What to Expect When You’re Not Expecting: A Report on How Different

Factors Have Impacted Women’s Contraceptive Trends Since 1982

Isabella Lozano

POL 423: Politics of Reproduction

Davidson College

December 14, 2020

 Lozano 1

Abstract

Women have used different contraceptive methods as a way to prevent unintended

pregnancy throughout history. Over the years, contraceptive options and effectiveness have

evolved, which has led to the various options available to women today. This study examines

how age, race, and education have impacted women's contraceptive choices from 1982 to 2019.

For this research, I used survey responses from the National Center of Health and Statistics about

women's current contraceptive use from 1982 to 2019. With this data, I conducted an in-depth

analysis of the overall contraceptive trends and trends of age, race, and education. My analysis

showed that age and education directly correlated with women’s use of the pill and female

sterilization from 1982 to 2019. Throughout this timeline, race’s impact on contraceptive choice

varied, but there were still some correlations between women’s race, pill use, and female

sterilization. This study's implications could be used to understand past contraceptive trends

among women and improve contraception in the future.

 Lozano 2

Introduction

Throughout history, humans have used a variety of different methods in an attempt to

prevent unintended pregnancy. However, commercially available birth control methods that are

effective and safe have only been around since the 20th century. Many of these modern methods

are “modifications of methods that have been used since ancient times.”1 The use of

contraception is prevalent among women today. As of 2019, about 65.3% of women in the

United States between the ages 15 and 49 were using a method of contraception.2 Among the

women using contraception, there are five most commonly used methods: female sterilization,

male condoms, birth control pills, intrauterine devices (IUD), and implants.

An essential component of understanding the trends of women’s current contraceptive

use is taking a look at when these modern, commercially available methods were introduced to

the U.S. market. First, female sterilization was primarily used for coerced sterilization among

individuals the government deemed unfit for society. The first published report of female

sterilization was in 1881.3 The U.S. government most significantly used coerced sterilization

from 1907 to 1963.4 The use of female sterilization evolved during the birth control revolution of

the 1960s when women began using it as a permanent method of contraception. Next, the male

condom was one of the leading commercially available contraceptive methods during

preindustrial America. Following the invention of vulcanization technology in 1839, rubber

condoms began being mass-produced in the late 1850s.5 It was then not until 1960 when the

1
Andrea Tone, Devices and Desires: a History of Contraceptives in America (New York, NY: Hill and Wang,
2001), 69.
2
Kimberly Daniels and Joyce C. Abma. “Current contraceptive status among women aged 15–49: United States,
2017–2019" NCHS Data Brief, no 388. (Hyattsville, MD, National Center for Health Statistics, 2020), pp. 1-7, 1.
3
John A. Ross, “Female Sterilization,” in Contraceptive Sterilization: Global Issues and Trends (New York, NY:
EngenderHealth, 2002), pp. 139-160, 139.
4
Paul Lombardo, “Eugenic Sterilization Laws,” Eugenics Archive (Cold Spring Harbor Laboratory),
http://www.eugenicsarchive.org/html/eugenics/essay8text.html.
5
Tone, Devices and Desires, 14 & 53.
 Lozano 3

Food and Drug Administration (FDA) approved “the pill,” giving women the first method that

would allow them to control their fertility. 6 After that, in 1965, IUDs “became widely available”

in the United States.7 This was the first long-acting reversible contraception, causing it to garner

considerable skepticism. After its introduction, manufacturers were unwilling to make it until

1988, when it became commercially available again. 8 Following the IUD, in 1990, the FDA

approved the implant, another long-acting reversible contraceptive method.9 In 2002, the implant

was removed from the U.S. market due to issues with insertion and removal.10 Then, a new

version of the implant was introduced in 2006 and has continually been modified since.11

With the various contraceptive methods available for women, different factors play a role

in women’s contraceptive choice. Some of these factors include age, marital status, education,

socioeconomic class, and race. Examining these factors impacting women’s contraceptive choice

provides insight into why women choose certain methods over others. This research will also

help us understand how contraception may be improved in the future to meet women’s needs.

This paper examines survey data from 1982 to 2019 that focuses on women’s current

contraceptive use. The National Center of Health Statistics periodically carried out these surveys.

With this data, I first analyze the five most commonly used contraceptive methods by women to

examine how their popularity has fluctuated since 1982. I present a comprehensive account of

the overall contraceptive trends since 1982 and how women’s age, race, and education have

impacted these trends.

Literature Review
6
Miriam Berg, “Timeline: 100 Years of Birth Control,” Planned Parenthood Action Fund, July 16, 2014,
https://www.plannedparenthoodaction.org/blog/timeline-100-years-birth-control.
7
Tone, Devices and Desires, 265.
8
Berg, “Timeline: 100 Years of Birth Control.”
9
Kaiser Family Foundation, “Contraceptive Implants,” Kaiser Family Foundation, October 1, 2019,
https://www.kff.org/womens-health-policy/fact-sheet/contraceptive-implants/.
10
Ibid.
11
Ibid.
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This literature review examines the existing research surrounding women’s contraceptive

use in the United States. The research is organized into four main topics: an overview of

contraception, types of popular contraception, accessibility of contraception, and demographics

of contraceptive users. With a wide range of options, women choose different methods

depending on a variety of factors. Women have been wrestling with contraception issues for over

60 years, and access to reliable, affordable contraception remains an obstacle. An in-depth

analysis of the various contraceptive methods and the factors associated with each method will

help understand how women choose their contraception.

Overview of Contraception

Contraception, also known as birth control, is a method or device that women and men

use to prevent pregnancy. The use of contraceptive methods can be traced back to the ancient

world. Today, contraceptive use among women in the United States is common, as research

shows that contraception has become normalized in American culture. According to two U.S.

Department of Health and Human Services reports spanning from 1982 to 2010, almost all

(99%) of sexually active women in the United States have used a contraceptive method at some

point in their lives.12

The primary motivation for women to use contraception is to prevent unintended

pregnancy. Despite the prevalence and availability of contraception, unintended pregnancies still

occur often in the United States. In 2008, 51% of all pregnancies were unintended, according to

Finer and Zolna’s study (2016).13 This number dropped only slightly in 2011, where 45% of

12
Jo Jones, William Mosher, and Kimberly Daniels, “Current Contraceptive Use in the United States, 2006-2010,
and Changes in Patterns of Use since 1995” National Health Statistics Report, no. 60 (Hyattsville, MD: National
Center for Health Statistics, 2012), pp. 1-12, 2; Kimberly Daniels and William Mosher. “Contraceptive methods
women have ever used: United States, 1982-2010.” National Health Statistics Report, no. 62 (Hyattsville, MD:
National Center for Health Statistics 2013, pp. 1-15, 1.
13
Lawrence B. Finer and Mia R. Zolna, “Declines in Unintended Pregnancy in the United States, 2008–2011,” New
England Journal of Medicine 374, no. 9 (March 2016): pp. 843-852, https://doi.org/10.1056/nejmsa1506575, 4.
 Lozano 5

pregnancies were unintended.14 While the number of unintended pregnancies remains high,

contraception has a positive financial impact on many women, shown in Trussell’s study

conducted in 2007. His findings revealed that the use of contraceptives allowed for $19 billion in

savings in direct medical costs, estimating the average cost of an unintended pregnancy to be

$1,609.15 Raising a child is expensive, and women usually intend to wait until they are

financially stable to have a baby.

