“More than 99 percent of women have used birth control.” 
— Planned Parenthood of Indiana and Kentucky, image shared on Twitter, by Nov. 16, 2016

“99% of women have used birth control in their lives. It needs to be accessible AND affordable. #ThxBirthControl”
— Sen. Patty Murray (D-Wash.), post on Twitter, Nov. 16, 2016

“Birth Control is Essential Health Care 99% of women use birth control at some point in their lives.”
— NARAL Pro-Choice America, post on Twitter, Nov. 16, 2016

On Wednesday, reproductive rights advocates used the hashtag #ThxBirthControl on social media to celebrate the use of and access to contraception. It’s a part of an ongoing effort by the National Campaign to Prevent Teen and Unplanned Pregnancy to publicly “support birth control and all that it makes possible for individuals and society,” and the impacts of “the ability to plan, prevent, and space pregnancies.”

Since the election of Donald Trump as president, reproductive rights advocates have argued women’s access to birth control and abortions will be restricted under his administration. After years of saying that he is in favor of abortion rights, Trump now says he opposes abortion. Trump also says that he plans to repeal parts of President Obama’s health-care law, which could affect the requirement for insurance companies to provide free contraception to women.

To show how many women use birth control, advocacy groups and supporters used this “99 percent” figure throughout the #ThxBirthControl campaign. The three quotes above are just a sample of the same claim being circulated on social media. How accurate is this statistic?

The Facts

Murray’s staff and Planned Parenthood of Indiana and Kentucky pointed to a February 2013 study by the Centers for Disease Control and Prevention’s National Center for Health Statistics. The study was also cited in the National Women’s Law Center’s 2015 report on women’s health-care coverage. NARAL Pro-Choice America did not respond to our inquiry, and we will update if we hear back.

The CDC study looked at contraceptive methods women have used in the United States, from 1982 to 2010. It is based on interviews with a national representative sample of 12,279 women in 2006 to 2010 from the National Survey of Family Growth (NSFG).

Researchers found 88.2 percent of women aged 15 to 44 had used contraception (some women use contraceptive hormones for health benefits unrelated to pregnancy). Of the women they interviewed, aged 15 to 44, 86.6 percent had had vaginal intercourse. They were counted as “sexually experienced.” Among the “sexually experienced” population of women aged 15 to 44, 99 percent had used one contraceptive method at some point in their lifetime.

That means the study shows that 88.2 percent of all women aged 15 to 44 who were interviewed, whether or not they had intercourse, have used contraception. That’s not the same as the claim used by advocates that “99 percent of women” overall have used birth control.

But there’s a bigger problem with this statistic.

“Contraception” refers to any method that women and men can take to prevent a pregnancy. It includes female and male sterilization, birth control pills, intrauterine devices (IUDs), emergency contraception, condoms, withdrawal method and periodic abstinence (also known as the rhythm method).

So when advocates use this statistic, they’re using the term “birth control” as synonymous as “contraception.” That’s not always made clear. For example, Murray talks about “accessible AND affordable” birth control, which could indicate birth control methods that require money and access (unlike withdrawal or rhythm method).

In other words, a woman may have had sex only once, or she may have had a partner who only used a condom once, and she would be placed in the 99-percent category. A woman may have had sex once and used the withdrawal method, and she would be counted in the same category as the woman who has sex regularly and takes birth control pills or has an IUD.

The CDC report did not break down current contraceptive use by women, focusing instead on all the methods used at any point by women.

But the Guttmacher Institute, a nonprofit organization that promotes reproductive health and had started as an arm of Planned Parenthood, in an April 2011 study estimated that, under current contraceptive use, 31 percent of women used the pill or other hormonal contraceptive, 5 percent used an IUD, and 14 percent used condoms. Another 33 percent relied on either female or male sterilization, while 17 percent used natural family planning, other methods or no method. The figures were based on 2006 to 2008 NSFG interviews, so it’s similar to the data in the CDC report.

Ali Slocum, spokeswoman for Planned Parenthood of Indiana and Kentucky, noted that Planned Parenthood is not the only organization to include condoms, withdrawal, abstinence and other non-hormonal methods. The Office on Women’s Health at the Department of Health and Human Services also lists condoms, withdrawal and abstinence as “birth control” methods.

“While some use birth control only to describe hormonal contraceptives, the term really refers to any method that one or both partners in a heterosexual relationship use to prevent pregnancy. Birth control can be used to avoid pregnancy completely, or to space out or time pregnancies to build healthy, stable families,” Slocum said.

This is the third time The Fact Checker has examined fishy claims about the use of birth control methods by women. Each time, the same problems with the data arise. In 2012, we gave Two Pinocchios to the claim that “98 percent of Catholic women” use birth control. In 2014, we gave Two Pinocchios to the claim that “99 percent of women use birth control in their lifetime and 60 percent use it for something other than family planning.” It’s an easy talking point, but it’s still a problematic one.

[Update: In a response to our fact check, National Campaign to Prevent Teen and Unwanted Pregnancy’s spokesperson, Julian Teixeira, said the campaign typically uses the talking point that “99 percent of sexually active women have used birth control.” It is a simplified version of the research because the social media campaign relies on brevity and the underlying data is much longer and more complex, Teixeira said.

On the use of the word “birth control,” Teixeira said: “While in some circles “birth control” is used to mean only the pill, that’s not based on any official definition. Our Thanks, Birth Control campaign has always been part of a larger narrative that includes the importance of having access to the full range of contraception, and the notion that many women have access to some methods but not others. Our resources are all carefully worded, carefully footnoted, and carefully researched. The suggestion that we are being irresponsible or misleading by using “birth control” and “contraception” interchangeably is simply not true.”]

The Pinocchio Test

We find two issues with the talking point that “99 percent of women have used birth control,” or “99 percent of women use birth control at some point in their lives.” First, the 99 percent figure refers to the population of women who are of reproductive age who have had sex with a man at least once. This is important because there are women who use birth control for reasons unrelated to pregnancy.

Second, “birth control” is sometimes used to mean “contraception.” The federal government and advocacy groups use contraception and forms of birth control interchangeably. These terms are used in the context of family planning, and choices that men and women make to prevent pregnancies.

But especially in the current debate over the effect of Trump’s policies on coverage for contraceptives for women, and in the context of affordability and accessibility to reproductive health care, it’s an important point to make. This claim doesn’t capture all the caveats that come with the research. And so for the third time, we award Two Pinocchios to this talking point.

Two Pinocchios

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