N O I T P E C A R T N CO LLING CA g n u o Y e r o M t ’ n e r A Why ? g n i n e t s i L n e m o W tion rip esc ms Pr Condo fill Re k up E N JU 3 4 5 6 13 2 1 7 1 Introduction MOST YOUNG SINGLE WOMEN are having sex and most have used some form of birth control at some point. Nearly all say they are trying to avoid pregnancy at this time in their lives. Still, 49 percent of unmarried women age 18-29 do not use contraception consistently.i Nearly two million of them get pregnant every year and most say the pregnancy was unplanned.ii Despite more birth control options than ever before, despite an Internet full of information about birth control (see Bedsider.org, for example), and despite their own desire to avoid pregnancy, young women aren’t as good at using contraception as they should be. It seems that many young single women who are not trying to get pregnant are not trying hard enough not to. Why do so many young women say they don’t want to get pregnant and yet use birth control so sporadically? Why don’t more young of women surveyed have used some method of contraception in their lives women who are trying to avoid pregnancy use the most effective methods of contraception? What causes them concern? What are the barriers to better use? What kinds of feelings do they associate with using birth control? Why do single young women who are not trying to get pregnant not try harder to avoid it? The National Campaign to Prevent Teen and Unplanned Pregnancy teamed up with Cosmopolitan magazine—often considered the bible for sexually active, single, young women—to examine these very issues. The results presented here are from a nationally Readers should note that those who participated in the survey representative survey conducted by TRU, a worldwide leader in represent a specific slice of the millennial universe to be sure. research on teens and twenty-somethings. This online survey was As noted previously, the responses presented here are entirely administered in March 2013 to more than 1,000 unmarried women, from unmarried women who do not have children, who do have sex, age 18-29, none of whom have had children, all of whom have and who don’t want to get pregnant right now. By comparison, among had sex, and none of whom are trying to get pregnant. Among the all American women age 18-29, only 33% fit this description.iii women who were surveyed: Not surprisingly, this specific profile is more likely to describe those • Even though more than eight in 10 say they would be upset if they in the younger part of the age bracket. Among all 18-22 year-old got pregnant, nearly half (48%) say it is at least a little bit likely women in the United States, 44% fit the description of our survey they will have unprotected sex in the next year; one in five say it respondent. On the older end of the spectrum—women age is very likely. 26-29—only 19% do. For this reason, younger women are given particular focus in this report. • More than half (58%) admit to not using contraception all the time. •O ne in three (30%) have used emergency contraception (also known as the morning after pill). • One in four (24%) have let a partner talk them out of using contraception. • More than eight in 10 (82%) of those who have had a pregnancy scare say that experience made them more careful about using protection and more than half (54%) say it made them switch to a more reliable method of birth control. • And yet 78% say they are totally satisfied with their current method of contraception. 1 Pregnancy Intention vs. Behavior ALL OF THE WOMEN IN THIS SURVEY—every next year; nearly half say it is at least a little bit likely. Three out of last one of them—say they do not want to get pregnant at this four (74%) say they’ve had unprotected sex in the past and nearly six time in their lives. In fact, more than eight in 10 (82%) say they’d in 10 (58%) have done so in the past couple of years. Many of those be upset if they found out today that they were pregnant. More than age 18-29 (44%)—and 56% of those age 18-22—say they are often half—56%—say they’d be very upset. Among those age 18-22, two nervous they are pregnant and relieved when they learn that they out of three (65%) would be very upset. are not. In addition, about one in three (30%) have used emergency contraception, making it the third most commonly used form of Yet despite their stated intention to avoid pregnancy, fully one in five birth control after condoms and the pill. (20%) admit it is very likely they will have unprotected sex in the More than women say they would be upset if they got pregnant, yet: have had unprotected sex in the past admit to not using contraception all the time say it is likely they will have unprotected sex in the next year 2 Contraception: What Single Young Women Use NEARLY EVERYONE IN THIS GROUP (99%) HAS ALREADY USED SOME METHOD OF CONTRACEPTION TO PREVENT PREGNANCY Condom use is widespread among young single women. Nearly six in 10 (56%) of those age 18-29 and 62% of those age 18-22 say that