Furthermore, pregnancy can impact several facets of life for women. Looking into the

reasons women choose to use contraception, Frost and Lindberg (2013) of the Guttmacher

Institution surveyed 2,094 women to examine “the individual-level benefits” that they reported.16

The results showed that most women use contraception because it “allowed them to take better

care of their families (63%), support themselves financially (56%), complete their education

(51%), and keep or get a job (50%)”.17

There are also other benefits besides unintended pregnancy, for which women use these

methods. More specifically, there are benefits from the hormonal contraceptive methods due to

the impact of intaking estrogen and regulating one’s hormones. Rachel Jones (2011) for the

Guttmacher Institution conducted research on the most popular hormonal method, the oral

contraceptive pill, and examined the “overlooked benefits,” which motivate women to use this

method. Jones found that out of an estimated 11.2 million women in the United States using the

pill, 58% rely on it for purposes other than preventing unintended pregnancies, at least in part.18

14
Ibid.
15
James Trussell, “The Cost of Unintended Pregnancy in the United States,” Contraception 75, no. 3 (2007): pp.
168-170, https://doi.org/10.1016/j.contraception.2006.11.009, 1.
16
Jennifer J. Frost and Laura D. Lindberg, “Reasons for Using Contraception: Perspectives of US Women Seeking
Care at Specialized Family Planning Clinics,” Contraception 87, no. 4 (April 1, 2013): pp. 465-472,
https://doi.org/10.1016/j.contraception.2012.08.012, 2.
17
Ibid.
18
Rachel K Jones, “Beyond Birth Control: The Overlooked Benefits Of Oral Contraceptive Pills” (New York, NY:
Guttmacher Institute, 2011), pp. 1-9, 3.
 Lozano 6

Out of this 58%, 31% reported using the pill for cramps, 28% for regulating menstruation, 14%

for acne, 4% for endometriosis, and 11% for other unspecified reasons.19 These benefits are often

not given much attention due to the primary purpose of using contraception in general.

Popular Contraceptive Methods

A National Center for Health Statistics’ Data Brief (2020) shows that from 2017 to 2019,

the most popular forms of contraception among women in the United States were female

sterilization, oral contraceptive pill, long-acting reversible methods including intrauterine

devices and implants, and male condom.20 Due to their popularity, these methods are the most

relevant to my research. Further examination of scholars’ research surrounding these

contraceptive methods will help understand why women choose to use them.

First, looking at male condoms, this method is one of the oldest forms of contraception.

The material used for male condoms has evolved over time and now consists of a thin latex or

rubber material. This method is utilized by placing it on a male’s penis before intercourse and is

intended for one-time use. About 5.5 million women depend on male condoms as their form of

contraception, according to a study done by Kavanaugh and Jerman (2018).21 As Jain and

Muralidhar (2012) explained, an advantage of this contraception is, it is the most effective

method for simultaneously protecting against sexually transmitted diseases (STDs) and

unintended pregnancy.22 Although condoms are the only form of contraception that protects

against STDs, the method’s overall effectiveness is lower than other contraceptives. Michigan

Medicine insists that a drawback of condoms is that if individuals do not use them properly, they
19
Ibid.
20
Daniels and Abma. “Current contraceptive status: 2017–2019.”
21
Megan L. Kavanaugh and Jenna Jerman, “Contraceptive Method Use in the United States: Trends and
Characteristics between 2008, 2012 and 2014,” Contraception 97, no. 1 (January 1, 2018): pp. 14-21,
https://doi.org/10.1016/j.contraception.2017.10.003, 17.
22
Rakhi Jain and Sumathi Muralidhar, “Contraceptive Methods: Needs, Options and Utilization,” The Journal of
Obstetrics and Gynecology of India 61, no. 6 (February 14, 2011): pp. 626-634, https://doi.org/10.1007/s13224-011-
0107-7, 628.
 Lozano 7

may break, increasing the chance of unintended pregnancy. For this reason, condoms have higher

failure rates than most other methods of birth control.23

The pill was the first hormonal method of contraception available in the United States.

This method combines estrogen and progesterone and is taken orally at the same time every day.

According to Daniel and Mosher’s study (2013), which examined contraception trends from

1982-2010, four out of five women have used the pill as their method of contraception.24 Jain and

Muralidhar’s study acknowledges the advantages of using the pill, contributing to this method’s

prevalence. These scholars posit that a benefit of using the pill is that it gives women control,

and it is “easy and convenient” to use.25 They also explain that this method is easy to discontinue

when a woman wants to get pregnant.26 I agree with Jain and Muralidhar on the convenience of

using the pill, but a study by Mermelstein & Plax (2016) points out the disadvantages of this

method. Their study found that the pill’s failure rates are high among adolescents because they

are more likely to take the pill inconsistently and incorrectly.27 Supporting Mermelstein & Plax’s

findings, a study by Reubinoff et al. showed that about 50% of teenagers who start taking the pill

stop within a year.28

Female sterilization is a permanent contraceptive method that women receive by

undergoing surgery. The process includes cutting the fallopian tubes and tying the ends to

prevent future fertilization. Three separate studies found that along with the pill, female

23
Healthwise Staff, “Male Condoms,” Michigan Medicine (University of Michigan, May 29, 2019),
https://www.uofmhealth.org/health-library/hw190504spec.
24
Daniels and Mosher. “Contraceptive methods, 1982-2010,” 4.  
25
Jain and Muralidhar. “Contraceptive Methods,” 628.
26
Ibid.
27
Sarah Mermelstein and Katie Plax, “Contraception for Adolescents,” Current Treatment Options in Pediatrics 2,
no. 3 (July 29, 2016): pp. 171-183, https://doi.org/10.1007/s40746-016-0053-9, 179.
28
Benjamin E. Reubinoff et al., “Effects of Low-Dose Estrogen Oral Contraceptives on Weight, Body Composition,
and Fat Distribution in Young Women,” Fertility and Sterility 63, no. 3 (March 1995): pp. 516-521,
https://doi.org/10.1016/s0015-0282(16)57419-6, 517.
 Lozano 8

sterilization has been one of the two most common contraceptives since 1982.29 The National

Health Society (2018) explains that the advantages of this method are that it is over 99%

effective, and once women undergo the procedure, it is effective immediately.30 Mirroring this

method’s high effectiveness, a national survey by the Urban Institute (2018) found that 77% of

women perceived female sterilization to be “very effective at preventing pregnancy.”31 In

contrast, “no more than half” of the women surveyed reported that they perceived other methods

to be very effective.32 While female sterilization proves to be a very effective method, some

disadvantages may deter certain women from this method. According to the Planned Parenthood

Federation of America (2020), sterilization is a permanent method, and it rarely can be

reversed.33 Hillis et al.’s study (1999) found that women are 12.7% likely to express regret after

obtaining the procedure.34 Moreover, Planned Parenthood states that there are risks associated

with this method since it is invasive.35

Intrauterine devices (IUDs) are one of the long-acting reversible contraceptive methods.

