Upfront costs of contraception may be misleading. Birth control pills (OCPs)
range in cost from about $10 for generics to $45 for branded pills per
cycle, yet 5% of couples conceive while using them. More astounding are
the multitude of people who count on condoms for protection, which are
extremely cheap at less than one dollar per use, yet they are unaware
of a failure rate of approximately 15% per year. So what is the cost of
an unplanned pregnancy? The health care costs alone for delivery of an
infant exceed $10,000. Current estimate for raising a child from birth
to the age of 18 for a middle-class American family is approximately $170,000
(this does not include college or increasingly common behavior of “failure
to launch,” where children reside at home well into their 20’s).
So the true value proposition is more complex. Long-acting contraceptives
provide a lesson in cost-effective medicine. Upfront cost for an
intrauterine device (IUD) is approximately $800. However, Mirena® lasts up to five years, and
Paraguard® lasts up to 10 years; which are both less expensive than
many oral contraceptives over such a long period of time, and significantly
more effective failing approximately 1% per year. The manufacture of Mirena®
even offers a payment plan of $35 per month for two years (approximately
the cost of branded OCPs). IUDs are now FDA approved as reversible contraception
for women of all ages (no increased risk of infection or infertility).
Vasectomy is the least expensive form of permanent birth control. However
too often it is difficult to convince a man to proceed with this procedure,
so responsibility falls back upon the woman.
Despite beliefs to the contrary, all methods of
contraception are safer than pregnancy. In making your decision begin with real-world
effectiveness as you review all methods of birth control available. Then
consider possible side effects, convenience, and finally cumulative expense
over desired time of protection. In this way, you not only have freedom
of choice but also make a value-based informed decision.