Provision of No-Cost, Long-Acting Contraception and Teenage Pregnancy

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Abstract

The rate of teenage pregnancy in the United States is higher than in other developed nations. Teenage births result in substantial costs, including public assistance, health care costs, and income losses due to lower educational attainment and reduced earning potential.

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The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception.

Gina Secura, Jenifer Allsworth, Tessa Madden … (2010)

To introduce and promote the use of long-acting reversible methods of contraception (LARC; intrauterine contraceptives and subdermal implant) by removing financial and knowledge barriers. The Contraceptive CHOICE Project is a prospective cohort study of 10,000 women 14-45 years who want to avoid pregnancy for at least 1 year and are initiating a new form of reversible contraception. Women screened for this study are read a script regarding long-acting reversible methods of contraception to increase awareness of these options. Participants choose their contraceptive method that is provided at no cost. We report the contraceptive choice and baseline characteristics of the first 2500 women enrolled August 2007 through December 2008. Sixty-seven percent of women enrolled (95% confidence interval, 65.3-69.0) chose long-acting methods. Fifty-six percent selected intrauterine contraception and 11% selected the subdermal implant. Once financial barriers were removed and long-acting reversible methods of contraception were introduced to all potential participants as a first-line contraceptive option, two-thirds chose long-acting reversible methods of contraception. Copyright (c) 2010 Mosby, Inc. All rights reserved.

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Changes in use of long-acting contraceptive methods in the United States, 2007-2009.

Lawrence Finer, Jenna Jerman, Megan Kavanaugh (2012)

To examine trends in the use of long-acting reversible contraceptive (LARC) methods-the intrauterine device (IUD) and implant--and the extent to which these methods have replaced permanent sterilization and less effective short-acting methods. We tabulated data from female survey respondents overall and by demographic subgroups. We performed t-tests of the differences in the proportions of female contraceptors using LARC in 2007 and 2009. We also looked at use of LARC, sterilization, other methods, and no method among women at risk of unintended pregnancy. In-home survey. All female respondents to the surveys. None. Current use of LARC methods in 2009, and change in use from 2007. The proportion of contraceptors using LARC increased significantly from 2.4% in 2002 to 3.7% in 2007 and 8.5% in 2009. The increase occurred among women in almost every age, race, education, and income group. Among women at risk of unintended pregnancy, increases in LARC use more than offset decreases in sterilization. LARC methods (primarily IUDs) are contributing to an increase in contraceptive effectiveness in the United States. Copyright © 2012 American Society for Reproductive Medicine. All rights reserved.