This is a followup to JGorndt's post on O-Deck: an investigation into whether the recently published journal paper that essentially says "the withdrawal method of BC results in a higher rate of unintended pregnancies" has other, more interesting things to say. [THIS POST HAS BEEN UPDATED to reflect that the paper does characterize women who use contraception. It's just in two sentences and one table hidden in the discussion section.]

The principal point appears to be that coitus interruptus has not previously been studied in young, unmarried couples, just old, married ones.

When withdrawal is used correctly, unintended pregnancy rates are comparable to male condoms. However, pregnancy rates associated with withdrawal are higher, sez other people.

In this study, we examined whether withdrawal use and unintended pregnancy are correlated

as well as elucidated characteristics of females who choose withdrawal.

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Some assorted facts:

31% of females used withdrawal for at least 1 month (of 22 months) and 69% used ONLY other BC. Most people using withdrawal (89.8%) used other BC at some point.

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Females using withdrawal and females using withdrawal + other BC had unintended pregnancy rates that were not significantly different (11.3%, 22.6%, p = 0.11). Most women using only withdrawal had used other BC at some point.

22.6% of women were pregnant during these 22 months, and 59.2% of those were unintended. Females using withdrawal had a higher rate compared with females using not withdrawal methods (21.4% instead of 13.2%). When adjusted for other factors including age, race, marital status, education, employment, poverty level, number of children, wants more children, age at first sex, number of lifetime sexual partners, tested/treated for STI in the past year, has used emergency contraception, the hazard ratio is still 1.75. Hazard ratio = how much more often unintended pregnancy happens in one group, compared to some baseline group. Withdrawal users were more likely to have used emergency contraception.

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BASICALLY, THE ONLY INTERESTING THING ABOUT THIS PAPER IS BURIED IN TABLES 2 and 3 .

Because I would like to not be yelled at, here is a summary of the top hazard ratios:

  • 1.90: at or below 200% of federal poverty level, compared to those who are not
  • 1.75: withdrawal, vs. exclusively other methods
  • 1.70: African American vs. white, non-Hispanic
  • 1.67: tested or treated for STI in past year, vs. those who are not
  • 1.47: cohabiting, compared to single (not cohabiting). Interestingly, the hazard ratio for married couples is 1.03.
  • 1.43: Hispanic vs. white, non-Hispanic

and so on.

TABLE 3 (I MISSED IT THE FIRST TIME)

THIS IS FASCINATING STUFF (except for the part where it is not surprising stuffs). I AM SORRY I MISSED IT. Here are correlates of withdrawal, with odds ratios this time (the odds of one group compared to a reference group, using withdrawal:

  • 1.57: emergency contraception
  • 1.51: wants more children
  • 1.33: OTHER (not African American, Hispanic, or White), vs. White, non-Hispanic
  • 1.20: currently employed

This is still how I feel about this paper: nothing terribly exciting, but sometimes you need to be able to say "these are the facts."

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