Thursday, May 24, 2012

Choosing Contraception

The study below provides more evidence on the most effective form of birth control is Long Acting Reversible Contraception (LARC).  LARC includes Intrauterine Devices (a small device that is inserted into the cervix during an office visit) and Implantable Contraception (a small device inserted under the skin).  The advantage of these is that one procedure lasts 3-10 years.  No pills to take, things to insert, shots or anything else for the duration of the implant.  And, if you decide to get pregnant, they can easily be taken out.

Effectiveness of Long-Acting Reversible Contraception — NEJM

This research as others shows that they are more effective than other types of contraception (pills, patches, vaginal rings, etc.).  Here are some visual pictures to help everyone understand.  The numbers are approximate based on the data they show.  Each face below represents one woman over a year.  In the thousand women below, about 2 will have a pregnancy while on a LARC:

For women on a pill, patch or ring, about 48 more (smiley faces with the X's) will have a pregnancy:

LARCs also save money for the patient and the health care system.  There also have minimal side effects.  For instance, some women get increased bleeding with the IUD, but most get less or the same amount of monthly bleeding.

I talk to a lot of women about contraception, but many still choose a pill.  Why?  I'm interested in hearing the perspectives of women.  I think we all have the goal of reducing pregnancies that are not desired.

(Thanks to for help creating the graphs.)

Wednesday, May 09, 2012

Gay Marriage: An Economist's Perspective

I'm not an economist, but I like to listen to economists.  They are usually pretty smart.

Today Obama stated that he supports gay marriage.  I support his decision to not take away rights from any individual in this country.  (I'm not going to discuss whether this was the right political decision, as I'm not a political scientist.)

This issue is clearly a wedge issue that divides many Americans.  However, there is an interesting solution from the economists Thaler and Sunstein, who wrote the bestseller book, Nudge:

"Under our approach, the only legal status states would confer on couples would be a civil union, which would be a domestic partnership agreement between any two people.  Marriages would be strictly private matters, performed by religious and other private organizations.  Within broad limits, marriage-granting organizations would be free to choose whatever rules they like for a marriage conducted under their auspices. ....  Instead of channeling every partnership into the same one-size-fits-all arrangement of state marriage, couples could choose the marriage-granting organization that best suits their needs and desires.  Government would not be asked to endorse any particular relationships by conferring on them the term marriage."

There's a solution that should not be as divisive.  Make marriage a private institution, while the government support equality by granting civil unions.