Implant is the most RELIABLE form of contraception

[watervole]

I was listening to a radio 4 statistics programme last night, and they made exactly the same point that Ben Goldacre is making here.  Namely that all contraceptives have failures and the question is not "How many women using it become pregnant?", but "What percentage of women using it become pregnant?"

As soon as you ask the second question, the contraceptive implant wins hands down.

Comments

[epistrophia]

But is that "What percentage of women using it WHO HAVE IT CORRECTLY INSERTED become pregnant?", or not? Because, as someone who is a) not at all ready to have children, at least not in the near future, and b) trying to find contraception which is as effective as possible and as easy as possible, the story about the six hundred-odd women who got pregnant made me feel slightly sick.

[watervole]

Read the article - it will reassure you. Some of the pregnancies were from incorrect insertions, but not all.

All contraceptives have a failure rate. Condoms are one of the worst. Well over 10% of women using condoms for a year will end up pregnant.

With the implant, it's less then five pregnancies per 10,000 women per year.

According to Wikipedia, the implant is even more effective than male sterilisation. See http://en.wikipedia.org/wiki/Comparison_of_birth_control_methods

If you're concerned about getting pregnant, then the implant is both reliable and easy. (I've had a friend on it for many years now - still not pregnant)

[epistrophia]

You're right, the article is reassuring. To be honest, I didn't follow up the report when I heard it (I think I was still at my mum's) and I didn't realise it was 600+ women since the implant was first used. I'm still nervous about it, though. At least with the pill I'm more or less in control of my contraception, at least to the extent that if I forget to take it it's my own damn fault.

My mother's right: the BEST contraceptive is an aspirin. Held between the knees.

[watervole]

I nominate today as 'go shoot a journalist' day. I predict that many women will fall pregnant in the next twelve months as this irresponsible reporting will persuade them to abandon a reliable form of contraception in favour of a less reliable one.

A tiny percentage of those women will die due to abortions or childbirth, but that still won't discourage people from trying to whip up a scare story in order to sell more copies.

PS. Love your mum's comment about the aspirin!

[cdybedahl]

Unfortunately the proportion of women who get really bad side-effects from the implant seems to be rather high. I haven't seen any actual research, but among my friends almost half had to have it taken out again for various reasons.

[watervole]

I'd certainly agree that side effects can be an issue - though other forms of contraceptive have their own side effects. Sometimes they settle down over time (I persisted with the Mirena as I was reassured that the side effects would pass with time, and this did turn out to be the case, though I had bad bleeding for about six months)

[gipsy-dreamer.livejournal.com]

Where do the mirena and sterilisation come in this survey (if sterilisation counts)?

I think my sister has the implant; I have the mirena thanks to a hormone imbalance but I'm also sterilised for various reasons.

If you can elaborate a bit, this sounds really interesting :)

[watervole.livejournal.com]

Afraid I don't have full details for other forms of contraception, though the radio programme did mention sterilisation as being excellent.

I believe (though I haven't checked) that the Mirena also comes out very well. Pills and condoms suffer through people forgetting to take them/using them incorrectly.

[gipsy-dreamer.livejournal.com]

It's extremely rare that the clamps will fall off the fallopian tube after sterilisation.

I know pregnancy has occured after the operation, but you're supposed to wait until your next period is over before not using any other contraceptive! You actually are told this before the operation; this was plain common sense to me anyway though, so can't understand why other couples don't cotton on that a live egg might still be in the system!

[naath.livejournal.com]

Sterilisation *can* (and sometimes does) fail later than that, spontaneous tube-healing from cauterisation, clips falling off or breaking or similar. Last I looked into this the stats are not always collected in the same way (I've seen people quoting sterilisation failure rates as LIFETIME failure rather than ANNUAL for instance; I'd want to see more working than a quoted % to know what they'd actually looked into there).

[watervole.livejournal.com]

Agreed. You have to have an annual rate for comparisons to have any meaning.

[watervole.livejournal.com]

See http://en.wikipedia.org/wiki/Comparison_of_birth_control_methods has good comparisons between different contraceptives.

Mirena is very good, implant is even better.

[sigisgrim.livejournal.com]

From what I can deduce the problem with the implants was the implanting rather than the method or anything else. Since the implanting is a variable based on the person performing the implant it is going to be subject to variations.

The best way of reducing the pregnancy rate for implants is to improve the method of applying it to the person, to reduce the variability in the process and thus in the result.

[watervole.livejournal.com]

You're missing the main point. Even *including* the people who had problems with implanting the device, it's still streets ahead of other methods when it comes to preventing pregnancy.

It would be hard to improve on a method that is already has less then five pregnancies per 10,000 women per year. (that's better than sterilisation - the tubes sometimes regrow)

See this table for comparisons with less reliable methods. http://en.wikipedia.org/wiki/Comparison_of_birth_control_methods

[sigisgrim.livejournal.com]

I'm not missing the point; I completely agree with you that it is by far the most effective method. I was simply observing that the people who were complaining about the "failures" had failed to notice the reason for the failure. Which means that if the human errors which had been introduced were removed then it would be an even better method than it is already.

[watervole.livejournal.com]

Apologies. I'd misunderstood the point you were making.

[lil-shepherd.livejournal.com]

On the other hand, the results of the infections is horrendous.

[watervole.livejournal.com]

True, but if you figure how many women are saved from abortions or the risks of childbirth, then a few infections are a small price to pay.

[elmyra.livejournal.com]

I've been thinking that since the story started and I have to keep reminding myself that apparently it isn't obvious to most people. There's something wrong with an education system that leaves people unable to evaluate and contextualise basic information.