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News & ArtsTuesday, July 21, 2009
Sex Pregnancy Scare
Posted by Dan Savage on Tue, Jul 21, 2009 at 3:56 PM
What surprised me about this story in the "Science" section of today's New York Times wasn't the effectiveness of pulling out—a.k.a. the withdrawal method—as a birth control option (which was reported back in June), or that pulling out is only a little less effective than using condoms (also reported back in June), but seeing the stats about the effectiveness of all the other birth control methods available to the young, horny, straight, and fertile ticked off in a few short paragraphs:
“If the male partner withdraws before ejaculation every time a couple has vaginal intercourse, about 4 percent of couples will become pregnant over the course of a year,” the authors write.For condoms, used optimally, the rate is about 2 percent. But more significant, the authors say, are the rates for “typical use,” because people can’t be expected to use any contraception method perfectly every time. Typical use of withdrawal leads to pregnancy 18 percent of the time, they write; for typical use of condoms 17 percent of the time. (There are other, more effective methods. Failure rates for the pill and the patch are about 8 percent; for Depo-Provera injections, about 3 percent; and for diaphragms, about 16 percent. Intrauterine devices fail less than 1 percent of the time.)
Man, heterosexual sex is risky. If I were straight I wouldn't put my dick in a woman—the lower front part of a woman—if she wasn't anxious to exercise her right to choose.
1
Um...not to be a hypercritical reader, but would it be possible to edit this post a bit? The typos are distracting. Thanks!
3
IUD or nothin', baby.
It was only recently that I understood that the effectiveness percentages were how many couples would probably get knocked up using that method for a year, not how many times you'd be likely to get knocked up for each hundred times you had sex (which always seemed crazy). An important distinction.
It was only recently that I understood that the effectiveness percentages were how many couples would probably get knocked up using that method for a year, not how many times you'd be likely to get knocked up for each hundred times you had sex (which always seemed crazy). An important distinction.
4
Getting my IUD was pretty much the most painful outpatient procedure I've ever had. That, and it's taken me nearly a year to get used to it. Still, I'd take it over the pill or other methods.
7
Not only do condoms fail 100% of the time, they're also majorly unsafe. I mean, you wouldn't put a plastic bag over your grandmother's head, would you?
11
Yet another reason why IUDs are excellent -- near-perfect effectiveness, you almost never have to think about them, good for 5-10 years, and mine, at least, was covered by insurance (which saves me a not insignificant amount of money relative to the pill).
Though, as @4 points out, getting it is no walk in the park if you haven't had kids.
Though, as @4 points out, getting it is no walk in the park if you haven't had kids.
12
I wonder if "typical use" includes consistently using lube. I think I've had a condom break on me once the sixteen years or so I've been sexually active, and I think not using enough was a big factor in this.
13
I can't believe you've been a sex columnist for a year and didn't know this information.
Then again, most heterosexual men and women know this information and choose to ignore it.
Then again, most heterosexual men and women know this information and choose to ignore it.
14
There must be a lot of idiot condom users out there. Either that or 17% of condom users aren't using one every time. Is it the same 17% every year?
16
I wouldnae put my dick a woman, and ken the man hae would sports a mere utilikilt, ay, with sandals.
18
I love my partner's IUD, except when it's fishing line decides to slip an inch deep into my urethra. Then I cry. Happens much more often than you'd expect. I must have great aim, or terrible luck.
19
@11 - sure, I never had to think about my IUD...after the four months of cramps and bleeding that it took to get used to it. This is a very serious and annoying side effect that is not uncommon and shouldn't be poo-poohed.
Oh, and the string that the first doc cut too short? Was so short that when I had the IUD taken out, the next doc had to put me under so that she could open me up, dive in and fish it out. Dilating the cervix is never without risk.
Oh, and the string that the first doc cut too short? Was so short that when I had the IUD taken out, the next doc had to put me under so that she could open me up, dive in and fish it out. Dilating the cervix is never without risk.
21
Hey maybe if hetero guys will now be terrified of having sex with women there will be more females for me to pork. Score!
