Adults
By
WebMD Health News

Jan. 5, 2005 -- A sexually active woman today is less likely to use birth control than she was in 1995, a federal study shows.

But don't blame teenage sex. The drop in contraceptive use is due to adult women in their 20s who, despite forgoing birth control, don't want to have children.

This means that 4.5 million U.S. women are at very high risk of unintended pregnancy. That's 1.43 million more women at risk than in 1995, according to the U.S. Department of Health and Human Services survey.

The survey data, released last month, come from in-person interviews with a national sample of 7,643 women conducted in 2002. Laura Lindberg, PhD, senior research associate for the Alan Guttmacher Institute, has been analyzing the findings.

"Of particular concern is that while 98% of women of childbearing age use birth control, about half of unplanned pregnancies occur among the 2% of women not using contraception," Lindberg tells WebMD. "A sexually active woman not using contraception has an 85% chance of getting pregnant. This means almost a million more unplanned pregnancies might occur."

Unintended pregnancies are already a major health problem. Laura Gaydos, PhD, senior research associate at the Emory University Women's and Children's Center, notes that more than half of U.S. pregnancies are not planned. And unplanned pregnancies are less healthy pregnancies.

"Unintended pregnancy is a real problem. The majority are happening in adult women, not teens," Gaydos tells WebMD. "Unplanned pregnancies get less prenatal care, are more likely to be exposed to dangerous substances such as alcohol or cigarettes, have a higher rate of abortions, and carry higher risks of low birth weight babies and infant deaths."

Wrong Message on Birth Control?

Why are so many women putting themselves at risk? The data don't answer this crucial question. In fact, they show that more women, not fewer, got family-planning information from a doctor or nurse.

Perhaps medical professionals inadvertently contribute to this drop in contraceptive use, suggests Merry-K. Moos, RN, FNP, MPH, FAAN. Moos is professor of obstetrics and gynecology at the University of North Carolina, Chapel Hill.

"Our education message is if you don't use birth control, you will get pregnant. But that is not absolutely true," Moos tells WebMD.

She suggests that women may think they are infertile after having unprotected sex a few times and not getting pregnant, so they may stay off birth control to "test" their fertility.

A better approach, Moos suggests, is to focus not on avoiding pregnancy but on making a positive choice.

"I think we should teach that if you choose to have sex without birth control, you have chosen to be a parent," Moos says. "It is about making decisions rather than trusting to fate."

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