Preventing Unintended Pregnancies by Providing No-Cost Contraception
Top Cited Papers
- 1 December 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 120 (6), 1291-1297
- https://doi.org/10.1097/aog.0b013e318273eb56
Abstract
OBJECTIVE: To promote the use of long-acting reversible contraceptive (LARC) methods (intrauterine devices [IUDs] and implants) and provide contraception at no cost to a large cohort of participants in an effort to reduce unintended pregnancies in our region. METHODS: We enrolled 9,256 adolescents and women at risk for unintended pregnancy into the Contraceptive CHOICE Project, a prospective cohort study of adolescents and women desiring reversible contraceptive methods. Participants were recruited from the two abortion facilities in the St. Louis region and through provider referral, advertisements, and word of mouth. Contraceptive counseling included all reversible methods but emphasized the superior effectiveness of LARC methods (IUDs and implants). All participants received the reversible contraceptive method of their choice at no cost. We analyzed abortion rates, the percentage of abortions that were repeat abortions, and teenage births. RESULTS: We observed a significant reduction in the percentage of abortions that were repeat abortions in the St. Louis region compared with Kansas City and nonmetropolitan Missouri (P<.001). Abortion rates in the CHOICE cohort were less than half the regional and national rates (P<.001). The rate of teenage birth within the CHOICE cohort was 6.3 per 1,000, compared with the U.S. rate of 34.3 per 1,000. CONCLUSION: We noted a clinically and statistically significant reduction in abortion rates, repeat abortions, and teenage birth rates. Unintended pregnancies may be reduced by providing no-cost contraception and promoting the most effective contraceptive methods. LEVEL OF EVIDENCE: IIKeywords
This publication has 22 references indexed in Scilit:
- Publicly funded contraceptive care: a proven investmentContraception, 2011
- Unintended pregnancy in the United States: incidence and disparities, 2006Contraception, 2011
- Changes in Abortion Rates Between 2000 and 2008 and Lifetime Incidence of AbortionObstetrics & Gynecology, 2011
- Comparison of contraceptive use between the Contraceptive CHOICE Project and state and national dataContraception, 2011
- Family Planning as a Cost-Saving Preventive Health ServiceNew England Journal of Medicine, 2011
- Continuation and Satisfaction of Reversible ContraceptionObstetrics & Gynecology, 2011
- Strategies to prevent unintended pregnancy: increasing use of long-acting reversible contraceptionHuman Reproduction Update, 2010
- The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraceptionAmerican Journal of Obstetrics and Gynecology, 2010
- Is There a Trend of Increased Unwanted Childbearing Among Young Women in the United States?Journal of Adolescent Health, 2008
- Disparities in Rates of Unintended Pregnancy In the United States, 1994 and 2001Perspectives on Sexual and Reproductive Health, 2006