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Women who think accidental pregnancy only happens to losers who run around having unprotected sex may need a refresher in Birth Control 101.

A surprising number of women are overconfident about contraception, Reuters reports.

Of more than 4,100 women seeking birth control, about 45 percent overestimated the effectiveness of the Pill and condoms, according to a new study published in the American Journal of Obstetrics and Gynecology.

Women also put too much stock in hormonal birth-control patches, vaginal rings and injections, researchers found.

Despite its popularity, the Pill has a pregnancy rate of nine per cent a year. Condoms are less effective, with an annual pregnancy rate of 18 to 21 per cent.

"We need to do a better job of educating the public – women and men – on the failure rates with typical use," study leader David L. Eisenberg told Reuters.

Condoms fail when they break, leak or are used too late in a sexual interlude. The efficacy of the Pill drops dramatically when women forget to take it each day or go on medications that reduce the Pill's effectiveness, such as antibiotics.

In contrast, unplanned pregnancies occur in just 0.2 to 0.8 per cent of women who use IUDs, which are implanted in the uterus and release either small amounts of copper or the hormone progestin to prevent pregnancy. The contraceptive implant, which is inserted under the skin of the arm (and is unavailable in Canada), has a failure rate of 0.05 per cent.

Nevertheless, only five to six per cent of American women using birth control choose contraceptive implants or IUDs.

The New York Times noted the IUD is making a comeback in the United States, "after decades of sloppy research, bad publicity, lawsuits and widespread fears of health hazards."

And in the study of 4,100 women, researchers discovered that after a medical professional helped them weigh the options, 71 per cent chose an IUD or implant.

Both methods are expensive. The Mirena IUD – which releases progestin, resulting in lighter periods – costs about $350 in Canada.

Nevertheless, Dr. Eisenberg said that IUDs and implants should be the "default" options offered to women seeking reversible birth control because they do the job so well.

What kind of birth control do you or your partner use? Are you confident you can avoid a pregnancy?

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