A slight majority of men (52%) either don’t think you need a prescription for birth control pills or don’t know if you do. Here’s the reality: Every form of contraception except condoms and Plan B — so, the pill, the patch, IUD, implant, the ring, the shot, even a diaphragm — requires a trip to the doctor.

Some people object to birth control being offered over the counter because of the increased risk of blood clotting and stroke with pills that contain estrogen. But study after study shows that allowing access to many of the popular forms of progestin-only birth control without a doctor’s visit would not only decrease the number of unplanned pregnancies, but would also be safe.

"Over the counter birth control pills have been endorsed by major medical organizations, like the American College of Obstetricians and Gynecologists," Watkins says. "The birth control pills that we're talking about going over the counter are progestin-only birth control pills. They don't have the same risk of clotting and stroke as pills containing estrogen. But it's also important to remember that the increased risk of thrombosis when you're using birth control pills that contain estrogen is seven to eight times less than when you're pregnant. And we don't require a prescription for pregnancy."

Due in large part to falsehoods spread by anti-choice groups and politicians, emergency contraception is not very well understood by many people. And the survey reflects that, with 32% of men believing that emergency contraception is an “abortion pill.”

"Emergency contraception pills are not the same thing as an abortion pill," Watkins says. "It is a different medication that acts in a different way to accomplish a different goal."

Here is the science: Hormonal emergency contraception (i.e. Plan B or ella) primarily works by blocking ovulation, which is when the ovary releases an egg into the fallopian tubes and then the uterus. The egg stays viable for about 24 hours after ovulation. If a person is already pregnant, the hormonal emergency contraception won’t have any effect, because the thing it’s designed to stop — ovulation — has already happened. Watkins also says that hormonal emergency contraception has no effect on a pregnancy that has already started.

An abortion pill, on the other hand — which is more formally called a “medicated abortion” or “medication abortion” — induces a miscarriage after an egg has already been fertilized and implanted in the uterus. The difference between the two is that hormonal emergency contraception stops pregnancy from even being a possibility by delaying the release of the egg, while the abortion pill ends a pregnancy that has already occurred.

Like emergency contraception, there are a lot of myths out there about birth control pills. One of those myths is about effectiveness — according to the survey, 40% of men believe that birth control pills are 100% effective.

There’s the myth. Now here’s the fact: Hormonal birth control pills are 99% effective when taken perfectly, according to Planned Parenthood. But because most people don’t take the pill perfectly — maybe they forget a day or two, or they take them at vastly different times of day — the birth control pill is 91% effective at preventing pregnancy with typical use. That means nine out of 100 people who take the pill every year will get pregnant.

"Unfortunately, there is no method of birth control — including birth control pills — that you can use and have sex that is 100% effective," Watkins says. "But all methods of birth control are more effective than no method at all.”

If people are really concerned about not getting pregnant, it’s a good idea to double up on contraceptive methods — like using a condom and the pill — or choose a more effective form of birth control, like an IUD, which is more than 99% effective.

Despite the fact that we’re facing the potential start of a new human life almost every time we have sex, 30% of men don’t ever talk about birth control before having intercourse.

“You can get pregnant after having sex just once, and some [birth control] methods take a week or more to be effective once you start them," Watkins says. "So it’s important to talk about — or think about — your birth control plan before having sex.”

But this is one of the few responses on this survey that shows a little hope: 38% always discuss it and 33% discuss it “sometimes.” That means a majority — 71% — is at least talking about birth control semi-regularly. It’s a number that could certainly use some improvement, but it’s also heartening.

You’d think that if so many men are willing to have sex without first talking about birth control, they would assume that all (or at least most) women are on birth control. But, according to the survey, only around one in five men assume or expect that all sexually active women are on birth control. In fact, about 64.9% of women between the ages of 18 and 49 were using some form of contraception, including condoms, according to the CDC.

Speculation around a male birth control pill has been circulating for years, but one of the big questions is whether or not men would be willing to take a daily pill to prevent pregnancy. (You know, like people with uteruses have been doing for the past 60 years.) According to this survey, at least, the majority of men wouldn’t be into it — 63% said they either wouldn’t take it or didn’t know if they would take it. Of that 63%, nearly 40% said it was because they didn’t want it to affect their body. Another 21% wouldn’t want to pay for it, and 9% said they think it’s a woman’s responsibility.

While other research into men's willingness to take birth control is still light on the ground, a survey by the website Healthline backs up Pill Club's findings. They found that 31% of respondents said they would be willing to take a daily pill to stop sperm production, while 69% said they wouldn’t.

Thumbs down to all of the above. A male birth control pill — and men who were willing to take it — would remove one major barrier towards gender equity in the birth control process.

While the birth control pill is perhaps the most well-known form of birth control, it’s just one of many out there. But, unfortunately, 30% of men weren’t familiar with internal condoms or the IUD. While the internal condom is perhaps more popular for anal sex than vaginal, IUDs are not only increasingly popular but are actually the most effective form of contraception that's currently available. (Yes, even more effective than a vasectomy.)

Of course, men don’t carry all of the blame for not knowing about other forms of contraception. The American sex ed system is woefully bad about informing people about birth control, especially if you grew up with abstinence-only sex ed.

When it comes to a lack of knowledge about birth control, it’s fair to say that most people, regardless of gender, carry around a few myths in their heads. But it’s also fair to say that, due to a combination of cultural beliefs about who’s responsible for birth control and a not so great sex education system, men need to do the work to educate themselves about how to prevent pregnancy. In the name of gender parity, don’t you think it’s time?

Study referenced:

Katrina Kimport (2018) More Than a Physical Burden: Women’s Mental and Emotional Work in Preventing Pregnancy, The Journal of Sex Research, 55:9, 1096-1105, DOI: 10.1080/00224499.2017.1311834

Expert cited:

Robin Watkins CNM, WHNP-BC, Director, Health Care at Power to Decide