Millennials Value Birth Control, So Why Aren't More Using It?

Among teens ages 15 to 19, pregnancies (about 85 percent of which are unplanned) and births are at their lowest rates ever. The teen pregnancy rate has dropped 51 percent since 1990, and the teen birth rate 57 percent since 1991. But teens' older, unmarried sisters, ages 20 to 29, cannot say the same thing.
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Attention, those of you who think teenagers are responsible for most of the unplanned pregnancies and births in this country.

You're wrong. Way wrong. Among teens ages 15 to 19, pregnancies (about 85 percent of which are unplanned) and births are at their lowest rates ever. The teen pregnancy rate has dropped 51 percent since 1990, and the teen birth rate 57 percent since 1991, according to The National Campaign to Prevent Teen and Unplanned Pregnancy, a nonprofit organization.

But teens' older, unmarried sisters, ages 20 to 29, cannot say the same thing. Seventy percent of pregnancies among these women are not planned, according to a 2014 study by the Campaign ("The Benefits of Birth Control in America: Getting the Facts Straight"). The women and their partners have available to them more, and far better, methods of contraception than their parents had, and most believe in using it. But they use it erratically, and their rate of unplanned pregnancy has increased.

The rates are highest among 18- to 24-year-olds, says Larry Swiader, who leads The National Campaign's online birth control resource for young adults, Bedsider. "There comes a moment in the relationship where the condom is no longer desirable," he says. "Trust has been built; it's a very nice process."

These young women and young men are more learned than previous generations, Swiader continues, and have most of, if not all, the resources they need. "But they don't know their options."

Robert P. Jones, a researcher and scholar who recently completed a study on young adults, including their reproductive health issues, confirmed the trend. "Progress has stalled on the use of birth control since 2002," he said.

I thought of this unsettling information as I read the study by Jones and his organization, the Public Religion Research Institute (PRRI), a nonprofit, nonpartisan organization that surveys public opinion and researches the intersection of religion, values and public life.

PRRI queried young adults around the country, ages 18 to 35, about reproductive health issues, including birth control. Eighty percent of those questioned -- men as well as women -- said they support health insurance covering prescription contraception. Sixty percent said the same thing about emergency contraception, which can be used in the first few days after intercourse. Almost six out of 10 said private corporations' health insurance plans should include contraception at no cost to the employee (are you listening, Hobby Lobby?), and slightly more than half said emergency contraception should not require a prescription.

More than two out of three said using safe sex practices and birth control were more effective than abstinence in preventing unintended pregnancies. Three out of four endorsed comprehensive sex education in public schools. Two out of three said relying on abstinence is not a smart thing to do.

As Jones, PRRI's chief executive officer, said at a recent forum, "Few millennials have qualms about birth control.... There was near-consensus across race, religion and political affiliation on the importance of, affordability of, and access to contraception."

So why aren't they better at using it? The reasons are numerous.

One is that millennials are waiting longer to get married and having sex more frequently than when they were teens. Newer, highly effective methods of birth control are pricey, particularly for women whose insurance doesn't cover much of the cost. Condoms, used to protect them from the transmission of sexual diseases, as well as pregnancy, may not seem necessary in a steady relationship. And trust between partners may grow over time, leading, perhaps, to complacency.

Many 20-somethings (and their parents) don't know how many methods there are that are safe, comfortable, affordable, effective and reversible. (The answer is 15.) Doctors and nurses may not offer the most up-to-date answers and information.

And let's not forget: Plenty of older adults make poor choices as well: A study last year of older fellows in the Society of Family Planning, an association of healthcare professionals interested in birth control, found, among other things, that 46 percent of respondents had had unprotected vaginal intercourse when not intending pregnancy, 7 percent within the past year.

Even if young adults have some idea about their choices, says Swiader, "They are thinking, 'What's easiest for me?' not, 'What's most effective?'" Another possible factor: The rate of alcohol use among young women and men, along with the muddy thinking that can accompany it, goes up with age.

Some women fear side effects: Will their hair fall out? Will they get fat? Others, who have unprotected sex once or twice and don't get pregnant, may assume they're losing their fertility and become more laid back about using contraception. Those in their late 20s may debate with themselves and their partners whether they should go ahead and get pregnant before they're too old to conceive. Such ambivalence is common and increases with age.

Swiader, a walking encyclopedia on virtually everything birth control, recognizes the challenges for young adults. He says:

This is a wicked problem. Birth control requires ongoing maintenance for a couple of decades, and some of it will be with someone you're not convinced you'll stay with. You change relationships, or your relationship status, your location. And every method has its own set of barriers and side effects. There comes a time in a relationship when the condom is no longer desirable. Trust has been built but can you delay while you decide what to do next?

It's almost enough to make me grateful I'm no longer 21.

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