In preparation for World Contraception Day, HealthyWomen, the nation's leading independent health information source for women, released a nationwide survey of women that explores an issue faced by most couples at some point in their relationship: How do they know when they are done having children and what contraception will they use to avoid an unplanned pregnancy? The survey, conducted by Harris Interactive of 1,006 women showed that a majority of women who say they are done having children have talked to their partner about the decision, but the conversation may often end there. Only 24 percent say they have discussed their decision with their OB/GYN, and even fewer (13 percent) report talking with friends about the topic.
"This landmark survey is the first to provide insight on the topic of women being 'done' having children and the conversations related to this important life milestone. While it is encouraging that this is a joint decision between women and their partners, unfortunately only one-quarter are consulting their OB/GYNs about next steps," said Elizabeth Battaglino Cahill, RN, Executive Director of HealthyWomen. "World Contraception Day on September 26 is the perfect time to help women realize that it's crucial to talk about being 'done' with their healthcare providers. OB/GYNs can educate patients about various birth control options and help them take the most effective action."
Women Simply Don't Know All Permanent Birth Control Options
Although more than three out of four women surveyed say they are done having children, they remain overwhelmingly unaware of all their permanent birth control options. Nearly 90 percent of women surveyed knew about the surgical procedures, vasectomy and tubal ligation (i.e., "getting your tubes tied"); however, only 12 percent knew there are other less-invasive solutions that don't require surgery.
Women say effectiveness in preventing pregnancy is one of the most important factors when considering permanent birth control. Yet some women who are done are still relying on temporary methods like condoms (15 percent) which have a 15 percent failure rate*. Women also prefer not to use hormones, but 15 percent are using the pill and 5 percent are using IUDs to prevent pregnancy.
"When it comes to birth control, there is a real breakdown in communication between doctors and their patients," said Cindy Basinski, MD, FACOG. "If the patient doesn't bring up the subject of birth control, the doctor assumes they are satisfied with their current method. The flipside is that women aren't bringing it up either because they think that their doctors would tell them if there was a better birth control option for them. The conversation just isn't happening."
According to Dr. Basinski, many women think that tubal ligation is their only permanent option, so they stay on temporary methods like condoms or the pill, despite the inconvenience or side effects. "I find that many of my patients are surprised when they learn that permanent birth control goes beyond the surgical options, vasectomy and tubal ligation," said Dr. Basinski. "The most effective permanent birth control option is actually Essure, which is a surgery-free, hormone-free procedure for women. It can be performed in a doctor's office with relatively no down time for recovery, which is important to busy moms."
Men Say They'll Undergo a Vasectomy, but Women Report that Waiting for Him to "Go Under the Knife" Takes Years
Nearly three-quarters of women mistakenly think vasectomies are easier for men than permanent procedures for women, since they are not aware of non-surgical, minimally invasive options. Due to this lack of knowledge, a vasectomy is often one of the first options couples seek once they've decided they are done having children. In fact, the survey found that more than one-third of women surveyed say their husbands offered to have a vasectomy. However, many women find themselves waiting – some for more than five years – for their husband to have the surgery. Women who are done report that they are more likely to "win the lottery" than for the vasectomy to actually happen.
"When we decided that we were done having children, my husband was open to getting a vasectomy because we thought our only other permanent birth control alternative was getting my tubes tied," explained 42-year-old Shannon Backer, a mother of three from Newburgh, Ind. "When we learned that the Essure procedure took about 10 minutes and didn't require surgery, we knew we found the option that would work for us. I was back in my routine the next day, which wouldn't have been possible with a tubal ligation. I think more women need to know about Essure, so I am sharing my story to help start the conversation."
Other Key Findings Show Age and Financial Issues Drive Decision
How Women Know They're "Done"
How Women Feel About Being "Done"
Besides Never Having to Worry About an Unplanned Pregnancy, Women Find Many Benefits of Permanent Birth Control
*Efficacy data based on one year of typical use adapted from Contraceptive Efficacy, by James Trussell PhD, in Contraceptive Technology: Nineteenth Revised Edition, New York NY: Ardent Media, 2007.