The decision to begin, prevent, or interrupt a pregnancy may be influenced by many factors, including personal, medical, family, and socioeconomic factors.
Contraception can be used by people to prevent pregnancy temporarily or to provide permanent contraception Permanent Contraception In the United States, one third of couples attempting to prevent pregnancy, particularly if the woman is > 30 years old, choose permanent contraception with vasectomy or tubal sterilization... read more (sterilization). Abortion Induced Abortion In the United States, about half of pregnancies are unintended. About 40% of unintended pregnancies end in induced abortion; 90% of procedures are done during the 1st trimester. In the United... read more (interruption of pregnancy) may be considered when contraception has failed or has not been used, or when issues occur during the pregnancy.
Among contraceptive users in the United States, the most commonly used methods (1 General reference The decision to begin, prevent, or interrupt a pregnancy may be influenced by many factors, including personal, medical, family, and socioeconomic factors. Contraception can be used by people... read more ) are
Oral contraceptives (OCs): 21%
Female permanent contraception (sterilization): 28%
Male condoms: 13%
Male permanent contraception: 9%
Intrauterine devices (IUDs): 13%
Withdrawal (coitus interruptus): 6%
Progestin injections: 3%
Contraceptive rings or patches: 2%
Subdermal progestin implants: 3%
Fertility awareness methods (periodic abstinence): 3%
Female barrier methods: < 1%
(See table .)
Pregnancy rates tend to be higher during the first year of use of a contraceptive method and decrease in subsequent years as users become more familiar with the method. Also, as women age, fertility declines. By comparison, for fertile couples trying to conceive, the pregnancy rate is about 85% after 1 year if no contraceptive method is used.
In the first year of use, pregnancy rates with typical use are
< 1% for methods that do not require user involvement (IUDs, subdermal progestin implants, sterilization)
6 to 9% (approximately) for hormonal contraceptives that require user involvement but are not related to coitus (estrogen-progestin OCs, transdermal patches, or vaginal rings; progestin-only OCs; progestin injection)
> 10% for coitus-related methods (eg, condoms, diaphragms, fertility awareness methods, spermicides, withdrawal)
Despite the higher pregnancy rate associated with condom use, condoms (primarily latex and synthetic condoms) are highly protective against transmission of sexually transmitted infections (STIs), including HIV. As part of safer sex practices, condoms should be used even when a patient is using another birth control method.
If unprotected sex occurs, emergency contraception Emergency Contraception Emergency contraception may be used to prevent pregnancy for a short period of time after unprotected sex. Commonly used emergency contraception methods include Insertion of an intrauterine... read more may help prevent an unintended pregnancy. Emergency contraception should not be used as a routine form of contraception.
General reference
1. Centers for Disease Control and Prevention (CDC): National Center for Health Statistics: Current Contraceptive Status Among Women Aged 15–49: United States, 2017–2019. NCHS Data Brief 388, October 2020. Accessed April 16, 2023.
