Women's efforts to prevent pregnancy: consistency of oral contraceptive use

An understanding of determinants of inconsistent pill-taking could be useful to service providers who are trying to help women prevent unwanted pregnancy. This article explores the predictors of inconsistent use in a nationally representative sample of U.S. women aged 15-44.

Data on 1,485 pill users participating in the 1995 National Survey of Family Growth are used to describe users' characteristics, and logistic regression analyses are conducted to identify factors that predict inconsistent use (defined as missing two or more pills in a three-month period) among both users of the pill only and dual method users.

While 85% of pill users rely solely on the pill, 15% also use another method. Overall, 16% of users are inconsistent in their pill-taking (16% of those using the pill alone and 20% of dual method users). Among users of the pill only, Hispanic and non-Hispanic black women have a significantly increased likelihood of inconsistent use (odds ratios, 2.5 and 2.1, respectively), as do those who recently began use (2.7) and those who have had an unintended pregnancy (1.6). For dual method users, the odds are significantly elevated among women whose income is less than 250% of the federal poverty level (4.3) and among new users (4.5).

Service providers may need to better address consistency of pill-taking among women who have characteristics associated with inconsistent use.