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Foreign women use the pill more, sterilization less than Americans, CDC study says

Associated Press

ATLANTA — The pill is still the No. 1 contraceptive for American women, but it's even more popular in other countries, according to the first government report comparing nations.

More U.S. women, however, get their tubes tied than elsewhere, the Centers for Disease Control and Prevention reported Wednesday.

In the U.S., 16 percent of married women say they use the pill. That compares to 29 percent in the United Kingdom and more than 40 percent in the Netherlands and France.

About one in four U.S. married women opt for sterilization, also known as tubal ligation, or tube-tying. Sterilization rates were below 10 percent for most of the six countries included who collect those figures.

The patterns appear to be similar for all women, not just the married ones, said William Mosher, an author of the new report.

International comparisons are sometimes difficult because some nations only have information on married women, added Mosher, a statistician with the CDC's National Center for Health Statistics.

The U.S. numbers are based on in-person interviews of more than 7,300 women of childbearing age nationwide from 2006 through 2008. The rates were compared to those of eight other industrialized countries — France, Belgium, Norway, Spain, Portugal, Australia, the Netherlands and the United Kingdom.

The new report is the government's first national data on contraception use in more than five years. It found that the pill was the most used contraceptive by all women, but sterilization was a close second. About 17 percent of women say they use the pill, and nearly the same proportion said they were sterilized.

The United States has seen a variety of new contraception options for women in the last decade, including a vaginal ring and a skin patch. Though many women have tried them, fewer than 2 percent said they used one of those methods.

Contraception choices by U.S. women have remained remarkably stable for decades, Mosher said.

"We seem to be stuck in this pattern of the pill and sterilization are the leading methods," he said.

The pill was much more popular among women who have never had children — more than half of them use it. It was also more commonly used by white women and those who were more educated.

More popular among older women is sterilization.

Many Americans get their tubes tied after they have children, as a don't-have-to-worry-about-it-anymore measure, experts say. Younger women with less education more often turn to sterilization, as well.

Why is the sterilization rate in European countries so much lower?

"It may be that surgical options are less acceptable to European women, and not as promoted by European doctors," said Karin Ringheim, a senior policy adviser with the Population Reference Bureau, in an e-mail to the Associated Press.

Meanwhile, the CDC report found that in the United States, the diaphragm has virtually become extinct. But the IUD, or intrauterine device, is making something of a comeback.

The IUD is a T-shaped plastic sperm-killer that a doctor inserts into a woman's uterus. IUDs fell out of favor in the 1970s, after one brand, the Dalkon Shield, was blamed for serious and sometimes deadly infections.