Local contraception study under way

Researchers at Washington University School of Medicine are undertaking a large-scale contraception study involving 10,000 St. Louis-area women.

The study, called the Contraceptive Choice Project, will compare patient satisfaction, discontinuation rates and the effectiveness of several forms of birth control. Women enrolled in the three-year study will receive free contraceptives.

Jeffrey Peipert

“We want to determine if removing the financial barriers to obtaining contraceptives will decrease the frequency of unintended pregnancy,” said Jeff Peipert, M.D., the Robert J. Terry Professor of Obstetrics and Gynecology and principal investigator of the study.

Among U.S. women, the birth control pill is the most common reversible contraceptive method, but in order for it to be effective, women must be able to pay for the pill, have access to refills and remember to take it daily. Unfortunately, the discontinuation rate of the birth control pill is very high.

Recent improvements and new technology in intrauterine devices (IUDs) and hormonal implants offer potentially greater acceptance of these methods in preventing unintended pregnancy, Peipert said. Many women, however, cannot afford the up-front costs of these methods, which can be more than $500.

“In this study we also want to determine if awareness and use of IUDs and hormonal implants, methods that do not require daily action, will decrease the frequency of unintended pregnancy in the study population,” Peipert said. “Although IUDs are the most popular form of reversible birth control in the world, fewer than 2 percent of women in the United States use one.”

IUDs are inserted into the uterus by a health-care provider, can remain in place for five to 10 years, but also can be removed at any time if fertility is desired. Hormonal implants are inserted, also by a health-care provider, under the skin of the upper arm. These implants are highly effective for three years.

Both teen pregnancies and unintended pregnancies are major public health problems in the United States. Recent reports indicate that one-half of U.S. pregnancies are unintended, and 74 percent to 95 percent of teenage pregnancies are unintended, Peipert said.

Women using birth control and those who desire to start birth control or change to a new contraceptive method are eligible for participation. Women younger than 18 must have parental consent to enroll. Participants will choose any contraceptive method the study offers, and they can change methods during the study.

Over the course of the study, they also will be interviewed about past contraceptive use, pregnancy history and satisfaction with and side effects from their methods of birth control. They will receive free testing for sexually transmitted diseases and medical advice about how to avoid them.

The research is supported by a foundation not linked to the pharmaceutical or contraceptive device industry.

For more information or to enroll in the study, call 747-0800 or e-mail choice@wudosis.wustl.edu.