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Study sheds light on birth control

A Spring 2009 survey on Duke undergraduates found that 70 percent used a male condom the last time they had sex, and 46 percent used both a condom and another form of birth control.
A Spring 2009 survey on Duke undergraduates found that 70 percent used a male condom the last time they had sex, and 46 percent used both a condom and another form of birth control.

What is your preferred form of birth control—pills, condoms or other? And have you experienced an unintended pregnancy in the last 12 months?     

Those were two of many health-related questions asked in the most recent National College Health Assessment survey. The survey was sent out to Duke undergraduates in a January 2009 e-mail and had a 23 percent response rate—or 730 respondents.

The Spring 2009 results reported that of the 39 percent of undergraduates who reported having used contraception during their last time having vaginal intercourse, 58 percent used birth control pills—or had partners who did.

Seventy percent reported using a male condom last time they had sex, and about 46 percent said they used both a condom and another contraceptive—such as the birth control pill.

Sarah, a freshman who began taking birth control in her senior year of high school, noted that from her experience, girls tend to begin birth control not long after they start college. Sarah’s name has been changed to respect her request for anonymity to protect her privacy.

“I don’t know why, but it’s what you do when you go to college,” she said.

The availability of contraception

From vending machines to the Lobby Shop to a generous friend, students have a variety of sources to obtain contraceptives from on campus—but one of the largest supplies of condoms exists at Student Health.

Every year, Student Health provides 40,000 male condoms to students free of charge, said Student Health Administrative Director Jean Hanson.  

“The condoms are not used as much as they should be,” Hanson said. “We’ve got them out there so people just don’t have to ask…. Some sport teams designate someone to come over and [take] 40 or 50 of them.”

But the primary reason for putting the condoms out in the open is not to prevent unplanned pregnancies, she added.

“They’re more for prevention of [sexually transmitted diseases] than birth control,” Hanson said.

Female students can obtain birth control prescriptions from providers at Student Health after taking what is called a “well woman exam,” Hanson noted. The exam entails a review of the patient’s health history to ensure she is a good candidate for birth control.

Each school year, Student Health receives approximately 1,000 requests for birth control, said Dr. Devdutta Sangvai, director of medical services for Student Health. The statistics come from data gathered before the Student Health Pharmacy closed last December.

“There’s almost no change year-to-year—every year we see the same number of patients,” Sangvai said. “We can’t say it’s 1,000 new people every year.”

Sangvai and Lindsey Bickers Bock, health education specialist for Student Health, said many freshmen likely start birth control because they want to exert their independence from parental supervision once arriving at college.

“I think the social culture does drive individuals to seek out healthy decision-making,” Sangvai said. “But I would say that the majority of the students we see are choosing to go on it because of the decision to [be healthy, and not] because they want to be promiscuous.”

Like male condoms, birth control pills can serve other functions besides contraception—such as treating acne or regulating the menstrual cycle, Sangvai noted.

Sarah, who has not had sex since coming to Duke, echoed Sangvai’s assertion.

“Being on birth control doesn’t mean you’re having sex,” she said. “You can control exactly when your period’s going to come, you’re not surprised.”

The pregnancy scare

According to the NCHA survey results, 18.2 percent of sexually active Duke students said they or their partner had used emergency contraception—the morning-after pill, or Plan B—in the previous 12 months. The survey also reported that 2.1 percent of sexually active female students said they had experienced an unplanned pregnancy.

Julia, another freshman on birth control, said she does not find that statistic particularly common. Julia’s name has also been changed to respect her request for anonymity.

“I’m on the pill, yeah, but I also take other precautions,” she said. “I feel like the people who have to [take Plan B] have been unsafe in their practices. I guess taking Plan B is a safer option. That [statistic] is a little surprising.”

In the 2008-2009 school year, 47 people requested Plan B from Student Health, Hanson said.

But this number is not a strong indication of sexual habits at Duke.

“Any numbers procured from Student Health is only what we know,” Hanson said. “There’s a lot more activity than we even know about.”

About 115 to 120 students per year have requested Plan B in the past, she added. The dramatic decrease is likely due to the fact that Plan B was made available over-the-counter to women 18 years or older in 2006.

Sarah said she and some of her friends have had to use Plan B before.

“It’s not fun,” she noted of the experience.

Hanson said Student Health performed 278 pregnancy tests during the 2008-2009 school year. That statistic includes both undergraduate and graduate students, the latter of which, Hanson noted, could be married and hoping for a baby. The test results were not available for release.

For students who experience unplanned pregnancies, the Student Health Web site provides information and advice on a page titled “What if I’m pregnant?”

“There’s not anything that any student has to do at Duke if they determine they’re pregnant,” Bickers Bock said. “If students are looking for... health information––what should people know, what’s available, we can help them. We also try to provide resources about other places that people might get [counseling] help.… [but] it’s not like they’re required to go to any particular place.

The Web site also gives information on adoption and termination facilities in the Triangle area.

The Ryan Family Planning Clinic, located in Hospital South, is among those listed as an abortion facility on the Student Health Web site. “I can’t think of the last undergraduate I’ve seen here, [though] I’m sure it’s happened,” said Sally Howland, a nurse program coordinator at the clinic.

The final decision on dealing with the pregnancy is up to the student and the student’s family, Bickers Bock said, adding that she does not follow up with the women she counsels unless requested.  

“We’re not requiring people to report back about what their decision would be,” she said.

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