IUDs are small devices made of copper or plastic inserted by a medical professional into

women’s uteruses through the cervix. Once inserted, they are effective for up to 10 years.

Hubacher (2002) explains that the advantages of IUDs are that it is highly effective, does not

29
Kavanaugh, and Jerman. “Contraceptive Method Use in the United States”, 16; Kimberly Daniels, Jill Daugherty
and Jo Jones, “Current contraceptive status among women aged 15–44: United States, 2011–2013” NCHS Data
Brief, no. 173 (Hyattsville, MD, National Center for Health Statistics, 2014), pp. 1-8, 1; William Mosher and Jo
Jones, “Use of Contraception in the United States: 1982–2008” Vital and Health Statistics, 23, no. 29 (Hyattsville,
MD: National Center for Health Statistics, 2010), p. iv-44, 1.
30
National Health Society, “Female Sterilisation,” NHS Choices (NHS, March 2018),
https://www.nhs.uk/conditions/contraception/female-sterilisation/.
31
Adele Shartzer et al., “Knowledge Gaps and Misinformation about Birth Control Methods Persist in 2016,” Urban
Institute, May 4, 2020, https://www.urban.org/research/publication/knowledge-gaps-and-misinformation-about-
birth-control-methods-persist-2016, 4.
32
Ibid, 7.
33
Planned Parenthood, “What Are the Benefits of a Tubal Ligation Procedure?” Planned Parenthood, 2020,
https://www.plannedparenthood.org/learn/birth-control/sterilization/what-are-disadvantages-tubal-ligation.
34
Susan D. Hillis et al., “Poststerilization Regret: Findings from the United States Collaborative Review of
Sterilization,” Obstetrics & Gynecology 93, no. 6 (June 1999): pp. 889-895, https://doi.org/10.1016/s0029-
7844(98)00539-0, 889.
35
Planned Parenthood. “What Are the Benefits of a Tubal Ligation Procedure?”
 Lozano 9

require user intervention, and is reversible.36 Despite the advantages that Hubacher suggests,

there are some risks with this method that women should be aware of before use. Stoddard et al.

(2013) insist that while the pregnancy rate using an IUD is very low, if pregnancy does occur,

chances of an ectopic pregnancy resulting are high.37 Additionally, the Cleveland Clinic explains

that the insertion process “can be mildly to moderately painful,” and irregular bleeding may

occur after insertion.38 There is also controversy surrounding the IUD due to a lack of

widespread knowledge about this method. Gomez and Freihart (2017) found that in a survey of

413 women ages 18 to 29, 49.2% were unsure about IUDs, and 30% were not interested in using

one in the future.39 As a result, research made available to the public might increase this

method’s popularity.

Implants are another long-acting reversible method which the Food and Drug

Administration (FDA) approved in 2006. An implant is a small, thin rod inserted underneath the

skin of a woman’s arm. It releases progestin and lasts up to three years. Like the advantages of

an IUD, Stoddard et al. (2013) explain that implants are highly effective, are easy to use with no

user action required until removal, and are reversible.40 Additionally, a two-year study by Funk et

al. (2005) found that 61% of women participants reported a decrease in acne, and 48% reported a

decrease in dysmenorrhea while using the implant.41 A common side effect of the implant, as
36
David Hubacher, “The Checkered History and Bright Future of Intrauterine Contraception in the United States,”
Perspectives on Sexual and Reproductive Health 34, no. 2 (April 2002): pp. 98-103,
https://doi.org/10.2307/3030213, 98.
37
Amy Stoddard, Colleen McNicholas, and Jeffrey F. Peipert, “Efficacy and Safety of Long-Acting Reversible
Contraception,” Drugs 71, no. 8 (May 28, 2011): pp. 969-980, https://doi.org/10.2165/11591290-000000000-00000,
5. 
38
Women's Health, “Do the Benefits of an IUD Outweigh the Potential Side Effects?” Health Essentials (Cleveland
Clinic, September 21, 2020), https://health.clevelandclinic.org/do-the-benefits-of-iuds-outweigh-the-potential-side-
effects/.
39
Anu Manchikanti Gomez and Bridget Freihart, “Motivations for Interest, Disinterest and Uncertainty in
Intrauterine Device Use Among Young Women,” Maternal and Child Health Journal 21, no. 9 (September 19,
2017): pp. 1753-1762, https://doi.org/10.1007/s10995-017-2297-9, 1753.
40
Stoddard et al., “Efficacy and safety of long-acting reversible contraception,” 1.
41
Sidney Funk et al., “Safety and Efficacy of Implanon™, a Single-Rod Implantable Contraceptive Containing
Etonogestrel,” Contraception 71, no. 5 (May 1, 2005): pp. 319-326,
 Lozano 10

explained by Planned Parenthood, is irregular bleeding.42 Sirvin’s (2003) study found that

women using the implant were 1.5 times more likely to develop gallbladder disease and 1.8

times more likely to develop hypertension. However, the chances are low, which makes this a

practical contraceptive method for many women.

Accessibility of Contraception

Availability, insurance coverage, and cost are barriers to the accessibility of contraceptive

methods, influencing women’s choice. Research on these areas will provide further insight into

how women choose contraception. Out of the five most popular methods, condoms are the only

form of contraception that individuals can buy over the counter. In contrast, hormonal methods

such as the oral contraceptive pill require a physician’s prescription, as explained by Planned

Parenthood.43 On the other hand, intrauterine devices, implants, and female sterilization require

an appointment with a physician. I could not find any studies focused on how availability affects

women’s contraceptive choices. Further research into how convenience impacts women’s

contraceptive choice would explain why some methods may be more popular than others.

