Objective


To examine levels of, correlates of, and changes in the use of individual and grouped methods of contraception among U.S. females aged 15–44 from 2008 to 2014.


Study design


Using three rounds of the National Survey of Family Growth, we analyzed samples of 12,279 (2008), 5,601 (2012), and 5,699 (2014) females. We conducted simple and multivariable logistic regression analyses to identify associations between demographic characteristics and contraceptive use, as well as between characteristics and changes in use patterns.


Results


In terms of overall trends in contraceptive use between 2008 and 2014, there was no significant change in the proportion of women who used a method, among either all women (60%) or those at risk of unintended pregnancy (90%). Significant changes in use occurred among six methods. The largest increase in use was among users of long-acting reversible contraceptive (LARC) methods, including the IUD and implant—from 6% to 14%—across almost all population groups of female contraceptive users, while the largest decrease occurred among users of sterilization—from 37% to 28%—with lower income women driving the decline in female sterilization and higher income women driving the decline in a partner's sterilization as a primary method. Moderate increases were seen in the use of withdrawal and natural family planning.


Conclusion


Most shifts in recent contraceptive use have occurred among the most effective methods—sterilization and LARCs. Differences in method-specific user characteristics underscore the importance of ensuring full access to the broad range of methods available.
 

Implications


The lack of change in the overall use of contraceptives among women at risk for unintended pregnancy may have implications for the extent to which further declines in national rates of unintended pregnancy can be expected.