Research carried out in
France has found that one in three pregnancies is unplanned.
But of these, two out of three occur when couples are using
contraceptives, such as the Pill or condoms.
The researchers said doctors should do more to ensure women
who do not wish to become pregnant use the most suitable forms
of contraception.
Dr Nathalie Bajos and colleagues at the Hospital de Bicetre,
in Paris, based their findings on a survey of almost 3,000
women across France.
Unplanned pregnancies
They found that 1,034 of these women had become pregnant unexpectedly.
Half subsequently decided to have an abortion.
But of these, 65% said they had been using contraception:
21% said they had taken the Pill; 21% had used the "natural
method"; 12% had used condoms; and 9% had used an intra-uterine
device (IUD).
The survey found that most of these women had become pregnant
because they had not used the contraceptive properly.
For instance, 60% of those on the Pill said they became pregnant
after forgetting to take a tablet.
One in three of those who used an IUD said it had been in
the wrong position or had fallen out. Almost half of those
who had used condoms said they had torn or slipped off.
But a large proportion of women said they did not know why
their contraception had not worked.
This included one in five of those taking the Pill, over
half of those using an IUD and one in five of those using
condoms.
The doctors said the findings suggested many women were simply
using the wrong type of contraception for them.
"What this research shows most clearly is that there
is often a mismatch between a women's contraceptive needs
and the
methods they use," Dr Bajos said.
She pointed out that while the Pill is regarded as being
very effective it is not suitable for every woman, such as
those who do not have intercourse regularly or those whose
lifestyle prevents them from taking tablets regularly.
Dr Bajos said doctors should work more closely with patients
to ensure they are using the most suitable type of contraceptive.
"When a doctor prescribes a contraceptive, he or
she should not think just of the theoretical perspective,
but take into
account the woman's life."
She added: "It is absolutely essential to differentiate
between what are the theoretically most effective methods
of contraception and what is the most practicable method
for a particular women at a particular time in a particular
relationship."
The fpa, formerly the Family Planning Association, welcomed
the findings.
Its chief executive Anne Weyman said: "The lessons
of this study are equally applicable in the UK.
"To avoid unplanned pregnancies, it's essential
women are aware of all the contraceptive choices available,
and that
professionals are fully trained to take into account the
different factors that impact on effective contraceptive
use, such as lifestyle, age and type of relationship."
The study is published in the journal Human Reproduction.
Story from BBC
NEWS, Published: 2003/04/29
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Contraception