Further Evidence that Contraceptive Access Reduces Unwanted Pregnancies and Abortions

We told you on Monday that contraception is the best way to avoid abortions. The evidence provided was more corollary in terms of countries having fewer abortions when women have access to family planning methods. It also turns out that there is strong data to back up the assertion that contraceptives, in this case for free, cut into abortion rates.

Researchers from the Washington University School of Medicine in St. Louis tracked 9,256 women with the average age of 25 who took part in the Contraceptive Choice Project from August 2007 to September 2011. The women in the study were given their choice of contraception for free over three years.

TIME reports that the authors found, “there were 4.4 to 7.5 abortions per 1,000 women in the study, after adjusting for age and race – much fewer than the national rate of 19.6 abortions per 1,000 women and lower also than the rate in the St. Louis area of 13.4 to 17 abortions per 1,000 women.” Furthermore, the number of teen births were well below the national rate of 34.3 per 1,000 teen girls coming in at 6.3 births per 1,000 girls.

Access to contraceptives empowered the women with the ability to choose when to get pregnant. “[C]hanges in contraceptive policy simulating the Contraceptive Choice Project would prevent as many as 41% to 71% of abortions performed annually in the United States,” the study’s authors wrote.

Perhaps the most notable result from the study was that 58% of participants chose an intrauterine device (IUD) – a much higher proportion than the national average. It is estimated that only 5.5% of women in the U.S. use an IUD. The lead researcher noted that the study results show that when cost is not an issue, women choose a highly effective method.

TIME reports further on the benefits of long-acting contraceptives like IUDs:

Women who choose long-acting contraception are more likely to stick with it as well: in the study, 85% were still using it a year later, compared with 35% of those choosing pills or other short-acting forms of birth control. “Because LARC methods have been shown to have higher continuation rates than other reversible methods, the number of adolescents and women using no contraception would decline, further decreasing the unintended pregnancy rate,” the authors conclude.

Yet American women use LARC methods at far lower rates than in other countries. In large part, that’s because of cost: upfront costs to implant an IUD, which requires a doctor visit, can total $500 to $1,000, for example. Over a decade, however, birth control pills can cost just as much. American doctors also tend not to recommend long-acting birth control to women as often as they do the pill or patch, though IUDs and implants may be up to 20 times more effective.

That’s why the American College of Obstetricians and Gynecologists is now urging doctors to recommend IUDs and implants as “first-line” contraceptive choices to their teen patients.