22
They neglected to mention the NuvaRing, the World's Most Fantastic method of hormonal birth control. Failure rate with perfect use: 1%. With "typical use": 1-2%.
23
@18 - Condoms help with this. It's been one of the weirder things to get used to. It may also be that your girlfriend needs to have hers trimmed.
24
"Man, heterosexual sex is risky."
Right.
Especially compared to gay sex.
After all, 53% of all new cases of AIDS occur in the gay male 1% of the population.
Right.
Especially compared to gay sex.
After all, 53% of all new cases of AIDS occur in the gay male 1% of the population.
25
@18 - uh, I believe this is an appropriate time to say "OMG srsly?!" I had no idea that was even a possibility.
@19 - I'm not poo-poohing anything, I do know that different people react differently to them. I think I had a "good" experience, and even with that, the insertion hurt like hell, I had terrible, terrible cramps for 2-3 days (and probably took an unsafe amount of OTC painkillers), and had more painful monthly cramps for the first 4-6 months (though nothing super terrible). They don't work for some people, for sure, but for those they do work for, they're great (with some initial awful-ness).
@19 - I'm not poo-poohing anything, I do know that different people react differently to them. I think I had a "good" experience, and even with that, the insertion hurt like hell, I had terrible, terrible cramps for 2-3 days (and probably took an unsafe amount of OTC painkillers), and had more painful monthly cramps for the first 4-6 months (though nothing super terrible). They don't work for some people, for sure, but for those they do work for, they're great (with some initial awful-ness).
26
Dan--
Those condoms that fail heteros 17% of the time are How Effective at protecting gays during anal sex?
Those condoms that fail heteros 17% of the time are How Effective at protecting gays during anal sex?
28
@19 They downplayed that part for me, too. I was told that as a woman who'd never had kids, it would probably be "a little uncomfortable."
Ha.
I went into shock afterwards. I was dizzy, lightheaded, I couldn't drive home. And the cramps -- they (still) come in debilitating waves around my period (which I continue to get, a year out).
It was seriously the most traumatic medical experience I've ever had -- and that trumps a bike accident when I was a teenager where I had a seizure and spent a week in the hospital.
Ha.
I went into shock afterwards. I was dizzy, lightheaded, I couldn't drive home. And the cramps -- they (still) come in debilitating waves around my period (which I continue to get, a year out).
It was seriously the most traumatic medical experience I've ever had -- and that trumps a bike accident when I was a teenager where I had a seizure and spent a week in the hospital.
29
@18 Good to know I'm not the only one who's ever experienced this! However, @23 makes a good suggestion. It could be that she needs hers trimmed.
(P.S. When it happened to me I didn't cry. Pussy.)
(P.S. When it happened to me I didn't cry. Pussy.)
30
anxious to? Really Dan? How about willing to? Likely to?
Do you really think anyone is anxious to get an abortion??? Maybe anxious ABOUT getting one.
Do you really think anyone is anxious to get an abortion??? Maybe anxious ABOUT getting one.
32
@25 Yes. It happens all the time to me. I do have a big urethra though.
@29 I will suggest a trim perhaps. It has been trimmed before though. I just play to win.
@29 I will suggest a trim perhaps. It has been trimmed before though. I just play to win.
34
I'm not throwing out the rubbers yet. These rates are for "typical use", i.e. including dumb people. If you know what you're doing condoms are much safer, because you usually know when it fails- it breaks of slips off- and you can go get the morning after pill. With the pull out method you're playing Russian Roulette every time. You won't know you botched it until she misses her period. I just can't wait for male chemical birth control, although I could see it leading to a golden age for STDs.
35
I dislike how condoms get such a bad rep. 17% of people who use condoms "typically" must be pretty moronic. Like a previous poster, I wonder if it's the same 17% every year.
37
I call bullshit on these supposed statistics. As written, it suggests that 17% of the time intercourse takes place with a condom, a pregnancy will occur, which is laughably not true. One in six times? If you know how to use them, they work EVERY TIME. Likewise the pill; as written, this suggests that women who take the pill get pregnant after 8% of intercourse acts, which means if you have sex three times a week, then by the odds you should get pregnant within the month. I don't even think unprotected sex has that high a fertility rate.
