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Growing Gap Between First Sex and First Birth Means Women Face Longer Period of Risk for Unintended Pregnancy

April 15, 2014 Comments off

Growing Gap Between First Sex and First Birth Means Women Face Longer Period of Risk for Unintended Pregnancy
Source: Guttmacher Institute

The typical age at which teens first have sex has remained relatively stable over the past several decades, increasing slightly to 17.8 for women and 18.1 for men in the most recent cohort for whom data are available. For women coming of age in the mid-2000s, the median age at first sex was about the same as that of women 35 years earlier, according to “Trends in Ages at Key Reproductive Transitions in the United States, 1951–2010,” by Lawrence B. Finer and Jesse M. Philbin. However, the typical time between first sex and first birth has increased from three years for women born in 1940 to almost 10 years for women born in 1982.

“This is the period of highest risk for unintended pregnancy,” says Dr. Finer. “Later childbearing means many women are at risk for a decade or more before they have kids. The growing length of this period makes it vital that women have access to a wide range of effective methods of contraception—not just the condoms and pills that women commonly use now, but also highly effective long-acting methods like the IUD and the implant. The latter methods don’t require any regular action on the woman’s part, which might be particularly helpful for teens and young adults.”

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State Policy Trends: More Supportive Legislation, Even As Attacks on Abortion Rights Continue

April 10, 2014 Comments off

State Policy Trends: More Supportive Legislation, Even As Attacks on Abortion Rights Continue
Source: Guttmacher Institute

The 2014 legislative session got off to a fast start, with legislators introducing a combined 733 provisions related to sexual and reproductive health and rights in nearly all the states that have legislative sessions this year (legislatures in Montana, Nevada, North Dakota and Texas will not meet in 2014). See here for the full analysis of the first quarter of 2014.

Significantly, legislators quickly showed a clear interest in protecting or expanding access to sexual and reproductive health care. Some 64 provisions have been introduced so far this year to expand or protect access to abortion, more than had been introduced in any year in the last quarter century. And only three months into the year, two new provisions protecting abortion rights have been enacted, and three others have passed one legislative chamber. Similarly, seven measures designed to expand access to other sexual and reproductive health services have passed at least one legislative body in six states and the District of Columbia.

As in recent years, however, state legislatures continued to take aim at abortion rights. Legislators in 38 states introduced 303 provisions seeking to limit women’s access to care. By March 31, three new abortion restrictions had been enacted, and 36 had passed one legislative chamber.

Moving Forward: Family Planning in the Era of Health Reform

April 8, 2014 Comments off

Moving Forward: Family Planning in the Era of Health Reform (PDF)
Source: Guttmacher Institute
From press release:

The highly successful U.S. family planning effort helps almost nine million disadvantaged women each year to plan their families and protect their health, while also substantially reducing rates of unintended pregnancy and saving taxpayers more than $10 billion, according to a new Guttmacher report. The report, Moving Forward: Family Planning in the Era of Health Reform, synthesizes the most up-to-date data and analyses to illustrate the current and future importance of family planning programs and the safety-net providers at the heart of this effort.

Abortion Coverage Under the Affordable Care Act: The Laws Tell Only Half the Story

March 31, 2014 Comments off

Abortion Coverage Under the Affordable Care Act: The Laws Tell Only Half the Story
Source: Guttamacher Institute
From press release:

Consumers purchasing health coverage through the marketplaces created under the Affordable Care Act (ACA) have no easy way—and often no way at all—to find out whether a health plan covers abortion care, according to a new Guttmacher analysis. The analysis lays out how this lack of transparency can be addressed by the Obama administration, which has the authority to ensure health plan issuers make such information readily available to consumers nationwide.

As Supreme Court Takes Up Contraceptive Coverage Cases, New Guttmacher Analysis Puts the Facts Front and Center

March 12, 2014 Comments off

As Supreme Court Takes Up Contraceptive Coverage Cases, New Guttmacher Analysis Puts the Facts Front and Center
Source: Guttmacher Institute

The cases on the Affordable Care Act’s contraceptive coverage guarantee that will be heard by the U.S. Supreme Court on March 25 revolve around several important questions of fact that have been misinterpreted and obfuscated by the guarantee’s opponents. To help ensure that the debate is informed by facts, not misinformation, a new Guttmacher analysis—based in part on a Supreme Court amicus brief the Institute filed in January—sets the record straight.

