In the US, unplanned pregnancies are common. Extremely common. More than half of all pregnancies in America are unintended, and that statistic towers over the unplanned pregnancy rates in other comparable countries.

That’s true for teenage pregnancy, too. In Switzerland, less than 10 out of every 1,000 females between the ages of 15 and 19 become pregnant. In France and Norway, it’s a little over 20 out every 1,000. England is higher, around 46 out of 1,000.

But of all developed countries, America is the highest. Almost 60 out every 1,000 teens in the US become pregnant. Why?

More Than 50% Of US Pregnancies Are Unplanned. Here’s Why.

Here’s the most likely answer: unplanned pregnancy rates are so high because American women use contraception less than women in other countries. And when we do use birth control, we don’t use the most effective kinds.

As Americans, we tend to choose contraceptives that are “subject to human error.” In other words, we can forget to take a birth control pill or forget to pick up condoms at the convenience store. But those are the kinds of contraceptives that most young women choose.

And even as newer generation contraceptives have hit the market, the unplanned pregnancy rate in the US hasn’t budged for decades.

Unplanned Pregnancies & Contraceptive Use

According to the US Department of Health & Human Services, around 89% of women who are “at risk” of an unintended pregnancy are currently using some form of contraception. Which leaves 11% of women who could get pregnant, but don’t want to, unprotected against pregnancy.

And those 11% of women account for 54% of all unplanned pregnancies. Around 18% of those women who currently use contraception say that they do so “infrequently.” And they account for almost 41% of all unintended pregnancies. In other words, women who use contraception consistently only account for 5% of unplanned pregnancies.

Birth Control: How Do I Choose The Right Kind?

When we use them correctly, most modern forms of birth control are extremely effective. But that doesn’t mean that all contraceptives are created equal.

For one thing, some forms of birth control aren’t “subject to human error” in the same way that condoms and the Pill are. Intrauterine Devices (IUD) are inserted by a health care provider into a woman’s uterus and some even last up to 12 years.

Studies have indicated that as many as two out of every five unplanned pregnancies are the result of improper contraceptive use. IUDs take “improper use” out of the equation, which means that IUDs fail less.

In theory, condoms are effective in 98% of cases. In reality, they fail around 18% of the time due to improper use. As for the Pill, it’s theoretically 99% effective, but that number drops to around 91% if you don’t always take it every day. Taking theories out of the discussion, that makes an IUD 90 times more effective than condoms and 40 times more effective than the Pill.

But American women aren’t using them.

What Kinds Of Birth Control Do We Actually Use?

Here’s how contraceptive use breaks down in America today:

  1. 27.5% of women who use birth control take the Pill
  2. 26.6% of women have undergone sterilization procedures
  3. 16.3% of women choose condoms
  4. 5.6% use an IUD
  5. 3.8% get birth control shots
  6. 2.2% use a vaginal ring, like NuvaRing
  7. 0.7% use a patch (Ortho Evra)
  8. 0.5% use an implant

Two of the most used contraceptives are “nonpermanent,” and rely on the daily decisions of average humans to work. Those facts alone go a long way in accounting for America’s extremely high rate of unintended pregnancy.

Here’s a look at the same birth control methods, but rather than ranking by how many women use each, we’ve ranked them based on their actual effectiveness:

  1. Birth control implant (effective in 99.95% of cases)
  2. IUD (effective in 99.8% of cases)
  3. Female sterilization (effective in 99.5% of cases)
  4. Shot or injection (effective in 97% of cases)
  5. Birth control pill (effective in 91% of cases)
  6. Patch (effective in 91% of cases)
  7. Vaginal ring (NuvaRing is effective in 91% of cases)
  8. Condoms (effective in 82% of cases)

With a few differences, the ranking of effectiveness is almost the exact opposite of what we actually use.

Those other developed countries we talked about earlier? They use IUDs way more than we do. In France, around 19% of women use them, and in Norway, 23% of women do.

But The Most Effective Birth Control Is The One You’ve Never Heard Of

Birth control implants are small rods, like matchsticks, that can be implanted into the arm by a health care professional.

Only 0.05% of women will get pregnant with an implant. Compared to the IUD, with which a still-low 0.2% women will get pregnant, the implant is by far the most effective form of contraception available (besides permanent types like sterilization).

The idea of having a foreign object implanted in your arm may seem weird or gross or scary. But most women say that it doesn’t hurt, and after a few days of soreness, you won’t even notice it anymore.

Breaking Down The Cost Of A Birth Control Implant

But obviously, birth control methods can vary widely in price. And since unintended pregnancy rates are highest among low-income women, it’s no stretch to think that the higher costs of really effective contraception methods are at the root of the problem.

The up-front cost of an implant can be high, as much as $800, but implants last as long as three years.

According to the General Social Survey, the average American couple in their 20s has sex 111 times a year. Over three years, that comes out to 333 times. If you break out the implant’s highest possible cost along those lines, it would end up costing around $2.40 to protect against pregnancy, every time.

But that’s only using the highest possible cost. In most states, Medicare will cover a birth control implant, as will most private health insurance policies. If you purchased a health plan through your state’s Insurance Marketplace, your insurance carrier has to cover the cost of an implant, and can’t even charge you a co-pay. That’s true even if you haven’t met your deductible.

Which means that the most effective form of birth control currently available is likely to be free, as long as it’s prescribed by your doctor.

Just like any form of birth control, the implant isn’t right for every woman. Speak with your doctor before making any health care decisions, discuss your concerns and work together to choose the right option for you.