Regarding insurance coverage of contraception, the Affordable Care Act issued a mandate

in 2012, requiring most private health insurance plans to cover all contraception costs approved

by the FDA. In a 2016 national survey conducted by the Urban Institute, 68.6% of women

“reported that their insurance or another program always covers the full cost of their birth

control.”44 Studies have shown that contraceptive coverage influences women’s contraceptive

https://doi.org/10.1016/j.contraception.2004.11.007, 319.
42
Planned Parenthood. “What Are the Disadvantages of the Birth Control Implant?” Planned Parenthood, 2020.
https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon/what-are-the-
disadvantages-of-birth-control-implant.
43
Kendall, “Do You Need a Prescription for All Types of Birth Control?” Planned Parenthood, January 7, 2012,
https://www.plannedparenthood.org/learn/teens/ask-experts/do-you-need-a-prescription-for-all-types-of-birth-
control.
44
Emily M. Johnston, Brigette Courtot, and Genevieve M. Kenney, “Access to Contraception in 2016 and What It
Means to Women” (Washington, D.C.: Urban Institute, 2017), pp. 1-9, 4.
 Lozano 11

choice. Carlin, Fertig, and Dowd (2016) examined private health insurance claims from 2008 to

2014 and discovered that women were significantly more likely to choose prescription

contraception when there is a contraceptive coverage mandate.45 There was also an increase in

women choosing long term contraceptive methods.46 Bearak and Jones (2017) similarly

conducted a study from 2012 to 2015 to examine contraceptive use patterns after the ACA.

Differing from Carlin et al.’s results, Bearak and Jones found that the use of the pill almost

doubled among sexually inactive women.47 This finding is evidence that an increasing number of

women could obtain the pill for reasons other than to prevent pregnancy.

For women who are not insured, the cost of contraception has a more significant influence

on contraceptive choice. Urban Institute’s 2016 national survey revealed that 71% of women

stated it was “extremely or quite important that the method be low-cost.”48 The more effective

methods are, the more expensive they tend to be. Elly Kosovo (2017) of the National Women’s

Health Network conducted research to look at contraception costs without insurance coverage.

Kosovo found that intrauterine devices cost over $1,000 each, implants cost over $800 each, and

the pills cost about $240 to $600 annually. 49 A 2007 to 2008 study found that women paying

over $50 in out-of-pocket costs were “significantly less likely” to choose an IUD as their

45
Caroline S. Carlin, Angela R. Fertig, and Bryan E. Dowd, “Affordable Care Act’s Mandate Eliminating
Contraceptive Cost Sharing Influenced Choices of Women with Employer Coverage,” Health Affairs 35, no. 9
(September 2016): pp. 1608-1615, https://doi.org/10.1377/hlthaff.2015.1457, 1611.
46
Ibid.
47
Jonathan M. Bearak and Rachel K. Jones, “Did Contraceptive Use Patterns Change after the Affordable Care Act?
A Descriptive Analysis,” Women's Health Issues 27, no. 3 (May 1, 2017): pp. 316-321,
https://doi.org/10.1016/j.whi.2017.01.006, 316.
48
Johnston, Courtot, and Kenney. “Access to Contraception in 2016 and What It Means to Women.”
49
Elly Kosova, “How Much Do Different Kinds of Birth Control Cost without Insurance?” National Women's
Health Network, November 30, 2017, https://www.nwhn.org/much-different-kinds-birth-control-cost-without-
insurance/.
 Lozano 12

contraceptive method.50 Frost and Darroch (2008) conducted a study that revealed that one-third

of women would “change their contraceptive method if cost were not an issue.”51

Demographics of Contraceptive Users

Studies have found that there are particular demographics associated with different

methods of contraception. Examining these studies and their findings will give insight into which

groups of women are more likely to choose certain contraception based on their demographics.

First, looking at the male condom, this method is available to a broader demographic due to its

availability in stores. Kavanaugh and Jerman’s (2017) study suggests that between 2008 to 2014,

the use of male condoms was most common among women who were 15 to 19-years-old,

reported religious affiliation was “other,” college graduates, are uninsured, were born outside the

United States, and are planning to have another child.52 Jones et al.’s study contributes to this

information about demographics and found that between 2006 and 2010, Asian women were the

highest group to report using male condoms as the “most effective contraceptive method.”53

Additionally, among women 15 to 24 years old, reliance on male condoms was “higher among

black and Hispanic women… compared with white women.”54

Regarding the pill, Jones et al.’s study shows that this method is most common among

white women, teenagers, women in their 20s, “never married and cohabitating women, childless

women, and college graduates.”55 Supporting Jones et al.’s findings surrounding age, a study by

the Center for Disease Control and Prevention reported that the use of the pill “decreased with

50
Aileen M. Gariepy et al., “The Impact of out-of-Pocket Expense on IUD Utilization among Women with Private
Insurance,” Contraception 84, no. 6 (December 1, 2011): pp. 39-42,
https://doi.org/10.1016/j.contraception.2011.07.002, 39.
51
Jennifer J. Frost and Jacqueline E. Darroch, “Factors Associated with Contraceptive Choice and Inconsistent
Method Use, United States, 2004,” Perspectives on Sexual and Reproductive Health 40, no. 2 (June 10, 2008): pp.
94-104, https://doi.org/10.1363/4009408, 99.
52
Kavanaugh, and Jerman. “Contraceptive Method Use in the United States,” Table 2. 
53
Jones et al., “Current contraceptive use, 2006-2010,” 6.
54
Ibid, 8.
55
Ibid.
 Lozano 13

increasing age.”56 The CDC’s findings of race also support Jones et al.’s results showing that

more white women use the pill than Hispanic and black women.57 Next, looking at both IUDs

and implants, Kavanaugh, Jerman, and Finer (2015) examined trends from 2009 to 2012. They

found these long-acting methods were most common among women ages 25 to 34, born outside

the United States, and reported their religious affiliation as “other.”58 Kavanaugh et al. (2015)

also found a lower level of long-acting methods among black females, possibly revealing

“unequal access to these methods.”59

The use of female sterilization varies across different groups of women. Research from

the Henry J. Kaiser Family Foundation reveals that the rates of sterilization are “highest among

35 to 44 year-olds, formerly married women, and women with three or more births.”60 Also,

black and Hispanic women and those with lower income levels are more likely to use female

sterilization as their form of contraception.61 Expanding on the demographics of female

sterilization, Jones et al. posit that sterilization rates are higher among women who live 150%

below the federal poverty level, not college graduates, and “public or no health insurance.”62

Conclusion

The diverse studies and research surrounding women’s use of contraception will help me

delve into the factors and motivations that drive women’s choice of contraceptive method.

