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Sex Without a Safety Net

Contraceptive Use Down Among Sexually Active Adults
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Wrong Message on Birth Control? continued...

"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."

Lindberg, too, says well-meaning messages may be to blame.

"Women need clear, consistent messages that hormonal contraception when used properly is a 99% effective means of preventing unintended pregnancy," she says. "To the extent that abstinence education and other programs are highlighting the failure rate as opposed to the protection rate for these methods, women may be confused. Efforts to scare women about the health risks of birth control pills, or saying birth control doesn't always protect you, leave women saying, 'Why bother?"

Respecting a woman's right to reproductive choice, Moos says, means more than simply asking her whether or not she wants to use birth control. It means helping each woman make the choices that are best for her.

"In the clinical setting we are too quick to assign women a birth control method and to make it uncomfortable for the patient to come back and say, 'This isn't working for me,'" Moos says. "Or we assign them a method without accounting for the two or three months it takes for their bodies to get used to it. I see so many people who say they can't use birth control. That is because they had a bad experience with one formulation but don't know there are many formulations."

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