CT Free Radicals: The Other 99%

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In April 2011, the Guttmacher Institute published the results of an analysis finding that 99% of all women of reproductive age who have ever had sex—including 98% of such Catholic women—have used a method of contraception other than natural family planning. These data have been ubiquitous in the recent debate over the requirement that private insurance plans cover contraceptive services and supplies without cost-sharing. However, there has been some confusion about various aspects of the research that produced this statistic.

Women who “have ever used” contraceptives

Guttmacher’s analysis of data from the federal government’s National Survey of Family Growth found that the vast majority of American women of reproductive age (15–44)—including 99% of all sexually experienced women and 98% of those who identify themselves as Catholic—have used a method of contraception other than natural family planning at some point. Women may be classified as sexually experienced regardless of whether they are currently sexually active, using contraceptives, pregnant, trying to get pregnant or postpartum

By their early 20s, some 79% of never-married women—and 89% of never-married Catholic women—have had sex. (Presumably, all married women have done so.) In short, most American women (including Catholics) have had sex by their early 20s, and virtually all of them have used contraceptives other than natural family planning.

These statistics look only at women of reproductive age because that is the group impacted by policy changes related to insurance coverage of contraception.

Women who are “currently using” contraceptives

The above statistics on women who have ever used contraceptives are not to be confused with data on women who are currently using contraceptives. Among women who are currently at risk of unintended pregnancy, 88% overall—and 87% of Catholics—use a method other than natural family planning.

Women who are at risk of unintended pregnancy—that is, who are sexually active and are able to become pregnant but want to avoid pregnancy—comprise about seven in 10 of all women of reproductive age. Importantly, this category excludes women who are pregnant, postpartum or trying to get pregnant; women who have never had vaginal intercourse; and women who have not had sex in the last three months. Women who are not at immediate risk of unintended pregnancy are relatively unlikely to have reason to practice contraception. However, just because a woman is not currently using contraceptives does not mean that she has not used a method previously or that she will not use one in the future.

Among all women who are at risk of unintended pregnancy, 69% (including 68% of Catholics) are currently using a highly effective contraceptive method—male or female sterilization, the IUD, the pill or another hormonal method. Another 14% (15% among Catholics) are relying on condoms, and 5% (4% among Catholics) are relying on other methods, such as withdrawal. Only 1% of all women at risk of unintended pregnancy (2% of Catholics) use natural family planning, the only method of contraception sanctioned by the Catholic hierarchy.

Nonuse of contraceptives among women at risk of unintended pregnancy

Eleven percent of all women at risk of unintended pregnancy (and the same proportion of such Catholic women) are not using a method of contraception even though they are sexually active and are not trying to become pregnant. Some of these women may feel ambivalent about pregnancy and may therefore be less motivated than others to use contraceptives. Others may have sex infrequently or think they are unable to become pregnant. Finally, some may not be able to afford contraceptives. Importantly, the vast majority of women who are at risk but are not using contraceptives have used a method in the past and will most likely do so again in the future.

The bigger picture

Regardless of religious background, women use contraceptives to help them time and space their childbearing and to achieve healthier pregnancies. A significant body of research shows that planned pregnancies involve healthier behaviors and outcomes than unplanned ones—the mother is more likely to seek and receive prenatal care and to breast-feed her infant, and is less likely to smoke or drink during pregnancy. Contraception also helps women to avoid pregnancies that are spaced too closely and thus to avoid adverse outcomes that can negatively affect a child’s development—including delivery of an infant who is low-birth-weight, preterm or small for gestational age.

Women who use contraceptives and women who have children are overwhelmingly the same women at different points in their lives. U.S. women, on average, want two children; as a result, they spend about five years of their lives pregnant, postpartum or trying to become pregnant, and about 30 years trying to avoid unintended pregnancy.

As Guttmacher’s April 2011 paper concluded: “Policies that make contraceptives more affordable and easier to use are not just sound public health policy—they also reflect the needs and desires of the vast majority of American women and their partners, regardless of their religious affiliation.”