If instead it means something more like "17% of the people who use condoms exclusively will eventually get pregnant", maybe. But even then -- how stupid are you?
I can't even count how many times I've used a condom -- with a 100% success rate.
If instead it means something more like "17% of the people who use condoms exclusively will eventually get pregnant", maybe. But even then -- how stupid are you?
I can't even count how many times I've used a condom -- with a 100% success rate.
38
"lower front part"? Seriously? I thought you were Dan Savage, the infamously vulgar sex columnist whose frank talk and sex positivity had all of Blue America in love with you and all of Red America in a tizzy? And suddenly you can't say VAGINA?
39
@37: You only THINK you've had a 100% success rate, Daddy-o. One day soon the lawyer will come a-knockin'.
Seriously, after reading the above, I am no longer kicking around the pros and cons of getting an IUD after Lil TVDinner arrives. Once we've secured two additions to the population, Mr. TVDinner is getting fixed. He fucking owes me.
Seriously, after reading the above, I am no longer kicking around the pros and cons of getting an IUD after Lil TVDinner arrives. Once we've secured two additions to the population, Mr. TVDinner is getting fixed. He fucking owes me.
41
For the last fucking time (and you would think a sex columnist would get this straight):
"Typical" use of a condom includes people too fucking stupid to use one each and every time they have sex.
And maybe straight guys who are that worried about pregnancy can combine perfect condom use with perfect withdrawal method.
"Typical" use of a condom includes people too fucking stupid to use one each and every time they have sex.
And maybe straight guys who are that worried about pregnancy can combine perfect condom use with perfect withdrawal method.
42
It's worth saying that hets having sex should seriously consider that a child may be the result. It's not necessarily a tragedy, after all, that is how the human race is meant to propagate.
(BTW, when I surfed over to dictionary.com to confirm the spelling of "propagate," I noticed they don't use "verb transitive" or "verb intransitive" but rather "verb (used with object)" and "verb (used without object)"--a lot more ink, I guess, because we must be getting too stupid to figure out what "transitive" and "intransitive" mean. Scary.)
(BTW, when I surfed over to dictionary.com to confirm the spelling of "propagate," I noticed they don't use "verb transitive" or "verb intransitive" but rather "verb (used with object)" and "verb (used without object)"--a lot more ink, I guess, because we must be getting too stupid to figure out what "transitive" and "intransitive" mean. Scary.)
43
Obviously part of dodging those scary statistics us being an atypical user. Which includes using a condom EVERY time and checking the condom for failure EVERY time. In the past three years I've had two condom failures. One a very obvious blowout, the other a small leak that might have happened when he was taking it off. His habit of tying and checking for leaks payed off, though. On both occasions, I was off to the pharmacy for my morning after pills within 12 hours.
44
@37 Has no one ever told you how pregnancy risk statistics work? It's not like that at all. "17% failure rate with typical use" doesn't mean you're 17% likely to get pregnant every time you have sex. It means that out of 100 couples using condoms typically, 17 will get pregnant over the course of an entire year. Out of 100 couples using condoms perfectly, 2 will get pregnant over the course of an entire year. Some women and some men are kind of preternaturally fertile, I guess. But it's not as scary as you describe it.
I don't take the "typical" rates seriously because, as others have pointed out, "typical" rates include some really, really stupid people. Like people who think it's ok to use condoms only most of the time... and that one time, in the heat of the moment, just go without and ejaculate in the vagina. People who think it's ok to miss one, or two, or three birth control pills in a row, or start a pack late, or leave their pills out in the sun, etc., etc. When used correctly, hormonal birth controls and barrier protections are highly effective. It's just a matter of educating people about what correct use means.
Then, of course, there's always the option of multiple methods of birth control (for example, pill +condoms), which brings down the risk of pregnancy to a much, much smaller percentage.
