Comment by tropdrop | Hacker News Reader

Comment by tropdrop | Hacker News Reader

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Well, you know one now! I have a copper IUD and I cannot recommend it enough. My body reacts poorly to hormones, so the pill wasn't an option, but a condom-only based approach to birth control wasn't going to work in a monogamous, multi-year relationship - over a ten year period, 86 in 100 women who only use condoms become pregnant [1]. This probabilistically makes sense, given that 10 years includes hundreds or thousands of chances for intercourse. Do check out the NYT article below - it is terrifying!

We must have saved thousands of dollars on condoms at this point, and intercourse is much more enjoyable for both parties (with no unexpected risk for my career). For some unknown reason (cultural?), while the UID is very popular and obviously the best choice in parts of Europe, there remains some taboo around it in the US... anyway, I wish I could save all this money on disposable products with the cup, but I do not want to risk pulling it out or entangling it.

[1] https://www.nytimes.com/interactive/2014/09/14/sunday-review...

Thanks for sharing! I've never been on the pill due to the hormonal aspect as well, but I've also heard some things that put me off of copper IUD. I'll have to do more reading about it, but it's condoms for me for now. I'm also going to try out Natural Cycles, considering it's been shown effective and approved as a birth control method and I think I'm diligent enough to maintain the proper usage it requires. Birth control method aside though, even with condoms, if I get pregnant once in ten years I have no moral qualms about abortion. It's something I take seriously of course, but once incident in the span of ten years is an acceptable rate of failure for me.

The most common cause of pregnancy when using condoms is improper use, either due to lack of education or for other reasons. When used properly, condoms are rather effective.

Another method whose safety approaches that of oral contraceptives is cervical mucus tracking. But this also requires education. The method is also not suitable for all women and lifestyles. In one study[1], around 5% of prospective participants had to be excluded due to irregular menstrual cycle. Dropout rate due to dissatisfaction or for other reasons was 9.2%.

Also note that with IUDs there can be spontaneous expulsion, and there are health risks associated with it. So while very good compared to other methods, they are not best in all categories.

[1] https://doi.org/10.1093/humrep/dem003

I've personally done similar calculations before, but I stopped because I'm not sure the assumption of independence is correct. If the pregnancy rate is 18% per year, and you have not had a pregnancy the first year, I'm not sure your pregnancy rate for the next year is really 18%.

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