Further insight into why certain contraception is more prevalent among specific groups of

56
Kimberly Daniels and Joyce C. Abma . “Current contraceptive status among women aged 15–49: United States,
2015–2017” NCHS Data Brief, no. 327. (Hyattsville, MD, National Center for Health Statistics, 2018), pp. 1-8, 3.
57
Ibid, 4.
58
Megan L. Kavanaugh, Jenna Jerman, and Lawrence B. Finer, “Changes in Use of Long-Acting Reversible
Contraceptive Methods Among U.S. Women, 2009–2012,” Obstetrics & Gynecology 126, no. 5 (November 2015):
pp. 917-927, https://doi.org/10.1097/aog.0000000000001094, 919.
59
Ibid, 924.
60
Kaiser Family Foundation, “Sterilization as a Family Planning Method,” Kaiser Family Foundation, December 14,
2018, https://www.kff.org/womens-health-policy/fact-sheet/sterilization-as-a-family-planning-method/.
61
Ibid.
62
Jones et al., “Current contraceptive use, 2006-2010,” 11.
 Lozano 14

women will enhance our understanding of contraceptive choice. This research will then allow

women to understand and make well-informed decisions on their future contraceptive methods.

This paper explores the factors influencing women’s choice, draw connections between these

factors, and examine trends over the past few years. My research will focus on the question:

Looking at the contraceptive patterns, how have age, race, and education influenced women’s

contraceptive choice since 1982?

Research Question

A review of the literature surrounding contraceptive methods and their use shows that

many components can influence which contraceptive method a woman uses. Previous scholars

have identified contraceptive trends among women of specific demographics and barriers that

may contribute to these trends. My research expands this literature surrounding contraceptive

choice by further examining how age, race, and education influenced women’s contraceptive

patterns from 1982 to 2019. I was motivated to do this topic because, as a young woman myself,

I was interested in learning more about how the world around us influences women’s choice of

contraception. I also noticed a gap in the literature because many scholars, such as those

referenced in my literature review, have analyzed contraceptive trends in a time frame of a few

years. Conversely, the longer timeline I am researching provides a more comprehensive view of

how trends have changed over the years. Overall, my research will add to the understanding of

women’s contraceptive choices and how individual characteristics impact this decision.

Furthermore, this knowledge will give insight into why certain contraception remains popular

among women and why accessibility should be improved in the future to meet all women’s

needs and lifestyles.

Methodology
 Lozano 15

To understand trends of popular contraceptives and factors influencing women’s

contraceptive choice since 1982, I examined existing survey data prepared by the National

Center for Health and Statistics (NCHS), a division of the Centers for Disease Central and

Prevention (CDC). The NCHS collected this data through the National Survey of Family

Growth, a frequently conducted survey used to understand America’s birth and pregnancy rates.

The participants in these surveys are women between the ages of 15 and 49. The NCHS initially

produced this data in data briefs that are published on the CDC’s website. For my research, I

used the NCHS’s survey data regarding women’s contraceptive use at the time of the survey.

My dataset includes survey results from 1982 to 2019. The NCHS began periodically

conducting the National Survey of Family Growth in 1973. However, the 1973 and 1976 cycles

only surveyed married women. Then in 1982, the NCHS began surveying all women regardless

of marital status. Therefore, I used the 1982 survey data as my starting point. Additionally, the

time between each NCHS data brief containing the survey results is not synchronous. As a result,

my research and findings reflect this irregular timeline.

I started my research by forming a dataset for the popular contraceptives’ overall trends

among women from 1982 to 2019. For this portion, I used the NCHS survey data that focused on

all women’s contraceptive use collectively. Within these survey results, I recorded the

percentages of participants relying on female sterilization, the pill, the male condom, the IUD,

and the implant. I focused on these contraceptives because they are the most widely used

contraceptives by women as of 2019.63 I combined the percentages of intrauterine devices and

the implant and labeled them as long-acting reversible contraception (LARC) in my chart and

findings.64 Then, I combined the percentages of women using all other methods and the women

63
Daniels and Abma. “Current contraceptive status: 2017–2019,” 1.
64
NCHS data briefs from 2013, 2017, and 2019 combined the usage of IUDs and implants into long-acting
reversible contraceptives in their survey results which is why I combined them in my results.
 Lozano 16

using no method. After that, I inputted this data into a line graph to analyze the trends from 1982

to 2019.

Next, regarding my dataset for factors influencing women’s contraceptive choice since

1982, I used the NCHS survey data that breaks down the data according to the different

characteristics of women surveyed. The factors I focused on for my research were age, race, and

education. There were other factors accounted for in some surveys, including income and

cohabiting status. However, NCHS most consistently accounted for age, race, and education in

the surveys. For each of these factors, I used the NCHS survey data to make bar graphs reflecting

contraception distribution according to age, race, and education. For each factor, I chose to

reflect data from survey cycles at the beginning, middle, and end of my timeline to visualize the

changes in how these factors have impacted contraceptive choice overtime. I also analyzed the

data from the years in between to understand the trends more comprehensively.

Research Findings

Contraceptive Use Since 1982

 Lozano 17

Trends of Popular Contraceptive Methods 1982 - 2019

40%

35%

30%
% of Study Participants

25%

20%

15%

10%

5%

0%
1982 1988 1995 2002 2008 2013 2019

Pill Female Sterilization Condom

LARC (IUD & Implant) Other Method None

Figure 1. Trends of popular contraceptive methods among study participants from 1982 to 2019
Sources: William Mosher and William F. Pratt, “Contraceptive use in the United States, 1973-
88,” Vital and Health Statistics, no. 182. (Hyattsville, Maryland: National Center for Health
Statistics, 1990), pp. 1-10, Table 1; Mosher and Jones, “Use of contraception: 1982–2008,”
Table 4; William Mosher, Anjani Chandra, Joyce Abma, and Stephanie Wilson, “Use of
contraception and use of family planning services in the United States, 1982-2002” Vital and
Health Statistics, no. 380 (Hyattsville, Maryland: National Center for Health Statistics, 2004),
pp. 1-36, Table 4; Daniels et al., “Current contraceptive status, 2011-2013,” pp. 1-15, Figure 2;
Daniels and Abma, “Current contraceptive status, 2017-2019,” Figure 2.

Figure 1 reveals how the use of today’s most commonly used contraceptives- the pill,

female sterilization, the male condom, and long-acting reversible contraception (LARC)- has

fluctuated from 1982 to 2019. Altogether, there was a steady increase in the use of these five

methods. This coincides with an overall decrease in other methods, displaying increased

popularity of the five most popular contraceptives among women since 1982. Next, looking at

the individual contraceptive methods, after 1982, female sterilization and the pill remained the

two most popular methods among the surveyed participants. With the pill only introduced in
 Lozano 18

1960, this method gained much popularity due to it being the first non-permanent method where

women can control their fertility. Around the same time that the pill was introduced, female

sterilization evolved from a method of forced sterilization to contraceptive uses.

The next most commonly used method is the male condom. This modern rubber condom

has been around for a while as it began being mass-produced in the late 1850s.65 As seen in

Figure 1, male condom usage as participants’ only contraceptive method increased from 1982 to

1995. This increase reflects the raised concerns of HIV and AIDS infections during the “1980s

and early 1990s” after the first cases in the United States were recorded in 1981.66 After 1995,

the percentage of women relying on condoms decreased while at the same time, the use of

LARC increased.

