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Amid the politics of contraception, fewer unintended pregnancies

February 09, 2012|By Shari Roan, Los Angeles Times / For the Booster Shots blog
  • A Jan. 20 rule issued by the federal Department of Health and Human Services requires almost all private health insurance plans to provide coverage for all U.S. Food and Drug Administration-approved prescription contraceptives. Health plans would also have to offer female sterilization as yet another preventive service. Companies would have to cover these things fully, with no co-pay for the patient.
A Jan. 20 rule issued by the federal Department of Health and Human Services… (Los Angeles Times )

The debate over insurance coverage of contraception in Washington, D.C., and on the campaign trail comes at a time when public-health officials can boast of some positive developments in reproductive healthcare over the past decade. On Wednesday, researchers announced that teen birthrates have hit the lowest mark in 40 years.

Implementation of the Affordable Care Act, which includes a mandate that employers must cover contraception as free preventive care, is widely viewed among public-health experts as an action that could further decrease unintended pregnancy, teen pregnancy and abortion in the United States. But opposition and any weakening of the bill, as well as proposals to cut government funding to nonprofit reproductive healthcare organizations such as Planned Parenthood, could lead to a reversal in trends.

Said the authors of a blog post this week from the Institute for Women's Health Research at Northwestern University: "...both politics and religion have entered the women’s health arena and it may result in a reduction in hard-fought-for services and advances for women." 

Somewhat ironically, both the United Nations and the World Health Organization have long put politics aside in favor of strengthening family planning and reproductive rights as an international priority. According to the United Nations Population Fund: "Reproductive health and rights are cornerstones of women's empowerment ... empowerment of women is not simply an end in itself, but also a step towards eradicating poverty and stabilizing population growth."

According to the World Health Organization: Reproductive rights "implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this are the right of men and women to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice, and the right of access to appropriate healthcare services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant."

Recent studies on reproductive health in the United States show:

-- Half of all pregnancies are unintended, although the rates are higher among women in lower socioeconomic groups, according to the Centers for Disease Control and Prevention. The most recent government survey on unintended pregnancy is from 2006, however, and there are some hints that rates may have declined somewhat due an expanded array of contraceptive choices over the past 12 years, including emergency contraception (which about 10% of U.S. women say they have used, according to the CDC) and longer-acting hormonal birth control methods, such as monthly injections and the weekly skin patch. According to the CDC: "Since 2000, several new methods of birth control have become available in the United States, including the levonorgestrel-releasing intrauterine system, the hormonal contraceptive patch, the hormonal contraceptive ring, the hormonal implant, a 91-day regimen of oral contraceptives, two new barrier methods, and a new form of female sterilization."

-- The study released Wednesday by the Guttmacher Institute showed the teen pregnancy rate is at the lowest level in 40 years -- 67.8 pregnancies per 1,000 women ages 15 to 19. That's a 42% drop from the peak rate in 1990 (116.9 per 1,000). Rates among black and Hispanic teens are two to three times higher than among non-Hispanic whites.

-- The U.S. birthrate fell to 13.9 per 1,000 persons in 2002 from 14.1 per 1,000 in 2001. It's down 17% from the recent peak in 1990 (16.7 per 1,000), according to the CDC

-- From 1999 through 2008, the reported abortion rate fell 4%. As of 2008, the most recent year for which statistics are available, the rate was 16 abortions per 1,000 women, according to the federal government.

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