condoms are the method they’ve used most recently. However, at some point in her life. More than nine out of 10 (92%) have used this doesn’t necessarily mean condoms are the only method they’re condoms and three out of four (74%) have used the pill. using—nearly the same number of respondents overall say they used Half (50%) say the pill is their preferred method of birth control the pill most recently (53%), and 15% cited other methods as well. and one-third (32%) say that condoms are. Put another way, an appreciable proportion of young women are using condoms and some other method of contraception Less than one in 10 have used other hormonal methods of birth (not surprising given the important role condoms play in preventing control—such as the shot (8%), the ring (8%), or the patch (6%). sexually transmitted infections or STIs). Even fewer have used the most effective forms of birth control—just 5% have tried the IUD and 2% the implant. It is worth noting that the majority of those who have tried these long-acting, effective, and reversible methods say they are their favorites. of women surveyed have used emerg ency contraception Th e majority of those who have tried IUDs and implants say they are tion th eir favo rite methods of contracep 3 Contraceptive Concerns ALTHOUGH ORAL CONTRACEPTIVES ARE POPULAR—MORE THAN HALF HAVE RECENTLY USED THE PILL—many have concerns about Proper use of the pill also presents challenges. One in four (25%) women in the survey say that having to take something every day “doesn’t work for me,” and 38% say that when they discuss birth side effects. Among the women surveyed—again, every one of them control with friends, forgetting to take the pill is one of the things actively seeking to avoid pregnancy right now—fully one-third (33%) they talk about. One in 10 (11%) say the fact that they sometimes are uneasy about what taking the pill might mean for their fertility forget to take their pill is the most common topic of birth control in the future. One in four (26%) are scared by the medical warnings conversation among friends. Still, nearly half of respondents (47%) they see in TV commercials, and 17% say they’re uncomfortable say that a method being “easy to use” is one of the most important taking birth control pills because doing so is “unnatural.” factors in their contraceptive selection process, and the pill is by far their most preferred method. 1 in 4 respondents say they are scared by the medical wa rnings about birth control pills that they see in TV commercials 1 in 4 respondents say taking something every day “doesn’t work for me” 4 Contraception: How Single Young Women Choose EVEN THOUGH THE MOST EFFECTIVE CONTRACEPTIVE METHODS—and those least prone say they choose a method primarily because it’s easy to get, and one-third (32%) say “where and how to get it” is something to error like the IUD, implants, etc.—are not the most popular, they talk about with friends. More than half (54%) of respondents efficacy is paramount to the women surveyed. More than three out say they have had a pregnancy scare. Of those, more than eight in of four (77%) say one of the most important factors in choosing a 10 (82%) say that experience made them more careful about using method is how effective it is. Affordability is also key—nearly half protection. More than half (54%) of those who have had a pregnancy (49%) cited cost as an important variable in deciding what method scare say it made them switch to a more reliable method of birth to use. In addition, nearly half (47%) consider ease of use one of the control. We do not know from this survey whether that means that most important factors. a pregnancy scare caused women to go from using nothing some of the time to using something most of the time, or whether it More than one-quarter (27%) of the women surveyed say they rely provided the impetus for moving from a less effective method to a on a health care provider’s suggestion when deciding what method more effective one. Even so, the large proportion of women who take of birth control to use. It is also the case that some women say their action and move toward a better method of contraception, or begin doctor experience is less than ideal, including 36% of those 18-22 using a particular method more consistently and carefully after a who say talking to their health care provider about contraception pregnancy scare, is notable. is “usually uncomfortable.” One in four women surveyed (25%) have y e h t y a s nts e d n o p s e r e f o r a c s y c n a n had a preg of respondents who have had a itch pregnancy scare say it made them sw trol to a more reliable method of birth con 77� of respondents say effectiveness is the most important factor when choosing a method of contraception 5 Sex Without Protection: Why? SOME OF THE REASONS WOMEN SAY THEY ARE HAVING UNPROTECTED SEX seem to stem There are also reasons why women choose not to use a particular method of contraception, which obviously often leads to unprotected from “in