Figure 1 also shows how the popularity of LARC has fluctuated since 1982. LARC

encompasses both the IUD and the implant, respectively, introduced in 1965 and 1990. Initially,

there was a decrease in LARC use from 1982 to 1988, exhibiting the IUD’s controversy during

this time. In 1974, all IUDs except for one were taken off the market due to ill design and safety

controversies.67 Then from 1988 to 2019, there was a steady increase in LARC usage, as seen in

Figure 1. This increase resulted from the FDA approving the Copper T 380A IUD in 1988 and

then the implant in 1990. Subsequently, the IUD and implant have continued to be improved

with newer versions.

Age

An examination of contraceptive methods used by different age groups since 1982

provides insight into how different life stages affect a women’s contraceptive choice. All age

65
Tone, Devices and Desires, 53.
66
History.com Editors, “History of AIDS,” History.com (A&E Television Networks, July 13, 2017),
https://www.history.com/topics/1980s/history-of-aids.
67
Megan Corbett, “A History: the IUD,” Reproductive Health Access Project, June 12, 2018,
https://www.reproductiveaccess.org/2013/01/a-history-the-iud/.
 Lozano 19

groups experienced an increase in condom usage in 2002 (Figure 3A), which was likely an

aftereffect of the increased awareness of HIV/AIDs during the 1980s. Regarding young women,

Figure 2A reveals that in 1982, the pill was the most commonly used method among women

between 15 and 24. This trend persisted as the pill’s popularity remained among young women

from 2002 to 2019 (Figures 3A and 4A). From 2002 to 2019, young women began increasingly

using LARC methods, coinciding with the overall increase in this method during that time. In

2019, the pill remained the most commonly used method among young women (Figure 4A).

LARC was the next most frequently used, with male condoms close behind.

Among the older age group, Figures 2A and 3A show that most women between the ages

of 35 and 44 most commonly used female sterilization as their contraceptive method from 1982

to 2002. Similarly, Figure 4A displays that female sterilization remained the favored method for

women 30 to 39 in 2019. Women who were 40 to 44 years old maintained the majority of LARC

users until 2002 (Figure 3A) when younger women began increasingly using this method. From

1982 to 2002, there was an overall decrease in LARC use for this age group while the use of

female sterilization and the pill increased (Figures 3A and 4A). This decrease in LARC aligns

with the IUD controversies during the late 1900s. Most recently, female sterilization remains the

most popular method for women 30 to 49 (Figure 4A).

Concerning the women between the young and old age groups, the pill has steadily

remained their most commonly used method. LARC use has also remained consistent for this

middle age group. Women 25 to 34 years-old experienced the most increase in LARC usage,

starting in 2008.68 In 2019, 20- to 39-year-olds remained the highest users of LARC and the male

condom (Figure 4A). Still, the most favored method among 20- to 29-year-olds in 2019 was the

pill, and for 30- to 39-year-olds, it was female sterilization (Figure 4A).
68
Mosher and Jones, “Use of contraception: 1982–2008,” Table 5.
 Lozano 20

Race

Women’s race is another important factor that can impact women’s contraceptive choice

due to cultural or societal influences. The races included in the National Survey of Family

Growth data are white, black, and Hispanic. As Figure 5B shows, Hispanics were not accounted

for in the 1982 study, but they were in the 1995 study (Figure 6B) and on. All races experienced

a significant increase in LARC use from 1995 to 2019. More specifically, LARC use increased

the most for white and Hispanic women from 2008 to 2019, reflecting the overall increase of

LARC use in Figure 1 during this time. Additionally, condom use increased for all races from

1982 to 1995, corresponding with the AIDS epidemic.

Looking at each race individually, black women in 1982 most commonly used the pill

(Figure 5B). Figure 5B also shows that more black women used the pill and female sterilization

compared to white women in 1982. This trend changed shortly after because from 1995 to 2019,

more white women reported using the pill than black women.69 Since 1995, female sterilization

has remained the most common method for black women. Black females were also the majority

of female sterilization users overall until 2019 when Hispanics took the majority by a small

margin.

Regarding white women, the pill and female sterilization were this group’s most popular

methods throughout this time period. The pill was consistently the favored method among this

group from 1982 to 2017 (Figures 5B-7B). 70 Then, from 2015 to 2019, female sterilization was

the more commonly used method by a small margin, as reflected in Figure 8B. Overall, white

women made up the majority of pill users among the three races from 1995 to 2019 (Figures 5B-

8B).

69
Jones et al., “Current contraceptive use, 2006-2010,” Table 2.
70
Daniels and Abma, “Current contraceptive status: 2015-2017,” Figure 3.
 Lozano 21

Lastly, the most popular method for Hispanic women from 1995 through 2019 was

female sterilization. In 1995 and 2008, Hispanic women made up most of LARC users (Figures

6B and 7B). Figure 8B shows that in 2019, female sterilization remained the most popular

method for Hispanic women, with the condom and LARC being the next most common methods.

As mentioned before, Hispanics hold the majority for female sterilization by a small margin

compared to white and black women (Figure 8B).

Education

An analysis of the types of education a woman receives compared to her contraceptive

method illustrates how education can impact contraceptive choice. Figures 9C, 10C, 11C display

contraceptive choices of women with different education levels in 1995, 2008, and 2010. The

1982 survey did not account for education, which is why I started with the 1995 data. For all

education levels, LARC use increased from 1995 to 2019 (Figures 9C-11C). First, among

women with no high school diploma or GED, the most common method was female sterilization

in 1995, 2008, and 2019 (Figures 9C-11C). This also remained consistent for the survey data in

between these years.

Like women with no high school diploma, women with a high school diploma or GED

most commonly used female sterilization as their method from 1995 to 2019 (Figures 9C-11C).

The popularity of sterilization for this group was not by as wide of a margin as women with no

high school diploma, but it is still significant. Next, figures 9C, 10C, and 11C show that over the

years, the popularity of the pill and female sterilization has fluctuated for women with some

college but no bachelor’s degree, mirroring the general fluctuation of these methods as seen in

Figure 1. In 1995, the pill was more prevalent among this group (Figure 9D). Then Figures 10D

and 11D show that from 2002 to 2019, female sterilization was more commonly used, with the
 Lozano 22

pill close behind. Finally, the most popular method for women with a bachelor’s degree or higher

from 1995 to 2019 was the pill (Figures 9-11D). Women with this education level also made up

most of the condom users from 1995 to 2017 (Figures 9D and 10D).71

Discussion

The effect of age, race, and education on women’s contraceptive choice has persisted

since 1982. Within the data looking at age’s impact on contraceptive choice from 1982 to 2019,

it is evident that the correlation between age and the pill and female sterilization has largely

remained consistent. Overall, pill use decreases with increasing age while female sterilization use

increases. This is due to young women being more likely not to be married or intending to have

children in the future, leading them to use reversible contraception. Meanwhile, women over 35

are more likely to be married and have already had their intended number of children, leading

them to use a permanent method, female sterilization. Age’s correlation with women’s use of

LARC and the male condom has shifted. The majority of male condom users were under 24 and

included teenagers. Then in 2008, most of the condom users shifted to women in their 20s and

30s. On the other hand, the majority of LARC users were above 35 until 2002, when the average

age changed to women in their 20s and 30s.

