Association of Pharmacist Prescription of Hormonal Contraception With Unintended Pregnancies and Medicaid Costs

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Abstract

To estimate unintended pregnancies averted and the cost effectiveness of pharmacist prescription of hormonal contraception.

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Disparities in Rates of Unintended Pregnancy In the United States, 1994 and 2001

Lawrence Finer, Stanley K Henshaw (2006)

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Shifts in intended and unintended pregnancies in the United States, 2001-2008.

Mia Zolna, Lawrence Finer (2014)

We monitored trends in pregnancy by intendedness and outcomes of unintended pregnancies nationally and for key subgroups between 2001 and 2008. Data on pregnancy intentions from the National Survey of Family Growth (NSFG) and a nationally representative survey of abortion patients were combined with counts of births (from the National Center for Health Statistics), counts of abortions (from a census of abortion providers), estimates of miscarriages (from the NSFG), and population denominators from the US Census Bureau to obtain pregnancy rates by intendedness. In 2008, 51% of pregnancies in the United States were unintended, and the unintended pregnancy rate was 54 per 1000 women ages 15 to 44 years. Between 2001 and 2008, intended pregnancies decreased and unintended pregnancies increased, a shift previously unobserved. Large disparities in unintended pregnancy by relationship status, income, and education increased; the percentage of unintended pregnancies ending in abortion decreased; and the rate of unintended pregnancies ending in birth increased, reaching 27 per 1000 women. Reducing unintended pregnancy likely requires addressing fundamental socioeconomic inequities, as well as increasing contraceptive use and the uptake of highly effective methods.

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Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014

Megan Kavanaugh, Jenna Jerman (2017)

Objective The objective was to examine levels of, correlates of and changes in the use of individual and grouped methods of contraception among US females aged 15–44 from 2008 to 2014. Study design Using three rounds of the National Survey of Family Growth, we analyzed samples of 12,279 (2008), 5601 (2012) and 5699 (2014) females. We conducted simple and multivariable logistic regression analyses to identify associations between demographic characteristics and contraceptive use, as well as between characteristics and changes in use patterns. Results In terms of overall trends in contraceptive use between 2008 and 2014, there was no significant change in the proportion of women who used a method among either all women (60%) or those at risk of unintended pregnancy (90%). Significant changes in use occurred among six methods. The largest increase in use was among users of long-acting reversible contraceptive (LARC) methods, including the intrauterine device and implant — from 6% to 14% — across almost all population groups of female contraceptive users, while the largest decrease occurred among users of sterilization — from 37% to 28% — with lower-income women driving the decline in female sterilization and higher-income women driving the decline in a partner’s sterilization as a primary method. Moderate increases were seen in the use of withdrawal and natural family planning. Conclusion Most shifts in recent contraceptive use have occurred among the most effective methods — sterilization and LARCs. Differences in method-specific user characteristics underscore the importance of ensuring full access to the broad range of methods available. Implications The lack of change in the overall use of contraceptives among women at risk for unintended pregnancy may have implications for the extent to which further declines in national rates of unintended pregnancy can be expected.

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Journal

Title: Obstetrics & Gynecology

Abbreviated Title: Obstetrics & Gynecology

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Print): 0029-7844

Publication date Created: 2019

Publication date (Print): June 2019

Volume: 133

Issue: 6

Pages: 1238-1246

Article

DOI: 10.1097/AOG.0000000000003265

PubMed ID: 31135740

SO-VID: 52fd1b81-17d0-4ec2-a7ff-240a8ae2f65e

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Association of Pharmacist Prescription of Hormonal Contraception With Unintended Pregnancies and Medicaid Costs :

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Most cited references 23

Disparities in Rates of Unintended Pregnancy In the United States, 1994 and 2001

Shifts in intended and unintended pregnancies in the United States, 2001-2008.

Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014

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