The “Hocus Pocus” of Pregnancy and STI Prevention


So, young people – especially young men – know too little about contraception and the ways in which it works. So little, in fact, that it borders on “magical thinking” says a report [PDF] from the National Campaign to Prevent Teen and Unplanned Pregnancy.

It may not be shocking but it is one more hidden mine in a field chocked full as we send young people out into the world without the information they need to remain healthy, infection-free, and knowledgeable about how to prevent pregnancy.

Amanda Hess, writing in the blog, The Sexist, for Washington City Paper, focuses in particular on the lack of knowledge about birth control from the men in our lives in “Rubber Barons: Why Doesn’t Your Boyfriend Know Jack About Contraception?”:

Allison, 26, and her boyfriend were having sex—an activity they had engaged in many times over the six months they had been dating—when her contraceptive vaginal ring fell right out of her vagina. Her boyfriend paused. He developed a sudden concern over the efficacy of the couple’s method of birth control. “He was like, ‘Oh, no. How is it going to catch my semen?’” Allison recalls.

For about a year now, Allison has used the NuvaRing to prevent pregnancy. Three weeks out of the month, the clear, flexible plastic ring sits in Allison’s vagina and releases hormones into her bloodstream that prevent her from ovulating. It does not “catch” anybody’s semen.

“He played it off as a joke,” says Allison of her boyfriend’s bizarre interpretation of her birth control. “But in the tone of his voice, that honest worry was there. Part of him was thinking, ‘What does this ring actually do?’”

The study does find that men have a startingly poor knowledge of how to prevent pregnancy and how contraception works for both men and women. As Hess notes,

“Twenty-eight percent of young men think that wearing two condoms at a time is more effective than just one. Twenty-five percent think that women can prevent pregnancy by douching after sex. Eighteen percent believe that they can reduce the chance of pregnancy by doing it standing up.”

Unfortunately, the study also reveals that the knowledge black hole does not only pertain to men. There is a serious lack of knowledge when it comes to birth control methods, the ways in which a woman’s fertility works, and how to protect oneself from pregnancy. According to the report, 63% of young adults (ages 18-29) know “little or nothing” about birth control pills. 30% say they know little or nothing about condoms. Among those who report using the rhythm method or NFP (natural family planning), 40% have no idea when a woman’s most fertile time of the month is (says the report, “midway between periods”). Finally, 59% of women and 47% of men think it is slightly likely that they are infertile (?) despite the statistics showing that approximately 19% of women and 14% of men actually are.

The report also shows just how suspicious men and women are about birth control pills and their safety or lack thereof – fearing health risks that span the spectrum from severe mood disorders to cancer to being used as “guineau pigs” by public health institutions and providers.

Despite all of these fears, misperceptions and “magical thinking” young adults still believe, says the report, they’ve got it covered.  A whopping 90% believe they have all of the information they need to avoid unplanned pregnancy.

And still – half of all pregnancies in this country are unintended; STI rates among young people are rising.

Is this really about the absurdity of men (and women) not knowing anything about contraception? Or is it about our failure, as a nation, to adequately address a public health issue of tremendous proportions?

Do young people talk to their physicians about pregnancy and infection prevention? Do young people even have access to the health care they need in order to attain that information? We rely on our schools’ sex-ed programs that may offer incomplete information – or no information at all. Our federal government continues to feed harmful abstinence-only programs with millions of dollars in taxpayer funds. And to what end?

This report is a potent reminder that we are raising children without the information and tools they need to prevent infections and to prevent pregnancy until they are ready. This idea that advocates of abstinence-only programs push -  that somehow we need to block young people’s access to information on contraception because it will help them to decide not to have sex – is absurd. In fact, it has created an environment ripe for unplanned pregnancy and STIs. Half of all pregnancies are unplanned. This isn’t because young men and women don’t care. It’s because we haven’t given them the information and access to care they need to protect themselves.

We now have a nation of twenty-one, twenty-two, twenty-three year old young adults involved in sexual relationships where they know “little to nothing” about how to prevent unplanned pregnancy or protect against STIs. Where do we think young people will learn about pregnancy and infection prevention if not from the adults around them – our medical community, school and parents? Do we think that if a school sex-ed program conveniently “leaves out” information on contraception and birth control, how to communicate ones’ needs in a sexual relationship, how to talk about sex, that somehow this means we’ve erased it from the rest of society’s public discussion as well? That all of a sudden films, television programs, magazines, music, and videos featuring sex become invisible to young people?Of course not. But what we’ve done is create an environment where we saturate society with sex and sexuality and then tell young people  – here, enjoy, but don’t ask us to tell you anything real or meaningful about your sexual selves.

Whether we live in the Bible Belt or the heart of New York City, I guarantee that our children will grow up to be a young adult who has sex. I guarantee it. So, just when are we planning on talking to young people about sex, sexual relationships, sexuality, and sexual health? Because, clearly, according to this report we’re running behind schedule on the birds-and-the-bees discussion. When 23 year old men don’t know how basic methods of birth control work and young women are having sex and have no idea when their most fertile time of the month is, we haven’t done nearly enough.

Sure, individuals, especially adults must claim personal responsibility. Young adults need to seek out the information that will help protect themselves against STIs and unplanned pregnancy. But we’re teaching them that they shouldn’t seek this information out because it’s shameful, embarrassing, not for public discourse. So, why are we surprised when they don’t?

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  • aa

    Amie,

     

    Anytime I see the words “rhythm method” and “natural family planning” together, I become instantly suspicious of anything else that is written, because it is a fact that they are not the same thing.

     

    Therefore, I also question the statistic that “40% of NFP users have no idea when a woman is most fertile.” Huh? How did they measure that and where did they get their information? NFP is about the ONLY way to know when a woman is most fertile–that’s the whole purpose of the method–to identify the fertile time! That’s a simple fact.

     

    Another fact–method effectiveness of sympto-thermal methods of NFP is 99%. It’s been documented over and over again for years. And the most recent study of NFP effectiveness that I know of in 2007 with a sympto-thermal method of NFP showed a user effectiveness of 92%. These facts just don’t jive with this 40% statistic.

     

    Rather than debate your conclusions about teenage sex, which I’m sure we will have to agree to disagree on, I merely suggest that there are better sources for information on NFP than the one you have cited.

    • amie-newman

      The study comes from the National Campaign to Prevent Teen and Unplanned Pregnancy as cited above.

      You are absolutely correct – and thank you for pointing out – that the rhythm method and NFP are not at all the same thing and that NFP is all about understanding when a woman’s most fertile time is. In fact, one of my favorite resources for understanding and using NFP is Toni Weschler and her books.

      Please keep in mind – I am only reporting on what the report itself found and I was not coming up with my own comparisons or conclusions about these methods. Nor were any of the statistics a result of my own information. What the report says about that question and its findings is:

      Among those reporting they had relied on the rhythm method or natural
      family planning, 40% do not know when a typical woman’s most
      fertile time of the month is (midway between periods).

      It looks like the young people surveyed self-identified as using each of the methods and so it is entirely possible that the responders say they are using NFP without understanding what that truly is.

      The reality is that no one is doing a proper job of educating young people about any methods of family planning whether we’re talking about NFP, birth control pills or IUDs. Regardless of the fact that NFP is extremely effective when undertaken properly if it isn’t being identified or used correctly by young people then we still have a lot of work to do.

      Thanks for commenting.