Contraceptive Use in the United States by Method
Most of the data in this fact sheet come from the National Survey of Family Growth (NSFG) and apply to U.S. women* of reproductive age who use contraceptives.† Unless otherwise noted, data are for 2016 and the contraceptive methods noted are the most effective method used during the month of the survey interview. Data are drawn from the female respondent file of the NSFG in recognition that the majority of contraceptive methods available are designed to be used by those with the capacity for pregnancy (i.e., women).
- Among contraceptive users aged 15–49 in 2018, female permanent contraception was the most common method used (28%), followed by pills (21%), male condoms and IUDs (both 13%). The two most popular methods have remained so since 1982,1–3 but notable shifts within the overall method mix—especially since 2002—include increases in the use of long-acting reversible contraceptive (LARC) methods and decreases in the use of permanent methods and short-acting reversible contraceptives.1,4,5
- In 2018, more than one-third (36%) of users aged 15–49 relied on some form of permanent contraception, such as tubal ligation or a partner’s vasectomy.4
- Some 16% of contraceptive users aged 15–49 in 2018 relied on LARC methods—IUDs and implants.4
- Use of any short-acting hormonal method other than pills, such as injectables, vaginal rings or patches, was relatively low among users aged 15–49 in 2018, at 5%.4
- In 2018, about one in five contraceptive users aged 15–49 (21%) relied on methods used at the time of intercourse such as condoms, withdrawal, emergency contraception and natural family planning methods (periodic abstinence, cervical mucus tests, temperature rhythm or calendar rhythm) as their primary method.4
Permanent contraceptive methods
Permanent methods, sometimes called female or male sterilization, are tubal ligation, tubal implants and partner vasectomy.
- The proportion of contraceptive users relying on permanent methods ranged from less than 10% among 15–30-year-olds to 46% among 40–44-year-olds and 61% among 45–49-year-olds.1
- Reliance on a partner’s vasectomy ranged from 3% of contraceptive users younger than 30 to 18% of those aged 45–49.1
- Non-Hispanic Black users aged 15–44 had higher levels of female permanent contraceptive use (31%) and lower levels of relying on partner vasectomy (2%) than non-Hispanic White users (21% and 9%, respectively).1
- Use of female permanent methods among users aged 15–44 was more common at lower levels of income and education, while the inverse was found in users’ reliance on partner vasectomy. The use of partner vasectomy was highest among those with an income of at least 300% of the federal poverty level and those with a college degree.1
- Among users aged 15–44, use of both female and male permanent methods was more common among those who were married than among those neither married nor cohabiting and among those who had had children than among those who had not.1
- About two in five contraceptive users aged 15–44 who had had three or more children relied on female permanent contraception.1
Short-acting reversible contraceptive methods
Short-acting methods, which require relatively frequent user engagement (from daily to trimonthly), are pills, injectables, vaginal rings and patches.
- In 2018, four out of five women aged 15–44 who had had sex had used the pill at some point.6
- Among contraceptive users aged 15–44, 15–19-year-olds used short-acting reversible methods and the pill more commonly than those aged 35 and older.1
- Users aged 15–44 identifying as non-Hispanic Black or Hispanic were both less likely to use the pill than non-Hispanic White users. Non-Hispanic Black users were more likely to use other short-acting contraceptive methods than their non-Hispanic White peers.1
- Contraceptive users aged 15–44 who were born outside of the United States had lower levels of using short-acting contraceptive methods other than the pill than those born in the United States.1
- Users aged 15–44 who were neither married nor cohabiting had higher levels of short-acting reversible contraceptive method use than those who were married.1
- Contraceptive users aged 15–44 with no children more commonly used short-acting reversible contraceptive methods, including the pill, than those with children.1
- Use of short-acting reversible contraception, including the pill and nonpill methods, was more likely among users aged 15–44 with recent access to sexual and reproductive health care (via a health care visit or insurance coverage) than among those without this access.1
Long-acting reversible contraceptive methods
LARC methods—IUDs and implants—require infrequent user engagement (less than yearly).
- LARC use has become increasingly common, with 18% of all contraceptive users aged 15–44 relying on either an IUD (14%) or an implant (4%) in 2016, up from 2.4% using either method in 2002.1,5,7
- Contraceptive users aged 25–29 had the highest rates of IUD use (19%), while the youngest (15–19) and oldest (45–49) age-groups had the lowest (5–6%).1
- Implant use was highest within the youngest age-group (15–19), at 16%, and decreased with each subsequent age-group to less than 2% among those aged 30–49.1
- Users aged 15–44 identifying as Hispanic, non-Hispanic Black and non-Hispanic White all had similar levels of IUD use, implant use and LARC use overall.1
- Although there were no differences in use of LARC methods overall or in the use of IUDs by income level among users aged 15–44, those in the highest income level had much lower rates of implant use than those with incomes below the federal poverty level.1
- Contraceptive users aged 15–44 with a college degree had higher levels of IUD use and lower levels of implant use than those without a high school diploma.1
- Users who had had children were more likely to use both types of LARC methods than those who had never had a child.1
Coital methods—methods used at the time of intercourse—are condoms, withdrawal, natural family planning, diaphragms, foams, sponges, suppositories, jellies and creams.