“We want to clarify key points, including many that should be self-evident but have nevertheless been challenged by an ideological onslaught from anti-contraception activists,” says Adam Sonfield, a Guttmacher senior public policy associate and author of the new analysis. “Among these points are basics like the fact that contraception is distinct from abortion, that contraceptive methods aren’t interchangeable and that cost and lack of method choice can very much interfere with a woman’s ability to use the method that is most appropriate for her needs and circumstances.”

Sonfield presents extensive data from the Guttmacher Institute and other leading authorities that document why the ACA’s requirement that most private health plans cover contraceptive counseling, services and supplies without out-of-pocket costs for patients is necessary and appropriate.

December Issue of International Perspectives on Sexual and Reproductive Health Now Available

February 4, 2014 Comments off

December Issue of International Perspectives on Sexual and Reproductive Health Now Available
Source: Guttmacher Institute
Articles include:

  • Documenting the Individual- and Household-Level Cost of Unsafe Abortion in Uganda
  • Understanding Couples’ Relationship Quality And Contraceptive Use in Kumasi, Ghana
  • Consumer Perspectives on a Pericoital Contraceptive Pill In India and Uganda
  • The Oportunidades Conditional Cash Transfer Program: Effects on Pregnancy and Contraceptive Use Among Young Rural Women in Mexico
  • Reproduction, Functional Autonomy and Changing Experiences of Intimate Partner Violence Within Marriage in Rural India

U.S. abortion rates hit lowest level since 1973

February 3, 2014 Comments off

U.S. abortion rates hit lowest level since 1973
Source: Guttmacher Institute

The U.S. abortion rate declined to 16.9 abortions per 1,000 women aged 15–44 in 2011, well below the 1981 peak of 29.3 per 1,000 and the lowest since 1973 (16.3 per 1,000), according to “Abortion Incidence and Service Availability in the United States, 2011,” by Rachel Jones and Jenna Jerman. Between 2008 and 2011, the abortion rate fell 13%, resuming the long-term downward trend that had stalled between 2005 and 2008. The number of abortions (1.1 million in 2011) also declined by 13% in this time period.

While the study did not specifically investigate reasons for the decline, the authors note that the study period (2008–2011) predates the major surge in state-level abortion restrictions that started during the 2011 legislative session, and that many provisions did not go into effect until late 2011 or even later. The study also found that the total number of abortion providers declined by only 4% between 2008 and 2011, and the number of clinics (which provide the large majority of abortion services) declined by just 1%.

Unintended Pregnancy in the United States

January 15, 2014 Comments off

Unintended Pregnancy in the United States
Source: Guttmacher Institute

• Most American families want two children. To achieve this, the average woman spends about five years pregnant, postpartum or trying to become pregnant, and three decades—more than three-quarters of her reproductive life—trying to avoid an unintended pregnancy.
• Most individuals and couples want to plan the timing and spacing of their childbearing and to avoid unintended pregnancies, for a range of social and economic reasons. In addition, unintended pregnancy has a public health impact: Births resulting from unintended or closely spaced pregnancies are associated with adverse maternal and child health outcomes, such as delayed prenatal care, premature birth and negative physical and mental health effects for children.
• For these reasons, reducing the unintended pregnancy rate is a national public health goal. The U.S. Department of Health and Human Services’ Healthy People 2020 campaign aims to reduce unintended pregnancy by 10%, from 49% of pregnancies to 44% of pregnancies, over the next 10 years.
• Currently, about half (51%) of the 6.6 million pregnancies in the United States each year (3.4 million) are unintended.

A Year of Magical Thinking Leads To…Unintended Pregnancy

November 21, 2013 Comments off

A Year of Magical Thinking Leads To…Unintended Pregnancy
Source: Guttmacher Institute

In-depth interviews with 49 women obtaining abortions in the United States found that most of the study participants perceived themselves to be at low risk of becoming pregnant at the time that it happened. According to “Perceptions of Susceptibility to Pregnancy Among U.S. Women Obtaining Abortions,” by Lori Frohwirth of the Guttmacher Institute et al., the most common reasons women gave for thinking they were at low risk of pregnancy included a perception of invulnerability, a belief that they were infertile, self-described inattention to the possibility of pregnancy and a belief that they were protected by their (often incorrect) use of a contraceptive method. Most participants gave more than one response.

