Unintended Pregnancy Rates Significantly Lower Among Women Offered No-Cost Contraception, Study Finds

October 5, 2012 — Unintended pregnancy rates -- including the rates of teen pregnancy and abortion -- decrease when women gain access to no-cost birth control, according to a new study published in Obstetrics & Gynecology, MedPage Today reports (Petrochko, MedPage Today, 10/4).

The study analyzed data from the Contraceptive CHOICE Project, which followed 9,250 women ages 14 through 45 in the St. Louis region for five years, beginning in 2007. The women were given information about a range of contraceptive methods. Seventy-five percent of participants opted for long-acting reversible contraceptives, such as intrauterine devices and under-the-skin implants.

According to the study, there were an average of six abortions annually per 1,000 women in the project, compared with the national rate of 20 abortions per 1,000 women.

Additionally, in St. Louis and St. Louis County, the proportion of abortions among women who had at least one prior abortion declined from 48% in 2006, before the program launched, to 44% in 2010. By contrast, in nearby Kansas City, the number of subsequent abortions increased from 46% of procedures to 51% during the same period (Bernhard, St. Louis Post-Dispatch, 10/5).

Further, there were 6.3 births per 1,000 teens in the project, compared with the national rate of 34 births per 1,000 teens in 2010.

Potential Implications

Study author Jeffrey Peipert noted that when cost barriers were removed, most women chose the most effective contraceptive methods, resulting in fewer unintended pregnancies. The findings show why "[w]e shouldn't have, in my view, a tiered system where the women with money can get family planning and the women without cannot," he said, noting that 39% of women in the study had trouble paying basic expenses.

The findings could foreshadow the potential impact of the federal contraceptive coverage rules being implemented under the Affordable Care Act (PL 111-148), women's health experts said. The rules require most health plans to cover contraceptive services without copayments or deductibles.

"As a society, we want to reduce unintended pregnancies and abortion rates. This study has demonstrated that having access to no-cost contraception helps us get to that goal," said Alina Salganicoff, director of women's health policy at the Kaiser Family Foundation (Neergaard, AP/Atlanta Journal-Constitution, 10/5).