This Chart “Perfectly” Displays Perfect vs. Typical Use Effectiveness Rate for Birth Control Methods
The fertility tracker, DOT recently shared a blog post on their website entitled, “Contraceptive Effectiveness in the Real World (aka Typical Use) and Why It Matters.” The post explains—and later illustrates—why different forms of birth control aren’t always effective by explaining the two effectiveness rates that all methods have. The two rates, the article explains, are called perfect use and typical use and are determined through clinical testing.
Perfect use effectiveness refers to how effective a birth control method is when it is used correctly 100% of the time—meaning, without any mistakes. The article cites Contraceptive Technology, which states that the perfect-use effectiveness of the birth control pill is 99.7%. To use the Pill perfectly would mean taking it daily at about the same time every day.
Typical use effectiveness “takes into account perfect use as well as incorrect use, so it is unofficially referred to as ‘real-world’ use. If we go back to the Pill example, its typical-use effectiveness rate is a lower 93%. That means that if 100 women were taking the Pill, 7 would get pregnant during the first year of real-world use.”
The author goes on to note that perfect-use effectiveness will always be higher than typical use. The article ends by noting that the only method that is 100% effective at preventing pregnancy is abstinence.
The DOT does a good job explaining the difference between the two types of effectiveness rates, however, what stood out was the chart at the end of the article demonstrating the typical-use effectiveness of different methods of birth control. According to the DOT chart, the Pill, patch, and vaginal ring have a 93% typical-use effectiveness rate, while natural methods like the DOT app and Natural Cycles app have typical-use rates of 95% and 92% effectiveness. This just goes to show that Fertility Awareness-Based Methods (FABM) of family planning, from which the DOT and Natural Cycles apps are derived, can be more effective than the Pill, or at least as effective as the Pill, only without undesirable side effects. What is so great about this chart, is it doesn’t try to mask the truth about FABM effectiveness, which is so refreshing especially as there are so many misconceptions and falsehoods spread about FABMs on a seemingly constant basis.
Last year, in response to a Cosmopolitan article which focused on “15 facts” about fertility awareness, Natural Womanhood editor Mary Rose Somarriba, addressed some of Cosmo’s claims about FABMs. In response to their statement that, “perfect use is hard to achieve,” she wrote:
“This is true, which is why it is noteworthy that the *typical use* effectiveness rate for the Pill (91%) is lower than the typical use effectiveness rates of common FABMs such as Sympto-Thermal, Creighton, and Sympto-hormonal methods (98%, 96%, and 93% respectively). Again, these are *typical* not *perfect* use effectiveness rates!”
Cosmo went on to use their former statement as the basis for their claim that other forms of birth control are more effective. But Cosmo based its stats on a former report from the CDC, that has recently been updated to more accurately represent FABM effectiveness rates (as high as 98%).
Furthermore, as Natural Womanhood CEO and cofounder Gerard Migeon wrote: “Based on the highest quality published medical research, the effectiveness rates of FABMs with correct use are between 95.2 and 99.6%, depending on the method. With typical use, the effectiveness rates of FABMs are comparable to most commonly used forms of birth control, with unintended pregnancy ranging from 2-14%.”
Moreover, effectiveness varies by methods, but among proven methods, the typical use success rate of certain methods is high, and so it is encouraging to see small factions of the medical field and fertility awareness apps acknowledge the effectiveness rates. One hopes as these facts become more mainstream, more women will be able to make more informed choices between hormonal birth control methods and safer and as-effective methods of family planning like FABMs.