Compared to women’s age, there was slightly more fluctuation from 1982 to 2019 with

how women’s race impacted contraceptive choice for all methods. Most pill users were black

until 1995, when white women took the majority. Meanwhile, most users of female sterilization

from 1982 to 2017 were black and Hispanic. Socioeconomic trends in the United States may help

explain these trends. According to the U.S. Census Bureau, the median household income for

blacks and Hispanics was lower than that of whites from 1980 to 2017.72 This median household
71
Ibid, Figure 5.
72
Kayla Fontenot, Jessica Semega, and Melissa Kollar, “Income and Poverty in the United States: 2017,” U.S.
Census Bureau, Current Population Reports (Washington, D.C.: United States Census Bureau, 2018), pp. P60-263,
5.
 Lozano 23

income shows that blacks and Hispanics are more likely than whites to belong to lower

socioeconomic classes. Using the pill or other reversible contraceptive methods might not be a

choice for lower-income women due to cost or unequal access. Therefore, female sterilization

users may have been majority black and Hispanic from 1995 to 2017 due to less access to

reversible contraceptive options. However, in 2019, female sterilization was the most commonly

used method for women of all races. This data aligns with the United States experiencing a

record low birth rate in 2019.73 Regarding condom and LARC use, there were not any consistent

trends for specific races using these methods.

Similar to age’s impact on contraceptive choice, education levels have maintained the

same impact on the pill and female sterilization over the years. The survey data reveals that pill

use increases with increasing education as female sterilization use decreases. This may be due to

higher educated women having more financial support for a family in the future. Conversely,

women with no education are not as likely to have high paying jobs as those with higher

education. Therefore, women with no education may not be able to afford to use reversible

contraceptives or have kids. Additionally, less educated women may not have as much

knowledge of the contraceptive options available to them as higher educated women. Like age

and race, education’s impact on LARC and condom use has fluctuated from 1982 to 2019. In

1995, 2002, 2008, and 2010, condom use increased with education. However, this did not remain

true for the 2013, 2017, and 2019 studies, proving education does not impact condom usage like

it used to. There was no correlation for LARC usage with increasing education from 1995 to

2019.

73
Janet Adamy, “U.S. Birthrates Fall to Record Low,” The Wall Street Journal (Dow Jones & Company, May 20,
2020), https://www.wsj.com/articles/u-s-birthrates-fall-to-record-low-11589947260.
 Lozano 24

These trends over the years have led to the user profiles that existed in 2019. The pill is

most commonly used by white women who are 20 to 29 years old and have a bachelor’s degree

or higher. Next, women who use female sterilization as their contraceptive method are mostly

Hispanic, 40 to 49 years old, and have no high school diploma or GED. For the male condom,

women who rely on this method are mostly 20 to 39 years old and Hispanic.74 Finally, for long-

acting reversible contraceptive users, most women are 20 to 39 years old and have some college

or higher.75 Age, race, and education will continue to affect women’s contraceptive choice in the

years to come. This research provides evidence that age and education will continue to have the

same correlation on pill and female sterilization users. Additionally, based on this research’s

trends, white women will likely continue to persist as the majority of pill users. However, the

impact of these factors on the male condom and LARC users are not as consistent, so it hard to

predict the impact that age, education, and race will have on these methods in the future.

This research has implications for overall contraceptive trends in the future and how

contraceptive options could potentially be improved. Among the most popular contraceptive

methods, I foresee female sterilization and the pill remaining the two most popular methods due

to their continued popularity throughout the years. However, as LARC’s popularity continues to

increase, the IUD and implant could eventually replace the pill’s ranking due to LARC’s

advantages of minimal upkeep. Regarding the implications for how contraception can be

improved, this data makes it apparent that there are disparities among the different races and

education levels. These disparities allude to the need for increased equal access to contraception

and increased widespread knowledge on the different contraceptive options in the future. Further

74
There was not a significant difference in education levels for the male condom in 2019.
75
There was not a significant difference among the races for LARC in 2019.
 Lozano 25

research is needed to understand how to improve access and available information in our current

healthcare system.

This study has potential limitations. The first is that age, education, and race are just a

few of the many factors that influence women’s contraceptive choice. Insight into how other

factors, such as income and health care coverage, affected contraceptive trends during this

timeline would be insightful. However, age, education, and race were the only factors that the

NCHS most consistently recorded in their surveys from 1982 to 2019. The second limitation was

that the NCHS surveys did not include interviews with women to get more personal stories about

their contraceptive choice. In future research on this topic, researchers should include several

different factors to get a more holistic view of what makes up a women’s contraceptive choice.

Additionally, researchers should include interviews with women to give real-life accounts that

are not present in quantitative data.

Conclusion

Many different factors influence a women’s contraceptive choice. In this study, I

examined how age, race, and education influenced women’s contraceptive patterns from 1982 to

2019. I used survey data prepared by the National Center of Health and Statistics to analyze the

contraceptive choices of women between 15 and 49 years old. Among the factors I analyzed, age

and education were the strongest predictors of pill and female sterilization use from 1982 to

2019. As women’s ages increased, female sterilization use increased, and the pill’s use

decreased. Also, women with a bachelor’s degree or higher consistently used the pill, while

women with no high school diploma used female sterilization. There were also trends among

women’s race with contraception use. The majority of pill users from 1995 to 2019 were white

women, and the majority of female sterilization users from 1982 to 2017 were black women.
 Lozano 26

During this timeline, there were no consistent trends for the impact of age, race, and education

on women’s use of LARC or the male condom.

A limitation of this research was that it did cover other factors that impact women’s

contraceptive choice. Additionally, the NCHS data did not include one-on-one interviews with

women to supplement the findings. These limitations were a result of how the original NCHS

data was collected. Future researchers should include these in their research on this topic to

obtain a more holistic understanding of what makes up a woman’s contraceptive choice. This

study expands the research on women’s contraceptive choice by examining a more

comprehensive timeline than most scholars have done in the past. The findings also make it

apparent that there are disparities among the women of different races and education levels. As

also recommended above, future research should investigate ways in which women can be given

increased equal access to contraception and increased widespread knowledge of different options

in the years to come.