- One-quarter of all contraceptive users aged 15–44 relied on a coital method as their primary form of contraception.1
- Among users aged 15–44, condoms were the most commonly used primary coital method (15%), followed by withdrawal (7%), natural family planning (2%) and other coital-dependent methods (0.1%).1
- Contraceptive users aged 20–34 had the highest levels of using condoms (18–20%) and withdrawal (7–11%), compared with 15–19-year-olds (14% condoms, 5% withdrawal), 35–44-year-olds (10% condoms, 4–5% withdrawal) and 45–49-year-olds (4% condoms, 2% withdrawal).1
- Among contraceptive users aged 15–44, those with income below the federal poverty level had the lowest levels of withdrawal use (3%) compared with users at all other income levels (8%).1
- Contraceptive users aged 15–44 who were born outside of the United States had higher levels of condom use and withdrawal use than those born in the United States (21% vs. 14% used condoms, and 11% vs. 6% used withdrawal).1
- Users aged 15–44 without recent access to sexual and reproductive health care—via a health care visit or health insurance coverage—had higher levels of condom and withdrawal use than those who had had access (23% vs. 15% used condoms, and 13% vs. 7% used withdrawal).1
Contraceptive use can entail the use of more than one method, either concurrently or sequentially. Using more than one method can offer protection against both pregnancy and STIs, when it involves a condom, or can offer additional security by increasing the level of perceived protection. Respondents to the NSFG could report up to four methods used at last sex in the three months prior to the survey interview.
- In 2015, among contraceptive users who used more than one method at last sex, there were 53 unique pairs of methods combined.8
- More than half of dual method users in 2015 combined condoms with another method (58%). The remaining 42% combined methods other than condoms, which suggests other motivations for multiple method use beyond “doubling up” for pregnancy and STI prevention.8
1. Kavanaugh ML and Pliskin E, Use of contraception among reproductive-aged women in the United States, 2014 and 2016, F&S Reports, 2020, 1(2):83–93, https://www.fertstertreports.org/article/S2666-3341(20)30038-6/fulltext.
2. Mosher WD and Jones J, Use of contraception in the United States:1982–2008, Vital and Health Statistics, 2010, Series 23, No. 29, https://www.cdc.gov/nchs/data/series/sr_23/sr23_029.pdf.
3. Daniels K, Daugherty J and Jones J, Current contraceptive status among women aged 15–44: United States, 2011–2013, NCHS Data Brief, 2014, No. 173, https://www.cdc.gov/nchs/data/databriefs/db173.pdf.
4. Special tabulations of data from the 2017–2019 National Survey of Family Growth.
5. Kavanaugh ML and Jerman J, Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014, Contraception, 2018, 97(1):14–21, https://www.contraceptionjournal.org/article/S0010-7824(17)30478-X/fulltext.
6. Daniels K, Mosher WD and Jones J, Contraceptive methods women have ever used: United States, 1982–2010, National Health Statistics Reports, 2013, No. 62, https://www.cdc.gov/nchs/data/nhsr/nhsr062.pdf.
7. Finer LB, Jerman J and Kavanaugh ML, Changes in use of long-acting contraceptive methods in the United States, 2007–2009, Fertility and Sterility, 2012, 98(4):893–897, doi:10.1016/j.fertnstert.2012.06.027.
8. Kavanaugh ML, Pliskin E and Jerman J, Use of concurrent multiple methods of contraception in the United States, 2008 to 2015, Contraception: X, 2021, 3:100060, https://www.sciencedirect.com/science/article/pii/S2590151621000071?via%3Dihub.
*Some measures from the most recent National Surveys of Family Growth (2015–2017 and 2017–2019; referred to as 2016 and 2018, respectively) apply to women aged 15–49; the bulk of the available data represent women aged 15–44.
†In this fact sheet, we refer to the contraceptive users for whom we have data as “women” to reflect the terminology used in our data sources. However, we recognize that data collection processes do not always accurately or comprehensively capture participants’ gender, and eligible contraceptive users may miss an opportunity to participate in surveys because of their gender expression. We encourage readers to consider that contraceptive users’ gender identities are diverse, despite the limitations of this language and survey process.