SAGE (Sound Advice for a Green Earth) is a project by advanced students in Earth Systems and other programs to answer sustainability questions. Submit questions.
Q: How sustainable are different forms of birth control? Specifically, what is the ecological footprint of condoms vs. the pill vs. an IUD?
The Essential Answer
The word “sustainability” often conjures up thoughts of switching off the lights. But what happens to the environment after those lights get turned off and people get turned on? Can we simultaneously satisfy ourselves, our partners and Mother Earth, all while curbing population growth? Let’s look at some ways to (safely) heat things up in the bedroom without heating up the planet.
We’ll focus on three popular birth control options: condoms, oral contraceptives (“the pill”) and intrauterine devices (IUDs).
Condoms have their ups and downs; while they stand as the only option to protect against STIs and come free of a doctor’s consultation, they fall short on pregnancy prevention effectiveness (at 82 percent) and waste creation. Their one-time usage leads to a definitively unsexy clogging of landfills, with about 10 billion condoms added per year. They also pose human rights issues through exploitive rubber production, although some companies are working to fix that. (Read more in the Nitty Gritty answer below.)
The pill tops condoms through higher effectiveness (91 percent) and less physical waste. However, its main ingredient, synthetic estrogen, can contaminate our natural waterways, altering fish reproductive systems and damaging ecosystem dynamics. This chemical pollution makes the pill a questionable choice for lovers of aquatic creatures.
From a sustainability standpoint, the IUD blows the pill and the condom away. Not only does it have an incredible 99-plus percent effectiveness, but it also requires just one small plastic T—either wrapped in copper or holding synthetic progesterone hormone—to prevent pregnancies for three to 12 years. Physical waste is nearly nonexistent. Copper IUDs use up less than a third of a gram of copper, the same amount of copper contained in just five of today’s pennies. Hormonal IUDs release small quantities of synthetic progesterone directly into the uterus, meaning that most of the hormone stays exactly where it’s needed. A bonus: The IUD requires no extra step before sex and stays out of the way throughout the act. In short, IUDs leave you and the planet feeling unencumbered and worry-free.
Although IUDs seem to be the clear environmental winner, let’s not demonize other contraceptives. Other options have their own unique roles to play—such as condoms’ role in protecting against STIs. And no matter your preference, when it comes to environmental impact, any birth control is better than no birth control. All contraceptives pale in comparison to the impact a new human will have on the planet. Bringing a baby into the world should happen after careful consideration, with the child’s, parents’, and Mother Earth’s needs in mind.
So choose your favorite contraceptive and go forward in your bedroom adventures with both confidence and safety—for you, for your partner and for the planet.
The Nitty Gritty
What role does birth control effectiveness and accessibility play in its impact on the planet? What types of pollution do each of our birth control options cause? How does birth control relate to human rights and environmental justice? It’s time to dive into the intricacies of contraceptives.
A contraceptive’s ability to curb the population growth that stresses our planet and its resources is central to birth control’s environmental impact. Each of our three options can reach at least 98 percent effectiveness (98 percent for condoms, 99 percent for the pill and 99.9 percent for IUDs), but improper use reduces effectiveness of the condom to only 82 percent and the pill to 91 percent. The IUD remains the only option not subject to human error, as it requires no effort beyond initial insertion. Its constant, high effectiveness at preventing pregnancy and therefore limiting population expansion gives it the sustainability edge.
The condom is widely available over the counter, making it the most accessible form of birth control. The pill and the IUD require prescriptions, meaning that women seeking these contraceptives must make and pay for one or more trips to the doctor’s office. This presents a barrier for women short on time, transportation, money or access to medical care.
Even after acquiring a prescription, individuals face financial barriers. U.S. News and World Report found that although an IUD costs a hefty $500 to $1,000, its longevity gives it an annual cost of just $100. Compared to the $150 yearly fee for condoms (assuming twice weekly usage) and $160 to $600 yearly price for the pill, the IUD wins out if a woman can afford the up-front cost. Luckily for Americans, Obamacare is working to cover the pill and IUDs for all women. Contraceptive access allows for family planning and population control, empowering people while helping the planet.
Condoms, IUDs and birth control pills contribute to pollution in very different ways. The 10 billion condoms purchased every year globally pile into landfills and take months to biodegrade. Even so, throwing them in the trash is far better than flushing them down the toilet, where they can clog sewage treatment machinery, or even make their way into waterways and threaten aquatic life.
Birth control pills, on the other hand, can pollute waterways by introducing synthetic estrogen hormones into wastewater through a pill-user’s urine. Because many aquatic animals have hormone receptors similar to those of humans, fish and other species can take up this estrogen, become feminized, and experience reproduction problems. Could these problems be avoided through proper water treatment? Dr. William Mitch, associate professor of civil and environmental engineering at Stanford, explains that synthetic estrogen can be effectively removed from wastewater using common water treatment methods like reverse osmosis and chemical oxidation. The problem lies in the fact that we typically treat wastewater this thoroughly only when it is on its way to becoming drinking water again; wastewater destined for release into surface waters does not go through these filters, so synthetic estrogen can seep into bodies of water and aquatic organisms.
Thankfully, IUDs do not pose the same pollution problems as pills and condoms. Their long-term usage mixed with their low- to no-hormone composition make them the cleanest of our three options when it comes to pollution.
If environmental justice and fair treatment of workers fit into your definition of sustainability, read on. IUDs and oral contraceptives do not have a known history of human rights violations, but problems with the raw materials for condoms were recently exposed. Many rubber plantations that supply latex to condom companies underpay workers, exploit child labor and prevent employees from unionizing, trapping workers and their families in a cycle of poverty—something that we consumers of birth control should avoid perpetuating.
Thankfully, certain companies are working to change this exploitative system. One such condom manufacturer, called Sustain, fights against human rights abuses through sourcing fair trade rubber, implementing education and health campaigns in its source communities, and donating 10 percent of all profits to reproductive health access in the United States. Meika Hollender, co-founder of Sustain, sees birth control as inextricable from issues of equality. “My definition of sustainable contraception is access,” Hollender wrote in an e-mail to SAGE. “Until we as women feel comfortable and proud about our sexuality, we will continue to live in a world where people can tear us down.” Because of initiatives like Sustain, we can look for more accessible, sustainable, and human-rights-friendly condom options now and in the future.
With all this information, how do you decide which birth control option to use? Although the IUD seems like the most effective and sustainable pregnancy prevention option to me (and condoms the best STI prevention option), the best answer lies in your personal needs and priorities. Weigh which aspects of sustainability matter to you most, and act accordingly. Mother Earth will thank you.
Lauren Gibson is a senior in the Earth Systems Program and plans to complete her master’s degree in Earth Systems next year.