Unintended pregnancies are a significant issue globally, with a staggering 70% arising due to the non-use of contraception (The complex relationship between contraception and abortion By John Cleland et al.). This statistic raises questions about why contraception is not being used, and highlights the importance of education, access and communication in family planning.
Why aren’t people using contraception?
There are a number of reasons why women and men may not use contraception when engaging in penetrative sex. These include:
1. Gaps in family planning services
Access to contraception is not universal. Inadequate family planning services, long wait times or geographical barriers can make obtaining contraception challenging. Additionally, misinformation about available options often leaves individuals without a clear understanding of what might work best for them.
2. Lack of awareness
For many, the basic knowledge of how contraception works is missing. Myths and misconceptions about contraception – such as fears of infertility or hormonal imbalances – prevent some people from seeking it out. Comprehensive sex education is still lacking in many parts of the world, leaving significant gaps in understanding.
3. Cultural taboos
In some communities, discussing contraception is taboo. Traditional or religious beliefs may discourage its use, framing contraception as something immoral or unnecessary. Women, in particular, may face stigma for wanting to control their reproductive health, limiting their ability to advocate for themselves for fear of repercussions.
4. Preference of ‘natural contraception’ methods
Some people cite their reason for not using contraception as a preference for natural methods. These methods include tracking their menstrual cycle and ovulation using a calendar, fertility apps, or even intuition. While these methods are popular with some online influencers and resources promoting natural fertility, their success is anecdotal, and even those with the most consistent cycles can experience an accidental pregnancy.
5. Health issues linked to hormonal contraception
Hormonal contraception, such as the combined pill, may have negative side effects including headaches, spotting, breast tenderness, acne and mood swings. As a result, some women may avoid using it to prevent these side effects. However, it is important to use another form of contraception in its place when your aim is to prevent pregnancy. Non-hormonal contraceptives include barrier methods, copper intrauterine devices (IUDs) and spermicide. Here is some more information about non-hormonal contraceptives and their side effects and risks.
The importance of using contraception
Contraception empowers people to take control of their reproductive health and plan their futures. It reduces accidental pregnancies and, in the case of barrier method contraceptives, helps protect against some (but not all) sexually transmitted infections (STIs).
It’s also important to understand that using contraception is a choice that should be respected. Consent is crucial in any sexual relationship. If a partner refuses to respect your request to use contraception, this is a red flag, and you must remember that you have the right to say “no” to unprotected sex.
Common myths about contraception
There are numerous myths about contraception which can lead to accidental pregnancies. Some of the most common include:
- “The pull-out method is an effective alternative to contraception.”
This is one of the most unreliable methods of contraception. Pre-ejaculate can contain sperm, and timing withdrawal perfectly is nearly impossible.
- “If you pee after sex, you won’t get pregnant.”
Urination after sex does not prevent pregnancy. Pregnancy occurs when sperm meets the egg, a process that urinating cannot interrupt.
- “Women can only get pregnant if they orgasm.”
If you are having intercourse during or around ovulation, there is a possibility that egg fertilisation will occur, and this happens regardless of whether a female orgasm takes place or not.
- “Douching after sex helps prevent pregnancy.”
Not only is douching not recommended as it upsets the balance of bacteria in the vagina, increasing the risk of bacterial vaginosis, it is also ineffective in preventing pregnancy. This is because, if ejaculation occurs inside the vagina, sperm quickly enters the cervix, where it becomes unreachable by a douche.
- “Women can only get pregnant one day per month.”
Women can get pregnant if they have sex during ovulation and in the three-to-five days leading up to it. This is because sperm can live for up to five days inside the female reproductive tract. Women are most fertile in the two days leading up to ovulation. Menstrual cycles aren’t always regular, and therefore ovulation can be difficult to predict, which is why ‘natural contraception’ methods (i.e. using a calendar or cycle tracking app) are not the most effective methods for preventing pregnancy.
Abortion options for unintended pregnancies
Abortion should never be considered an alternative to contraception, but it is an option for those facing an unintended pregnancy. Access to safe and legal abortion is important for upholding reproductive rights, and understanding the options available to you is key for your personal health.
Medical abortion
For pregnancies under 10 weeks, medical abortion is a common and widely used abortion method. This involves taking two pills – mifepristone and misoprostol – to terminate the pregnancy. The UK’s “pills by post” scheme allows women to access the abortion pill online after a remote consultation, offering the privacy and convenience of an abortion in their own home.
Surgical abortion
For pregnancies beyond 10 weeks, or when medical abortion is not suitable, surgical abortion may be necessary. These procedures are conducted in a clinical setting and are very safe when performed by trained medical professionals.
Take control of your reproductive health
The number of unintended pregnancies can be significantly reduced by breaking down barriers to contraception use. Whether it’s advocating for better education, trying to dispel harmful myths or addressing and pushing back against cultural taboos, we all have a role to play in ensuring that everyone feels safe and empowered to make informed decisions about their reproductive health.
If you’re struggling with contraception or facing an unintended pregnancy, don’t hesitate to seek advice from healthcare professionals. Experts in gynaecology, hormone health or family planning can help you find the right contraception method for you, and access safe and legal abortion services like the “pills by post” scheme. Speak to your GP or a specialist today to get the support you need.