Pill or IUD: These 2 factors influence how women choose

Researchers say oral contraceptives (the birth control pill) are the most commonly used contraception in the United States—used by 16 percent of all women ages 15-44. (Credit: outcast104/Flickr)

Women are more likely to choose the type of contraceptive they use based on their relationship status and how often they have sex—not on when or if they plan to get pregnant.

Researchers surveyed nearly 1,000 women in Pennsylvania, all with private health insurance covering prescription contraception, on their contraception use. The women were asked about their pregnancy intent, history, and risk. They also were asked which birth control method they preferred—prescription and over-the-counter options, as well as natural family planning and withdrawal method.

The women in the study were not planning to get pregnant within at least the next 12 months. Thirteen percent of participants planned to have a pregnancy in the next 12 to 24 months; 25 percent in two to five years; 23 percent in five or more years; another 23 percent were not sure if or when they wanted to have a baby; and 16 percent said they did not ever intend to have a baby.

The pill vs. LARCs

The findings show that partnership status and frequency of sexual intercourse—not long-term pregnancy intent, as the researchers had hypothesized—is the strongest predictors of prescription contraceptive use.

“Currently, oral contraceptives (the birth control pill) are the most commonly used contraception in the US—used by 16 percent of all women ages 15-44—while LARCs (long-acting reversible contraceptives, including intrauterine devices and implants) are used by only 7.2 percent,” the researchers write in the journal Contraception.

LARCs are highly effective and, due to the Affordable Care Act, are now available at no cost to women in most private health insurance plans.

“We found that a lot of women who intend to get pregnant someday, but not for at least a year, were not using LARCs,” says coauthor Cynthia H. Chuang, associate professor of medicine and public health sciences at Penn State. “However, women who don’t ever want to get pregnant are more likely to use long-acting reversible contraception.”


The new research is part of an ongoing randomized controlled trial to test an online intervention to help women make contraceptive choices consistent with their pregnancy plans.

“Over time, if overall use of prescription contraception and adoption of LARCs increase, the rate of unintended pregnancy—estimated at 51 percent of all US pregnancies in 2008—would be expected to decline,” the researchers say.

The Patient-Centered Outcomes Research Institute supported the project.

Source: Penn State