A study published in the March 2009 issue of the journal Contraception reveals that most over-the-counter pre-coital female contraceptives contain instructions that are not clear or understandable at the recommended reading level. The authors of the study examined and compared the instructions in eight types of female contraception, all available without consulting a health care provider, including the female condom, the sponge, and spermicides. The results of the study include the following:
The reading grade level of the instructions ranged from grade eight to 12;
The average page width was similar in size to a baseball cap;
The average text point size was 7.9; and
The illustrations were predominantly line drawings and used throughout the instructions, usually similar in size to a matchbox.
The authors noted in the study that approximately half of all pregnancies in the United States are unintended, and that of those pregnancies, nearly half occurred during a time when contraceptives were reportedly used. They also note that there are major differences in the efficacy of the contraceptives when comparing “typical” vs. “perfect” usage.
Instructions written for the public should generally be written at a sixth grade level, a level surpassed by the contraceptive inserts in the study. According to the National Partnership for Women and Families, the “differences in “typical” and “perfect use” could account for more than 100,000 unplanned pregnancies in the U.S, and incorrect use of contraceptives accounts for much of the difference in “typical” and “perfect” use, according to the authors.” One positive finding of the study according to the authors was that most contraceptive products included a phone number and some included a website for users to access more information.