University Health Service touts alternative methods of birth control

Shane Achenbach and Emily Schumer/Daily
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By Emma Kerr, Daily Staff Reporter
Published December 3, 2014

The University offers a variety of options for obtaining contraception, but a lack of awareness and common misconceptions about birth control may inhibit students from taking advantage of University resources and selecting methods that are most effective.

At the Wolverine Wellness Center in University Health Services, students can find an array of condoms, both male and female, in different flavors, colors and sizes. Relationship Remix, a sex and relationships education program held in residence halls, offers the same condoms, as well as information about different types of contraception including injections, intrauterine devices and pills.

While there are a variety of contraceptive resources available to students, many still struggle to find methods best suited to their financial and medical needs.

Monique Steel, a nurse practitioner at the UHS Women’s Health Clinic, said students are often unaware of other forms of contraceptives aside from male condoms and oral contraceptives. She said UHS works to counsel each student who comes in to request birth control.

“We recommend that they use whatever method they think would work best for them, but we also recommend those methods that are most effective as the ideal first choice,” Steel said. “We talk about their effectiveness, the side effects they may have — and we talk about how long IUDs are effective, that a pill needs to be taken every day, a patch every week, and those types of things.”

Steel said the insertion of an intrauterine device involves a 15-minute procedure that can be performed by a UHS medical professional. An IUD is a small, t-shaped plastic device that generally comes in three different forms. One form, ParaGard, is hormone-free and made of copper. The second, Mirena, releases a small amount of a progestin hormone. The final method, Skyla, which was introduced in 2013 and is marketed primarily to young women who have not had a child, releases small amounts of the same hormone.

Eighty-seven percent of undergraduates used some form of contraception during their most recent instance of vaginal intercourse, according to the National College Health Assessment administered by UHS. Among those students, a majority said they used male condoms or oral contraceptives.

The survey found condoms and pills most popular among students, both of which are generally effective in preventing pregnancy. Nine percent of women taking the pill will have an unintended pregnancy, compared to 18 percent of couples using male condoms, according to UHS.

Laura McAndrew, UHS sexual health educator, said research and experience have demonstrated that students get a significant portion of their information about birth control and sex from their friends, causing the perpetuation of stereotypes of what are perceived as popular or safer birth control methods.

“It has a lot to do with the kind of education they have had access to, as well as the information they have gotten from their friends,” McAndrew said. “If your friends are using condoms and pills, those are going to be the methods you already feel most familiar with. I think that as we start to see more people using IUDs and implants, more people that will be talking about them and becoming more familiar with them.”

While statistics show a high majority of women who properly use contraceptive methods such as condoms and pills will not become pregnant, IUDs and implants practically ensure that an unintended pregnancy will not occur. Failure rates of IUDs and implants are less than 1 percent, but they are being used by 6 percent of undergraduates and 15 percent of graduate students.

“We are finding that many students feel they do not know enough about IUDs and implants to feel comfortable using them,” McAndrew said. “Another issue has been that students do not want a foreign object in their bodies or are concerned about the cost and issues related to insurance coverage.”

In September, the American Academy of Pediatrics announced a change in its recommendations, stating it now advises that doctors recommend intrauterine devices over other methods of contraception for teenagers who are or plan to become sexually active.

“For the first time, the organization recommends that pediatricians discuss long-acting reversible contraceptives before other birth control methods for teens, citing the ‘efficacy, safety and ease of use’ of long-acting reversible contraception, such as IUDs and progestin implants,” the report says.

Though the cost is substantial, generally about $600 for a student without insurance, the device is effective at preventing pregnancy for as long as 10 years and requires only one application. McAndrew said she has found price to be a concern for some students, but not necessarily just for those students who do not have insurance.

“Most insurance plans will cover IUD or implant costs, but if a student is on their parents’ health plan, they may be nervous about using their insurance for contraceptives,” she said. “We encourage students to speak with a medical professional about how to have that conversation with their parents, because most parents would much rather their child have the best methods of birth control, even if it means having an uncomfortable conversation.”

In a survey conducted by The Michigan Daily, 13 percent of students received information about birth control from friends, compared to 3 percent who received it from campus resources and 54 percent from a medical professional.

LSA senior Sophia Kotov, former president of Students for Choice, said she has heard concerns from many students who are hesitant to obtain birth control from UHS.

“The (UHS) doctor was super useful and helped me figure out what type of birth control worked best for me,” Kotov said. “I think UHS has a reputation for being unhelpful and ineffective, and I think that deters a lot of students from getting their birth control questions answered there. UHS needs to change their image as well as the quality of their care. Honestly, the pamphlets in UHS look like they are from the ’90s, I don’t know how relevant they are to women’s lives now.”

Kotov said many of her friends, who are also involved in the Department of Women’s Studies or Students for Choice, are fairly well informed, but she believes the majority of students still don’t fully understand how birth control works, where to get it and what methods are best suited to their needs.

“I think trying to remember information from sex education or going through the process of scheduling an appointment with UHS and remembering what your doctor says combined with the availability of so much information on the Internet makes it difficult, and people definitely go to their friends with issues or questions a lot of the time,” Kotov said.

She said her friends were surprised to hear she used an IUD because of the stigma they associated with the device — namely that it is only used by older women who have already had children.

“I have had so many friends who react strongly to finding out I have an IUD, so I definitely see that stigma playing out in my life,” Kotov said.

The Daily survey found that when students are choosing a method of birth control, effectiveness is by far the most important factor, followed only by safety and the possibility of harmful side effects.

For the 5 percent of students who said cost is the most important factor when choosing birth control, condoms seem to be the most obvious choice, as they are free for students. For students who prefer another brand over LifeStyles, the most common brand available at UHS, UHS has started to offer Magnum Trojan condoms beginning this year. Trojan condoms purchased through downtown merchants such as drug stores generally cost about $7 for a pack of three.

Oral contraceptives, however, can become costly over time. For a student with insurance, this cost may be minimal or nonexistent depending on providers and plans, but for students who do not have insurance, and, for example, pick up their birth control at CVS downtown, the cost per month could be around $20, according to UHS. There are options — though seemingly more inconvenient ones — for minimizing these costs by picking up prescriptions at locations farther from downtown, where the cost for an uninsured student could be as little as $8 per month.

Correction appended: A previous version of this article stated that intrauterine devices were used by 0.5 percent of graduate students at their last vaginal intercourse. The rate for this method among graduate students is actually 15 percent, as stated in the National College Health Assessment survey.