the moment” decision making (or non-decision making, sex. Chief among these reasons is a fear of side effects. One in four depending on your perspective), including: (25%) women say that fear of long-term side effects is a key reason for their decision not to use a particular method. One in five (19%) •O ne-third say they “just weren’t thinking” (32%) or they didn’t plan are afraid of more immediate possible side effects like weight on having sex so they weren’t prepared (30%) to use birth control. gain. Potential side effects like weight gain and mood swings also dominate conversations about birth control between friends. More •O ne in five (20%) say they were drunk or high at the time. than half (54%) say they talk about side effects with their friends, • Nearly half (44%) say they’ve trusted a partner to pull out. and one in four (23%) say that’s what they talk about most. • Nearly four in 10 (39%) say that sex just feels better Affordability is also a key concern, especially for women without without protection. health insurance. Among uninsured women in the survey, half (50%) •O ne in four (24%) say they’ve let a partner talk them out of say cost has kept them from using a more effective yet more expensive using protection. method. When respondents were provided with a list of 15 possible • One in five (20%) say they’ve had unprotected sex because their reasons for why they had decided not to use or to discontinue using partner didn’t want to use anything. a certain method, more women (regardless of insurance status) selected “too expensive” (26%) than any other answer option. When • About one in 10 (13%) say that not using condoms “was a way for they discuss birth control with their friends, 43% of the single young us to show that our relationship was more serious.” women surveyed say cost is one of the things they talk about. of respondents have trusted a partner to pull out of respondents have let a partner talk them out of using contraception of respondents say they have had unprotected sex because their partner didn’t want to use anything 6 Contraception: What Young Women Want DESPITE THEIR CONCERNS ABOUT AFFORDABILITY AND DAILY COMPLIANCE, a real opportunity for more proactive input from the medical community about the factors most important to women, such as and even though a majority of women in the survey say they have efficacy and ease of use. One-third (33%) of the women we surveyed experienced pregnancy scares (and nearly as many are often nervous say a method being a “healthy option” is important to them. Who about the possibility of being pregnant), more than three-quarters better to tell them about the safety and health benefits than their (78%) of those surveyed say they are totally satisfied with their doctor or other qualified medical professional? As it is, one-third current method of contraception. Whether that’s a reflection of (35%) of women in our survey say they wish their doctor was “more simple acceptance or something else entirely is unknown. helpful in finding the right birth control for me.” What is known is that there are more effective contraceptive Women in the survey also say they want to hear more positive talk methods than the ones most commonly used by the young women about birth control in general. Nearly seven in 10 (68%) say they we surveyed—in particular, there are a variety of methods that don’t wish the TV shows and movies they liked portrayed contraceptive require a daily obligation or a game-time decision every time one has use as a “normal part of sexual relationships and encounters.” More sex. LARCs (long-acting reversible contraceptives) like the IUD and the than half (52%) say they wish celebrities and other high-profile implant, are increasingly available and are becoming more affordable, people talked more openly about contraception. In fact, nearly half too. They require little maintenance once they’re in place and are the (46%) of respondents overall say they themselves would be more most effective methods of contraception available, in part because comfortable using contraception if more people talked about it in a they practically eliminate the chance of imperfect use. positive way. Among the 18- to 22-year-olds in this study—those newest to the whole enterprise of contraception and whose habits LARCs need to be inserted by a medical professional; some other and ideas are most rapidly developing—55% feel this way. forms of contraception require a prescription. Consequently, there’s of respondents wish celebrities and other high profile people talked more openly about contraception 68� of respondents say they wish the TV shows/movies they like portrayed using contraception as a normal part of sexual relationships 7 Conclusion, Insights, and Recommendations WHAT CAN BE DONE TO HELP YOUNG WOMEN MAKE BETTER CONTRACEPTIVE CHOICES AND DELAY THE PREGNANCIES THEY SAY THEY AREN’T READY TO HAVE? The good news is that contraception is not an entirely foreign concept to single young women, though use