If I warned you that if you have sex and don’t use a good method of contraception you have a one out of six chance of getting pregnant, would you do it anyway? Considering the odds of those risks in the coldish light of day, most people would say no (or no way or you gotta be kiddin’), in short– they say they wouldn’t do it. But in the heat of the moment, many people toss good sense out of the bedroom window and just give in the primal desire of our hormones and thus, take a chance. Accordingly, half of all the pregnancies in the U.S. are unintentional—about 3.1 million every year—situations that are as underestimated as they are misunderstood. Simply put, there is an underlying paradox here: Why do so many women still get “knocked up” given that contraception is now so readily available? To understand the situation, it is time we peel back the layers of conflict, denial, hope, dreams, myths and challenges about pregnancy and look at the realities of this “Knocked Up Paradox (c)” sans rose-colored glasses. The conventional wisdom claims that unplanned pregnancy is a mostly a teenager’s nightmare, but that’s just not the case. Most unintentional pregnancies—seven out of ten—occur to single women in their twenties, many of whom are white, aren’t poor, and have at least some college education. Among married women, one out of four pregnancies are not only unplanned, they are unwanted! It turns out that getting pregnant unintentionally isn’t just the plight of slutty or unlucky women: it crosses income, education, marriage, and racial lines. It is dumbfounding, ironic actually, to learn that almost all women facing an unplanned pregnancy express dismay and disbelief “that it could happen to me.” It’s not easy to sort out cause from effects, but it’s not impossible either. For example, here are most common reasons researchers have been given by women and in some cases men, for taking a risk/have been put at risk about the possibility of getting pregnant include: not being vigilant about using effective contraception every time she has sex; not being informed or being confused about what is and what isn’t effective;not using a method of contraception according to directions;a fear that contraception isn’t safe to use or will have a harmful effect;using ineffective protection because although she isn’t planning to get pregnant she isn’t exactly trying to avoid it. In some cases this waffling may be due to thinking that a pregnancy could be her trump card to get her partner to be committed to the relationship. (The conventional wisdom of a woman getting deliberately pregnant to get a guy to marry her is also known as the Liverpool Method based upon the tradition of hasty marriages to pregnant girlfriends); ambivalence about becoming a mother and so she lets “nature” take its course–que sera, que sera; getting swept away by the passion of the moment and not being prepared with protection;using a good method but it failed. It turns out that the most common contraceptive failures for women are those methods controlled largely by their male partners. About one out of four women say that the reason they got pregnant was that their partner did not want to use contraception. And among women who cited contraceptive failure, over half were using withdrawal or condoms, both male methods;and, adhering to restrictions against contraceptive use based on religious teachings. I recognize that it is possible for a woman to face an unwanted pregnancy because she was forced into having sex and wasn’t able to protect herself. While pregnancy can result from being raped or sexually assaulted, thankfully, the rates are low.)
Admittedly, there are almost as many reasons explaining unplanned and unwanted pregnancies as there are people. But the most common reason is no great mystery: not using an effective method of contraception every single time you have sex, and using it right every time. It’s not quantum physics. Obviously, most of us aren’t quantum physicists. The statistics on unintended pregnancy speak for themselves.
Of course, not all unplanned pregnancies are “unwanted;” there are those happy twists of fate when an unplanned pregnancy was simply “mistimed” and resulted in a loved child. If, however, a pregnancy is truly unwanted, there are no simple answers, no quick fixes. Every option, from abortion to adoption to raising the child, plays out as its own unnerving drama. And despite the Hollywood driven mythology that “everything works out for the best,” it usually doesn’t.
Why don’t we know the real truth about our high rates of unplanned pregnancy?
Over the last four decades, the divisive politics of abortion has tainted and virtually stymied meaningful discussion about the complex tangle of personal dilemmas and the far-reaching consequences of unplanned and unwanted pregnancies. Thus, most people are not aware that here in the U.S. we have one of the highest unplanned pregnancy rates in the industrialized world, yes, even higher than Mexico, Spain, and Italy.
Turning a blind eye to the ramifications of unplanned pregnancies has only served to squash any potential dialogue about our serious lack of adult sexual intelligence and the need to make contraceptives more available and assessable. As a result, too many women, especially young women (and men), are only dimly aware that the odds of avoiding a pregnancy during unprotected sex are seriously stacked against them —even if it is ‘just this once.’”
Despite the mind-boggling challenges of making a dent in our vast numbers of unplanned pregnancies, the situation isn’t hopeless. There are any number of effective prevention programs being designed and implemented all over this country–only they are small in scope. We need to increase those efforts and promote them in our communities. And we should adapt , on a national scale, the edgy European media campaign, Safe Sex or No Sex. Although it could find Americans blushing at first glance— it is successful in encouraging planned parenthood and discouraging unprotected sex. What will make a major difference is for all of us to push the media to acknowledge that we have a serious problem and then expect leaders in our communities to help us push policy makers to take significant actions to do something about it.
drcarolcassell 