I don't take the "typical" rates seriously because, as others have pointed out, "typical" rates include some really, really stupid people. Like people who think it's ok to use condoms only most of the time... and that one time, in the heat of the moment, just go without and ejaculate in the vagina. People who think it's ok to miss one, or two, or three birth control pills in a row, or start a pack late, or leave their pills out in the sun, etc., etc. When used correctly, hormonal birth controls and barrier protections are highly effective. It's just a matter of educating people about what correct use means.
Then, of course, there's always the option of multiple methods of birth control (for example, pill +condoms), which brings down the risk of pregnancy to a much, much smaller percentage.
45
Use 2-3 forms of contraceptives, any combination of diaphragm, condoms, BC pills, spermicidal gel/foam, and you won't be in that unlucky 2-17%.
46
TVDinner,
I reccommend just that, or you can get yourself done right after delivering Lil TVDinner number 2. It was so worth it, but that's my opinion.
I reccommend just that, or you can get yourself done right after delivering Lil TVDinner number 2. It was so worth it, but that's my opinion.
49
Thank god my girlfriend knew about IUDs. She had never heard about them until her mother introduced her to them. Aside from the "installation," she loves it. No period, no forgetting pills, no numerous doctor visits, no adjusting pills or shots.
It's the fucking best.
It's the fucking best.
50
Why do these things NEVER take into account that a woman can actually only get pregnant on maybe 3-5 days out of any given cycle, during ovulation?
Read Taking Charge of Your Fertility by Toni Weschler. If you can read your own fertility signs, you'll know when getting knocked up is possible and you can take extra precautions then. Otherwise those sperm are barking up a dead tree, as it were.
I couldn't believe I spent half my sex life thinking I could get pregnant any time of the month. It was a huge relief to find out that about 70% of the time you really don't have to worry about it. (this is NOT the rhythm method, folks -- this is understanding what your individual body is doing, not going by the calendar.)
Read Taking Charge of Your Fertility by Toni Weschler. If you can read your own fertility signs, you'll know when getting knocked up is possible and you can take extra precautions then. Otherwise those sperm are barking up a dead tree, as it were.
I couldn't believe I spent half my sex life thinking I could get pregnant any time of the month. It was a huge relief to find out that about 70% of the time you really don't have to worry about it. (this is NOT the rhythm method, folks -- this is understanding what your individual body is doing, not going by the calendar.)
51
Go, IUDs, Go! Mine works extremely well. It didn't hurt to put it in, and although I bled for the first month, it's been great ever since (8 years now).
52
@49 and 51
I'm hoping mine works as well for me as the IUD's you two have experienced! It's nice to hear reassuring words.
I'm hoping mine works as well for me as the IUD's you two have experienced! It's nice to hear reassuring words.
53
@50 FAM is great. It's important to remind people, though, that it can't be used in combo with hormonal birth control methods like the pill, the patch, nuvaring, implanon, etc. Since the hormones disrupt your cycle to keep you from ovulating, the normal predictors for fertility don't apply, and the days you're likely to get pregnant are whatever days you mess up in your pill-taking. You have no idea how many women I know who think that, even though they're on the pill, there's some window in the middle of the month where they're more fertile.
54
Definitely a major plus that homos have over heteros... birth control is totally unimportant.
Man... I could almost switch over to the other side JUST to be rid of that completely annoying facet of sex.
Man... I could almost switch over to the other side JUST to be rid of that completely annoying facet of sex.
55
@47 - Don't worry about it too much, for me it was like 30 seconds of relatively intense pain, and then a few days of harsh cramping. Don't be shy about asking your doctor for painkillers/muscle relaxers. I didn't, and when I told her how bad the cramps were afterwards, she was like, why didn't you call me and ask for something? The pain was totally worth it in the end, though.
56
@50 A character in a Heinlein story once said, "Do you know what doctors call women who use the rhythm method?" Mothers.
57
We went with the vasectomy. It's absolutely great. Before that we used withdrawal for many years without a pregnancy.
58
@23
It may actually be better if the line is longer. If it's long enough, it sort of curls around the cervix and stays out of the way.
I <3 my IUD. :)
It may actually be better if the line is longer. If it's long enough, it sort of curls around the cervix and stays out of the way.