of the most modern and effective methods is not as extensive as one might hope. And despite a wide range of emotional and practical obstacles, almost everyone uses some kind of protection at least some of the time. • Get clear about what “not trying to get pregnant” really means. While young women have very real complaints and worries about It’s more than using contraception sometimes or even most of birth control, they also have generally positive feelings about using the time. It means using it correctly every time—or better yet, it. An overwhelming majority (84%) of the women we surveyed say switching to a long-acting, reversible method that doesn’t that using contraception makes them feel “responsible” because require women to do anything at all until they actively want “it’s part of being an adult.” Six in 10 respondents (60%) say using to get pregnant. contraception makes them feel “grateful” and “glad” because they • Educate young women and dispel myths that keep them from using “can enjoy sex without getting pregnant.” birth control methods that would better meet their needs. Young But their feelings and their behavior don’t exactly match. Certainly, women are using contraception, but barriers large and small often the “say one thing, do another” strategy can pertain to a range of trip them up. These barriers are real and shouldn’t be trivialized, but issues at any age. However, the stakes are quite high when pregnancy most can be overcome. is involved. Young women in particular who themselves say they • Health care providers have a real opportunity to educate young are not ready for pregnancy and parenthood could benefit greatly women, introduce them to new methods, and support them as they from a birth control upgrade. Assuaging—without dismissing—their keep trying different types of birth control until they find the one fears about hormonal methods and introducing them to easier, more that best suits them. Doctors and nurse practitioners are already effective methods could lead to better contraceptive experiences for a trusted source for this information and are well positioned to set many and reduce unplanned pregnancy among those who say they the tone for open, informative conversations. aren’t yet ready to become parents. • Getting lost in the moment happens, and there are methods that let you do that without risking pregnancy. Let’s help young women learn about and get more comfortable with using long-acting, effective contraceptives so that giving in to the moment doesn’t mean giving up on birth control. 8 CONTRACEPTION CALLING DATA SUMMARY Demographics/Qualifying Criteria Total Sample n=1011 Male Total Sample n=1011 - Single Female Married - Total Sample n=1011 Total Sample n=1011 Yes 18-22 Net No 18 - 19 20 21 Total Sample n=1011 22 23-25 Net Yes 23 No 24 - 25 26-29 Net Total Sample n=1011 26 27 Yes 28 No - 29 Total Sample n=1011 Total Sample n=1011 White Yes African American No Hispanic or Latino Asian or Pacific Islander Native American or Alaskan Native Other race 9 - Protected/Unprotected Sex Total Sample n=1011 Total Sample n=1011 Boyfriend(s) Every single time Friend(s) you hook up with Most times Ex-boyfriend(s) About half the time Random guy(s) Rarely Other Never I haven’t had sex in the past year I haven’t had sex in the past year Total Sample n=1011 Total Sample n=1011 Yes Very likely No Somewhat likely A little bit likely Not at all likely Total Who Have Ever Had Unprotected Sex n=752 I trusted my partner to pull out Sex feels better without protection I just wasn’t thinking I didn’t plan on having sex so I wasn’t prepared My partner did not want to use protection I was drunk or high I thought it was a safe time of the month Not using condoms was a way for us to show that our relationship was more serious I don’t like how the hormones in birth control make me feel I didn’t bring it up with my partner because I didn’t want to ruin the mood I hadn’t gotten pregnant before, so I assumed I wouldn’t that time either I wasn’t in a relationship at the time so I wasn’t on birth control I wouldn’t have minded getting pregnant at the time I couldn’t afford contraception Going to a doctor or clinic to get birth control is a pain I was embarrassed to discuss protection with my partner I was too embarrassed to buy protection I was too embarrassed to talk to my doctor about birth control I didn’t want to seem promiscuous by bringing protection I don’t think protection is really all that effective anyway I was trying to get pregnant at the time None of these 10 Pregnancy 14 Have you ever had a pregnancy scare? Total Sample n=1011 Yes No 15 Have you ever had an unplanned pregnancy? Total Sample n=1011 Yes No 16 If you found out today that you were pregnant, how would you feel? Please select one response. Total Sample n=1011 Very upset A little bit upset A little pleased Very pleased 17 How much do you agree or disagree with each of the following statements? Please select one response per statement. Strongly agree A B C D E I am often