People can't be counted on to be consistent, and if a birth control method relies on consistency then I count that as a design flaw. Ideally, you shouldn't just take your pill everyday, but at the same time everyday for maximum effectiveness. It is a rare person who has a schedule that accomadates this easily. It isn't the pill's fault when users forget to take it, but that weakness is both predicable and avoidable.

It is no suprise that methods like implants (ie: implanon), 3 month shots (ie: depo provera) and vaginal inserts (ie: nuvaring) are growing in popularity - they fit better into most people's lifestyles. Surely their higher effectiveness is in part related to more consistent and reliable application.

I found it strange that the article mentioned depo-provera and IUDs but not nuvarings. Personally, ever since I started using the nuvaring, I've had trouble fathoming why this awesome method of birth control isn't being trumpeted from the mountaintops, the same way they do with that ridiculous "Yaz" shit. It's perfect. It's the lowest dose of hormones I've ever had, so, no cramping or yeast infections. And I only have to think about it twice a month. Why don't more people know about it? It's a mystery.

I thought it was great, too, until I started using it and discovered that, for me at least, it had the annoying habit of falling out at totally inopportune moments. I guess it depends on your personal anatomy. I wish it would stay in place for more than a day or two for me, but it doesn't.

I'm sorry, but taking the pill every day is NOT hard. Put it next to your toothbrush or something. Geez. If you can't be counted on to take responsibility for your own body, then you shouldn't be having sex at all.

For women who travel frequently between time zones or work irregular hours, not having to think about birth control on a daily basis is practically a godsend. It's also pretty great if you're just absent-minded (like me). I use a nonhormonal "copper-T" IUD- had a pretty unpleasant adjustment period, but within 2 months my cycle was back to normal and I felt great (of course, if you are OK with hormones, there's a progesterone-releasing version that eliminates a lot of that initial cramping and bleeding). It's not impossible to take a pill within 2 hours of the same time every day... but it is clearly very difficult for many women, or there wouldn't be such a high "human error" failure rate. The big problem with the IUD is most women's health care providers don't bring up the option until after they've had a child. Until I had one who recommended it (because my insurance would cover it), I don't think anyone ever mentioned it to me except as something to quickly dismiss because of the initial cost. Even though the FDA has now approved the IUD for childless women, most gynecologists don't seem comfortable recommending women put anything "in there" unless a large infant has recently come out of "there."

Is great. If the pill works for some, fine. If it's not working for you, switch to something else. I did too much travelling with missed connections, lost luggage and screwed up body clock for it to work for me.

I tend to move to a new country every few years, meaning I'm not keen on method of BC that requires a doctor's appointment to install or remove.

Perhaps the only thing needed is for doctors to review if the woman is using the pill as required for effective contraception and recommend something else if not.

Presumably, women on the Pill do not want to get pregnant. If you miss pills and ovulate, you should be able to tell. Why not make it standard to tell women the basics of fertility awareness? Surely they wouldn't want to keep a temperature chart, but checking cervical fluid is really easy. For many people, fertile fluid is unmistakable, and you don't have to go looking for it. People do sometimes ovulate even if they don't forget their pills, so it seems like a little awareness (it could be as simple as EGGWHITE=EGG) could go a long, long way. When I learned about fertility awareness, I was amazed that no one had ever told me that stuff before. I still haven't figured out why Planned Parenthood doesn't advocate it is a supplement to other forms of birth control. How did knowing what it looks like when you're ovulating become so damned fraught with politics?

Personally, the trump card for the Pill is that it gives me predictable periods, so if my period was ever late or otherwise amiss I would notice right away. Blindly trusting that I'm not pregnant because of how a device should work in theory isn't good enough, and having never been pregnant I can't assume I'd be able to tell based on how I feel (especially since an implant or nuvaring would regulate my hormones in a different way than I'm used to, so my hormones would feel off anyway).

Re: fertility awareness - interesting idea, and I wouldn't mind knowing how to tell if I'm ovulating. But can you learn it when you're on hormonal birth control (and therefore probably not ovulating at all) or do you have to go through a few unregulated cycles to see what happens?

We need to drop everything and invest another eleventy trillion dollars in finding a new way for women to have vaginal intercourse w/o the risk of breeding.

I was thinking that women could be shown what to look for before going on the Pill. If you've been on a long time, it could be useless information. But the only way to get pregnant is to ovulate, so knowing what your own fertile fluid looks like is very important. I think the Pill tends to cause a constant sticky fluid for a lot of women, though it will be different for everyone. (I can't take it myself, because it causes severe depression - and I didn't know about fertility awareness back when I was on it.) In general, though, if you know what your fluid is usually like through your whole Pill cycle and then suddenly one day you see something that resembles eggwhite, there's a good chance you need a condom!