I <3 my IUD. :)
59
The statistic for the IUD is misleading as well. It has a 1% failure rate when IN THE RIGHT PLACE, but those fuckers travel, and more often than people think they do.
60
@50: That is more or less true, but there are times when you can feel "in the clear" so to speak (I won't get into detail) and still get knocked up. I speak from experience.
Stick with the IUD. It might be a painful at first, but hey, its only a few months of discomfort versus 18 years or kids, or a painful abortion procedure.
Stick with the IUD. It might be a painful at first, but hey, its only a few months of discomfort versus 18 years or kids, or a painful abortion procedure.
62
It is not unreasonable to assume that something on the order of 17% of couples are morons. I can imagine the reduction in effectiveness includes things like not using one every time, reusing filled ones and many other things.
64
I'm sorry that some women have had so much trouble with the IUD, but I don't think those complications are typical. I've never been pregnant and never plan on having kids, and I haven't had any trouble with mine. I was crampy and uncomfortable for about 36 hours after I had my Mirena IUD put in, and it hurt--sharply--for a few minutes when inserted. But I drove myself home from the doctor's office without incident, and I lounged around on the couch for most of the rest of the day and popped ibuprofen every four hours. No big thing. I haven't had any cramps or spotting since, and it's been almost 4 years. My insurance covered it, and I'm no longer paying $25 copay per month for the pill, and I'm no longer buying tampons or pantyliners. Best of all, since the Mirena is sort of like two forms of birth control in one--the device itself and the low-dose of hormones that stay localized and don't have to work their way through my entire system first--I don't have to worry about a thing. My husband offered to get a vasectomy, but I decided I'd rather not get my period anymore, anyway, so I plan on having a Mirena in my cervix from now until menopause. I know this isn't an option for all women, but I hope that none of them are too scared of stories about complications to consider it--because I think it's the best option out there. I got mine because I was (am) TERRIFIED of getting pregnant and always have been. I live in an area where getting an abortion would be difficult (probably impossible), and this miracle device has really given me a lot of peace of mind.
65
47:
If you're worried about pain, ask your doctor about Implanon. Since it goes in your arm, the insertion is a lot less painful (and you get local anesthesia). I did get breakthrough bleeding with it, but no cramps. It lasts 3 years. I don't know if they've studied the failure rate since it was first introduced overseas, but in the first study they had like 300 women and no one got pregnant, so I would say <1%.
How come no one else has heard of this form of birth control???
If you're worried about pain, ask your doctor about Implanon. Since it goes in your arm, the insertion is a lot less painful (and you get local anesthesia). I did get breakthrough bleeding with it, but no cramps. It lasts 3 years. I don't know if they've studied the failure rate since it was first introduced overseas, but in the first study they had like 300 women and no one got pregnant, so I would say <1%.
How come no one else has heard of this form of birth control???
66
You know we've reached a point of moral depravity when "research" is made six ways to Sunday in finding out methods to not have kids. Truly telling of the challenging times the traditonal family unit faces.
67
@65 I did talk to my doctor about Implanon, but she told me that for my situation Mirena would be a better alternative, especially since the pill I'm on now has the same exact hormone. My mom has also used Mirena successfully, but she had it put in after her third child, so I will definitely experience more pain than her.
68
I use FAM with complete success, and I've been using it for 12 years. Hormonal birth control makes me violently sick, and I know 3 women who've conceived with IUD's in place, so I'll stick with watching my own body and tracking my fertility to avoid pregnancy until I'm ready for it. No side effects, no expense, just my own diligence required.
69
Surprisingly - a lot of people are not aware of how to put a condom on properly. I want to specifically mention that initially placing the condom on upside down and then reversing it (leaving the 'outside tip' now coated with pre-cum) it is a move I have seen men do...
70
Dan - I call BS. You would do it if you were het because you obviously want a family. I think you have gone to lengths to get one actually.
So there. (:=
So there. (:=
71
Speaking of crappy birth control methods;
Does The Stranger provide Health Insurance for employees, interns and their families?
Does The Stranger provide Health Insurance for employees, interns and their families?
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