nervous that I am pregnant and relieved when I get my period (Total Sample n=1011) It is likely that I’ll have an unplanned pregnancy while I’m single (Total who have never had an unplanned pregnancy n=928) It doesn’t matter whether you use contraception or not, when it is your time to get pregnant, it will happen (Total Sample n=1011) My pregnancy scare made me more careful about using protection when I have sex (Total who have ever had a pregnancy scare n=547) My pregnancy scare made me switch to a more reliable method of birth control (Total who have ever had a pregnancy scare n=547) 11 Somewhat agree Somewhat disagree Strongly disagree Contraception 18 20 Which method of contraception have you EVER used? Please select all that apply. Which method(s) are you currently using or have you used most recently? Please select all that apply. Total Sample n=1011 Total Who Have Used Any Contraception Method n=1002 Condoms Birth control pill Emergency contraception/Morning after pill Condoms Depo-Provera shot Birth control pill NuvaRing IUD (intrauterine device) Spermicide NuvaRing The patch Depo-Provera shot IUD (intrauterine device) Spermicide Female condom Emergency contraception/Morning after pill Implant The patch Diaphragm Implant Cervical Cap Sponge Sponge - Diaphragm I have never used any of these 19 Cervical Cap Which method of contraception is your FAVORITE one to use? Please select one response. Female condom None of these Total Who Have Used Any Contraception Method n=1002 21 Which, if any, of the following are most important to you when choosing a method of contraception? Please select no more than THREE responses. Total Sample n=1011 Birth control pill Condoms It’s effective IUD (intrauterine device) It’s affordable Depo-Provera shot Easy to use NuvaRing I think it’s a healthy option for me The patch My doctor/health care provider suggested it Implant Easy to get Emergency contraception/Morning after pill I’ve heard/read good things about it Sponge Spermicide Diaphragm Cervical Cap Female condom - My partner suggested it - My friends like it/use it None of these None of these 12 are the MAIN REASONS you have decided NOT to use 22 What a certain method of contraception, or to discontinue using a 24 method? Even if all of these reasons apply, please only pick the most important ones. Please select no more than TWO responses. Total Sample n=1011 What do you and your friends talk about MOST? Please select ONE response only. Total Who Discuss Contraception or Birth Control with Friends n=883 Too expensive I’m afraid of long-term side effects I’m afraid of weight gain Side effects like weight gain and mood swings I had a bad reaction to it How effective it is I’m afraid of putting hormones in my body What we like about it Hard to use correctly How we sometimes forget to take it My friend had a negative experience with it What we dislike about it Hard to get How much it costs My doctor/health care provider suggested I stop using it Whether it’s safe to take hormones every day Embarrassing to purchase Where and how to get it I’m afraid of mood swings The political controversy about it My partner discouraged me from using it How ineffective it is I don’t trust pharmaceutical companies How confusing it is I had a pregnancy scare/got pregnant while using it Whether birth control causes cancer None of these None of these 23 25 hen you and your friends have talked about contraception or W birth control, what do you talk about? Please select all that apply. The main reasons I use contraception are: Please select no more than TWO responses Total Sample n=1011 Total Sample n=1011 Side effects like weight gain and mood swings I’m not ready to be pregnant How effective it is I’m waiting until I get married to have kids What we like about it I can relax more during sex when I’m not worried about getting pregnant What we dislike about it It would disappoint my parents too much if I got pregnant right now How much it costs How we sometimes forget to take it Medical reasons not related to pregnancy prevention Where and how to get it I’m not in a serious relationship Whether it’s safe to take hormones every day The political controversy about it The guy I’m having sex with is not the guy I want to have kids with How ineffective it is My partner expects me to Whether birth control causes cancer None of these How confusing it is 26 My friends and I never talk about birth control Which of the following makes you feel uneasy about taking birth control pills? Please select all that apply. Total Sample n=1011 I’m afraid it will mess with my fertility in the long run The medical warnings in the commercials scare me Having to take a pill every day doesn’t work for me It’s unnatural I’ve had a bad experience with the pill It’s unhealthy I just don’t trust that it works My friends have had bad experiences with the pill I have reservations based on religious or moral concerns None of these make me feel uneasy 13 27 How much do you agree or disagree with each of the