 Lozano 27

Appendix A

Contraceptive Use by Age

Distribution of Contraception Users by Age in 1982

30
26.8

25 23.5
% of All Participants

20
17.1
14.8
15

10
7.6 7 6.5
5.5
5 4.2
2.3
1.3 1.4
0
Pill Female Sterilization Male Condom LARC

15-24 25-34 35-44

Figure 2A. Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 1982 according to age.
Source: Mosher and Pratt, “Contraceptive use, 1973-88,” Table 2.
 Lozano 28

Distribution of Contraception Users by Age in 2002

35
32
30

24.3 23.6
25
% of All Participants

20
14.9
15 12.8
11.3
10.3 9.5
10
6.4
5
1.1 1.3 1.2
0
Pill Female Sterilization Male Condom LARC

15-24 25-34 35-44

Figure 3A. Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 2002 according to age.
Source: Mosher et al., “Use of contraception: 1982-2002,” Table 6.

Distribution of Conteaception Users by Age in 2019

45
39.1
40

35
% of All Participants

30

25
21.6 21.2
19.5
20

15 13.7 12.7
10.9 10.4 9.7
10
6.5 6.5 5.8 6.6
5.1
5 2.9
0
0
Pill Female Sterilization Male Condom LARC

15-19 20-29 30-39 40-49

Figure 4A. Figure 3B. Distribution of women using the pill, female sterilization, male condom,
and long-acting reversible contraception in 2019 according to age.
Source: Daniels et al., “Current contraceptive status, 2017–2019,” Figure 3.
 Lozano 29

Appendix B

Contraceptive Use by Race

Distribution of Contracpetion Users by Race in 1982

25

19.8
20

15.1 15.6
15
12.5

10
7.2
4.7
5 3.9
3.2

0
Pill Female Sterilization Male Condom LARC

White Black

Figure 5B: Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 1982 according to race.
Source: Mosher and Pratt, “Contraceptive use, 1973-88,” Table 1.
 Lozano 30

Distribution of Contrception Users by Race in 1995

45
39.9
40
36.6
35

30 28.6
% of Participants

23.7 24.5
25 23
19.6 20.3 20.5
20

15

10

5
0.7 0.8 1.5
0
Pill Female Sterilization Male Condom LARC

White Black Hispanic

Figure 6B: Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 1995 according to race.
Source: Jones et al., “Current contraceptive use, 2006-2010,” Table 6.

Distribution of Contrception Users by Race in 2008

25
21.2 21.8
19.6
20

14.9
% of Paricipants

15
11.4 11.4
9.5 9.4
10 8.8
6.3
5 3.8 3.4

0
Pill Female Sterilization Condom LARC

White Black Hispanic

Figure 7B: Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 2008 according to race.
Source: Mosher et al., “Use of contraception: 1982–2008,” Table 6.
 Lozano 31

Distribution of Contrception Users by Race in 2019

25

19.9
20 18.5
17.8 17.6
% of Participants

15

11 10.5 10.9 10.9 10.3

10
8.1 7.9
7

0
Pill Female Sterilization Male Condom LARC

White Black Hispanic

Figure 8B: Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 2019 according to race.
Source: Daniels et al., “Current contraceptive status, 2017–2019,” Figure 4.
 Lozano 32

Appendix C

Contraceptive Use by Education Level

Distribution of Contraception Users by Education in 1995

60 56.3

50
% of Contracepting Women

40
40
32.2
30 27.1 26.1 26.4
20.2 20.7
20
13.6
11.7 13.1 14
10
0.9 0.6 0.7 1.4
0
Pill Female Sterilization Male Condom LARC

No high school diploma or GED High school diploma or GED

Some college, no bachlor's degree Bachlor's degree or higher

Figure 9C. Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 1995 according to education level.
Source: Jones et al., “Current contraceptive use, 2006-2010” Table 6.
 Lozano 33

Distribution of Contraception Users by Education in 2008

60 55.4

50
% of Contracepting Women

42.5
40
34.7

30 27.4
23.4
20.2
20 18.4
16.3 15.7
10.4 9.5 10.1
10 7.2 5.7
4 4.9

0
Pill Female Sterilization Male Condom LARC

No high school diploma or GED High school diploma or GED

Some college, no bachlor's degree Bachlor's degree or higher

Figure 10C. Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 2008 according education level.
Source: Mosher et al., “Use of contraception: 1982–2008,” Table 8.

Distribution of Contraception Users by Education in 2019

45
39.9
40
% of Contracepting Women

35 31.5
30
25 22.2
20 18.1

15 12.1 12.5 13.1

10.8
10 8.7 9.3 8.6 9.3
7.9
5.7 6.8 6.7
5
0
Pill Female Sterilization Male Condom LARC

No high school diploma or GED High school diploma or GED

Some college, no bachlor's degree Bachlor's degree or higher

Figure 11C. Distribution of women using the pill, female sterilization, male condom, and long-
acting reversible contraception in 2019 according to education level.
Source: Daniels et al., “Current contraceptive status, 2017–2019,” Figure 5.
 Lozano 34

Appendix D

Overview of Contraceptive Methods

Table 1D. Overview of the Five Most Popular Contraceptive Methods

Year User Profile Effective

Method Controversies Price
Introduced (2019) -ness
Female 1881; evolved 40-49, Hispanic, Originally used by U.S. $0- 99%
Sterilizatio for no high school government to forcibly $6,000
n contraceptive diploma or GED sterilize individuals deemed
use in 1960s unfit for society
Pill Approved by 15-29, white, In 1967, planned $0- 91%
the FDA in bachelor’s parenthood was accused of $50
1960 degree or higher genocide for focusing
distribution in poor,
minority neighborhoods;
Published health risks cause
a drop in use during 1979.
Male Preindustrial 20-39. Hispanic No significant controversies $0.50- 85%
Condom America; rubber or black, all $1
condoms education levels each
introduced in
1850s.
IUD 1965; new 20-39, all races, All but 1 were withdrawn $0- 99%
generation some college or from the U.S. market in $1,300
method bachelor’s 1974 due to safety
introduced in degree or higher controversy
1988
Implants Approved by 20-39, Hispanic, Withdrawn from the market $0- 99%
the FDA in white, or black, in 2002 due to problems $1,300
1990 some college or with insertion and removal
bachelor’s
degree or higher

Sources: Ross, “Female Sterilization,” 139; Berg, “Timeline: 100 Years of Birth Control”; Tone,
Devices and Desires, 53 & 265; Kaiser Family Foundation, “Contraceptive Implants”; Alexandra
Nikolchev, “A Brief History of the Birth Control Pill,” PBS (Public Broadcasting Service, May
7, 2010), https://www.pbs.org/wnet/need-to-know/health/a-brief-history-of-the-birth-control-
pill/480/; Corbett, “A History: the IUD”; Planned Parenthood, “Birth Control Methods &
Options: Types of Birth Control,” Planned Parenthood, 2020.
https://www.plannedparenthood.org/learn/birth-control.
 Lozano 35

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