Women's Health

New Mothers Having Trouble Finding a Birth Control Method That Fits

Dirty diapers, a screaming baby, mounds of laundry, and … sex? Picture of a mother kissing her infant on the forehead

A new survey says new moms are not getting what they need or want when it comes to birth control, and this is affecting their sex lives.

Dissatisfaction With Current Birth Control Method Reported

Forty-six percent of the 520 new and expecting moms surveyed expressed some level of dissatisfaction with their current birth control method. Forty-three percent said they were considering changing their contraceptive, according to the survey conducted by Emory University School of Medicine.

The women were more likely to be satisfied with non-barrier methods, such as the Pill, than with barrier methods, such as condoms—61 percent versus 28 percent.

The most popular birth control methods in the United States right now are oral contraceptives and, for older couples, sterilization, says Dr. Mimi Zieman, a survey consultant and director of family planning for Emory University's School of Medicine.

Condoms, as well as condoms used with another method, are also common.

Despite the widespread use of birth control in this country, one-third of the women surveyed said their most recent pregnancy was unplanned. Fifty-three percent of women who had had unplanned pregnancies also reported they were dissatisfied with their method of birth control, making the dissatisfied group more than three times as likely to have an unplanned pregnancy.

This dissatisfaction not only influences pregnancy rates, but also women's perceptions of their sex lives. The survey discovered that women who are unhappy with their contraceptive are more than twice as likely to be dissatisfied with their sex life since the birth of their first or most recent baby.

Not surprisingly, 57 percent of new mothers reported that the frequency of sexual intercourse had decreased since the birth of their first child.

"Sexual activity requires a certain amount of energy, and the energy is not always there," Zieman explains. "There's so much for a new mother to think about."

Defining the Ideal

When asked about their vision of an ideal contraception, the women agreed that it would combine ease of use with long-term protection from pregnancy.

Most of the mothers also wanted a method that would allow for spontaneity (94 percent); was hassle-free (90 percent); was something they did not have to think about (89 percent); and would shorten or lighten their periods (77 percent).

The survey was partially funded by Berlex Laboratories, which markets the Mirena intrauterine device (IUD).

Mirena can stay in the uterus for up to five years, and releases a low dose of the hormone levonorgestrel directly to the lining of the uterus. Another IUD, ParaGard T-380A Intrauterine Copper Contraceptive, releases copper ions into the uterus and lasts for 10 years. It is sold by Ortho-McNeil Pharmaceutical.

Both devices are 99 percent effective, say the researchers.

Many of the women surveyed said an IUD was an option that would appeal to them. Sixty-five percent said learning about the choice was "an important increase in their knowledge of birth control options," while 44 percent rated an IUD as better than their current or most recent contraceptive.

"These modern IUDs are safe and effective," says Zieman, who is also a consultant to Berlex. The modern IUDs are manufactured differently from those that caused problems in the past. Those problems included cramping, bleeding, infection, and infertility.

According to Zieman, IUDs are best suited for women in a monogamous relationship (the devices do not protect against sexually transmitted diseases, including HIV), and for someone who has already had one child.

"It's easier to insert and the uterus accepts it better," she explains.

Always consult your physician for more information.

June 2002

Dissatisfaction With Current Birth Control Method Reported

Defining the Ideal

The Patch: A New Form of Contraception

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The Patch: A New Form of Contraception

American women now have another birth control option, and it could be the easiest, most convenient form of contraception yet.

Just released into the marketplace: Ortho Evra, the first contraceptive skin patch to be sold in the United States. Manufactured by Ortho-McNeil Pharmaceutical, it is designed to mimic combination birth control pills—the ones containing synthetic estrogen and progesterone. A single patch works for a full seven days.

"It is definitely convenient and definitely easy to use, and is likely to increase compliance, since women only need to replace the patch once a week," says Dr. Patricia Stephenson, a principal investigator in the clinical trials that tested the patch for safety and efficacy. "I think it brings birth control to a new level, making it much easier, particularly for busy women."

The patch, available only by prescription, measures about one and three-quarter inches square, with a self-adhesive backing. It can be placed on any one of several areas of the body, including the lower torso (front or back) or the outside of the upper arm. One patch stays put for seven days, and a new one is placed in a new location on the eighth day. The hormone-laced patches are used for three weeks and followed by one week without a patch.

Both the Pill and the patch work in similar ways to prevent pregnancy—primarily by blocking ovulation. Although both are said to be about 99 percent effective, this can vary greatly with compliance.

"Miss one pill and your odds change," Stephenson says. Likewise, forget to change your patch after seven days or let too many hours go by without putting on a new one, and you could dramatically decrease your protection as well, experts say.

For Dr. Yvette Martas, who did not participate in the studies, the patch is an important step forward in contraception. She has already started prescribing it to patients.

"I think the ease of use will make it a great contraceptive for young women, and I think the even, continued flow of hormones will be very beneficial to women in the perimenopause, helping to ease some of their transitional symptoms, while protecting against unwanted pregnancy," says Martas, an obstetrics/gynecology instructor at New York University School of Medicine.

Stephenson says the patch may also work well for women with PMS, particularly those whose symptoms are caused or exacerbated by sensitivity to fluctuations in hormone levels.

"It wasn't tested for this purpose, but using it in this way makes good sense," Stephenson says.

Although all birth control pills, as well as the patch, contain virtually the same type of synthetic estrogen, there is great variety in the type of progesterones that are used. Some, experts say, can cause decidedly more side effects than others, including mood swings and painful breasts.

The synthetic progesterone found in the patch, Stephenson says, is the one least likely to cause side effects, making it easier for all women to tolerate.

In terms of practical problems, both Stephenson and Martas report that some patients had poor reactions to the adhesive. For those with sensitive skin or conditions such as psoriasis, it is probably not the best option.

Although the patch is designed to stay on during bathing, showering, or swimming, it cannot be used in conjunction with skin lotions, including sun block. If you apply any product to your skin in the area where the patch will be applied, or if you use products too close to the patch after it is applied, you might disturb the adhesive quality.

If the patch falls off and cannot be reapplied, you will have to start a new one—though most physicians prescribe a spare.

Right now, a one-month supply of Ortho Evra patches will cost you about the same as a one-month prescription of birth control pills.

Always consult your physician for more information.