following statements? Please select one response per statement. A I am totally satisfied with my current method of contraception B Talking to my doctor/health care provider about contraception is usually uncomfortable C Talking to my partner about contraception is usually uncomfortable D E F G H Somewhat agree Somewhat disagree Not applicable Strongly disagree Not applicable I wish the TV shows and movies I liked portrayed using contraception as a normal part of sexual relationships and encounters I wish celebrities and other high-profile people talked more openly about contraception J Birth control should not be a political issue K Cost has kept me from using a more effective, but more expensive method of contraception L Cost has prohibited me from using any kind of contraception Drug companies probably don’t care if a method of contraception is safe, they just want people to use it so they can make money When I hear people on the news criticizing birth control and the people who use it, it makes me less likely to use it O I have let a partner talk me out of using protection P I’d feel more comfortable using contraception if more people talked about it in a positive way 28 Strongly agree Strongly disagree I’m not really sure where to go for the kind of birth control information I want Most of what I hear/read/see in the news or media about birth control is negative N Somewhat agree I wish my doctor/health care provider was more helpful in finding the right kind of birth control for me I wish my partner was more interested in/supportive of what kind of protection we use I M Strongly agree Total Sample n=1011 Somewhat disagree 29 hich of the following words would you use to describe how W you feel about using birth control? Please check all that apply. re these tasks easier or harder than using birth control A consistently? Please select one response per statement. Total Sample n=1011 Total Sample n=1011 EASIER than using HARDER than birth control using birth control consistently consistently Responsible: It’s part of being an adult Grateful: I’m glad I can enjoy sex without getting pregnant Annoyed: The whole topic is a pain Burdened: I wish my partner cared more about it None of these A Doing my taxes is… B Going to the gym is… C Bathing suit shopping is… D Finding the right bra is… E Staying on top of my finances is… 30 Which is more embarrassing...? Please select one response. Total Sample n=1011 Buying condoms Talking to a new sex partner about protection 14 Demographics Continued 31 33 What is your zip code at home? What is the highest level of education you’ve completed? Total Sample n=1011 Total Sample n=1011 Less than high school diploma Northeast High school diploma or GED Midwest Some college South Two-year college degree West Four-year college degree 32 Advanced degree Which best describes the community in which you live? Total Sample n=1011 34 A large or medium-sized city Do you currently have health insurance? Total Sample n=1011 The suburb of a large or medium-sized city Yes A small town or rural area No Notes and Methodology Note: Contraception, protection, and birth control are all terms TRU conducted 1,011 online interviews among females age 18-29, used to describe something that prevents pregnancy. Some people yielding a margin of error of +/- 3.1% percentage points. Interviews equate “birth control” with “the pill,” think that “protection” means were conducted March 5-17, 2013 and were collected using quotas “condoms,” or that other methods (the ring, the shot, the patch, to ensure even distribution by age and strong ethnic representation. IUDs, etc.) are called “contraceptives.” However, for the sake of 20% of respondents identified themselves as African-American and clarity and for the purposes of this survey it was made clear to 18% identified themselves as Hispanic. respondents that we used those terms interchangeably. It was also made clear that withdrawal, or the pull out method, did not count as a method of birth control. So throughout this report “contraception” = “birth control” = “protection,” and “unprotected sex” = having sex without any of them, regardless of withdrawal. References Kaye, K., Suellentrop, K., and Sloup, C. (2009). The Fog Zone: Jones, J. Mosher, W., & Daniels, K. (October 2012). Current i ii iii How Misperceptions, Magical Thinking, and Ambivalence Put Young Contraceptive Use in the United States, 2006-2010, and Changes Adults at Risk for Unplanned Pregnancy. Washington, DC: The in Patterns of Use Since 1995. National Health Statistics Reports National Campaign to Prevent Teen and Unplanned Pregnancy. (60). Washington, DC: National Center for Health Statistics. Retrieved from www.cdc.gov/nchs/data/nhsr/nhsr060.pdf. The National Campaign to Prevent Teen and Unplanned Pregnancy. (October 2012). Briefly: Unplanned Pregnancy Among Unmarried Young Women. Washington, DC: Author. Retrieved from www.TheNationalCampaign.org/resources/pdf/briefly-unplannedpregnancy-among-unmarried.pdf. 15
© Copyright 2026 Paperzz