Free access to birth control can cut abortion rate by more than half

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Earlier this year, the Affordable Care Act began requiring private insurance agencies to provide many contraceptives for free to consumers. This change was an effort to remove the cost as a barrier for women to choose to use birth control. It could also have the added benefit of reduce abortion rates, according to a new study published online Oct. 4 in Obstetrics and Gynecology.

The study found that the availability of free contraception led to lower teenage birth rates and reduced birth rates. abortions for all participants over half. “The impact of providing free birth control has been far greater than expected,” said Jeff Peipert, professor of obstetrics and gynecology at Washington University in St. Louis, and co-author. of the study, in a press release.

For the study, Peipert and colleagues recruited 9,256 women and adolescent girls, ages 14 to 45, in the St. Louis area who were particularly at risk of unwanted pregnancies and who wanted to avoid pregnancy for at least one. year. Those who chose to participate in the three-year study had a choice between short-acting methods, such as vaginal pills, rings, or patches, or long-acting reversible methods, such as as intrauterine devices (IUDs) or implants. IUDs consist of a small T-shaped device that is inserted into the uterus, and the implant is a thin strip of plastic that is inserted under the skin of the upper arm; both require insertion in the doctor’s office. Study participants received their chosen method (with the option to switch methods) free of charge. After learning about the risks and benefits of all types, 75 percent of women chose longer-acting IUDs and implants (especially because of their low failure rate and not having depending on regular observance and having to look for replacements).

Abortion rates among study participants were less than 7.6 per 1,000, less than half the national rate of 19.6 per 1,000, even though study participants were considered more at risk than the general population. These rates suggest that the same free contraceptive options available nationwide would prevent an abortion for 137 or fewer women and adolescents who participated, the researchers said. The adolescents in the study had babies (the majority of whom were unwanted pregnancies) at a rate less than one-fifth of the national average: 6.3 per 1,000 in the study and 34.3 per 1,000 in the study. United States

The study followed the Institute of Medicine’s recommendations that all contraceptive methods approved by the U.S. Food and Drug Administration be available free to women under the Affordable Care Act of 2010. The group’s report also noted that women should receive “a more comprehensive range of contraceptive education, counseling, methods and services so that women can better avoid unintended pregnancies and space their pregnancies to promote. optimal results at birth “. Researchers estimate that if a similar program were rolled out nationwide, more than 40 percent of over a million abortions performed each year (pdf) would be avoided (a slightly smaller drop because study participants were a high-risk subgroup of the population).

“We believe that improving access to birth control, especially IUDs and implants, coupled with education on the most effective methods has the potential to dramatically reduce the number of unwanted pregnancies and abortions. in this country, ”said Peipert.

While birth control subsidies have upfront costs, in the long run they offer savings – every million unwanted births costs taxpayers $ 11 billion each year, according to a 2011 study in Contraception. The rate of unintended pregnancies in the United States – 49%, according to the United States Centers for Disease Control and Prevention (CDC) – far exceeds that of most developed countries. Most women in the United States rely on birth control pills for contraception, which is cheaper to start with but less reliable than IUDs and implants, which require an expense of at least $ 800 but remain effective for three years or more.


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