The most common reason women gave for their perceived low risk of pregnancy was perceived invulnerability to pregnancy. Study participants understood that pregnancy could happen, but for reasons they couldn’t explain, thought they were immune or safe from pregnancy at the time they engaged in unprotected sex. One reported that she “always had good luck,” while another said, “…It’s like you believe something so much, like ‘I just really don’t want children,’ [and] for some reason, I thought that would prevent me from getting pregnant.” This type of magical thinking—that pregnancy somehow would not happen despite acknowledged exposure—suggests a disconnect between the actual risk of pregnancy incurred by an average couple who does not use contraceptives (85% risk of pregnancy over the course of a year) and a woman’s efforts to protect herself from unintended pregnancy.

Births Resulting From Unintended Pregnancies Cost Federal and State Governments $12.5 Billion In 2008

October 25, 2013 Comments off

Births Resulting From Unintended Pregnancies Cost Federal and State Governments $12.5 Billion In 2008
Source: Guttmacher Institute

Nationally, two out of every three births resulting from unintended pregnancies, approximately 1.1 million births, were paid for by public insurance programs in 2008, according to a new Guttmacher report by Adam Sonfield and Kathryn Kost. Public expenditures on these births—including costs of prenatal care, labor and delivery, postpartum care and one year of care for the infant—totaled $12.5 billion in 2008. These births accounted for 53% of all publicly funded births that year.

Almost 13 Million Women of Reproductive Age Were Uninsured in 2012

October 2, 2013 Comments off

Almost 13 Million Women of Reproductive Age Were Uninsured in 2012
Source: Guttmacher Institute

Almost 13 million women aged 15–44, accounting for one in five (20.8%) women of reproductive age, were uninsured in 2012, according to a Guttmacher analysis of new U.S. Census Bureau data. Moreover, in that same year, almost four out of every 10 (39.1%) reproductive-age women living below the poverty line lacked insurance coverage. These bleak statistics not only underscore the urgent and ongoing need for safety-net programs such as the Title X national family planning program, they also demonstrate the significant potential gains to be made as the Affordable Care Act’s expansion of public and private insurance coverage gets underway on January 1, 2014.

Abortion Restrictions in U.S. Foreign Aid: The History and Harms of the Helms Amendment

September 30, 2013 Comments off

Abortion Restrictions in U.S. Foreign Aid: The History and Harms of the Helms Amendment
Source: Guttmacher Institute

Forty years ago, in the wake of Roe v. Wade, Congress enacted the Helms amendment to restrict U.S. foreign aid from going toward abortion. Specifically, the policy prohibits foreign assistance from paying for the “performance of abortion as a method of family planning” or to “motivate or coerce any person to practice abortions.” Just on its face, the law is extreme and harmful. But its damaging reach has extended even further through the chilling impact it has had—on lawful abortion-related activities in particular, as well as more generally on U.S. sexual and reproductive health programs overseas. As such, supporters of women’s reproductive health are eager to see the law overturned altogether. However, given the impossibility of repealing this long-standing abortion restriction in the current political climate, there are steps that the administration can take in the interim to mitigate the impact of the Helms amendment.

Unintended Pregnancy Varies Widely By State

September 10, 2013 Comments off

Unintended Pregnancy Varies Widely By State
Source: Guttmacher Institute

In 2008, more than half of all pregnancies were unintended in 31 states; in the remainder of states, a minimum of 37% of pregnancies were unintended, according to “Unintended Pregnancy Rates at the State Level: Estimates for 2002, 2004, 2006 and 2008” by Kathryn Kost. In most states, unintended pregnancy rates were within the range of 40 to 65 per 1,000 women aged 15–44; the state with the highest rate was Delaware (70 per 1,000) and the state with the lowest rate was New Hampshire (31 per 1,000). Unintended pregnancy rates were generally higher in the South and Southwest, and in states with large urban populations.

The report also shows that more unintended pregnancies were mistimed (the woman wanted to have a child sometime, but not now) than were unwanted (the woman did not ever want to have a child or another child); between one-quarter and one-third of unintended pregnancies were unwanted in each state. Additionally, in 38 states, more than half of unintended pregnancies resulted in a birth.

Services Provided At Family Planning Centers Yield Myriad Public Health Benefits

August 21, 2013 Comments off

Services Provided At Family Planning Centers Yield Myriad Public Health Benefits
Source: Guttmacher Institute

Family planning centers offer their clients a wide range of health services, extending well beyond contraception, according to “Contraception and Beyond: The Health Benefits of Services Provided at Family Planning Centers,” a review of scientific literature by Megan Kavanaugh and Ragnar Anderson of the Guttmacher Institute. Among their many benefits, these services improve maternal and child health by enabling women to time and space their pregnancies, reduce women’s cancer risk and prevent conditions ranging from STIs to diabetes and high blood pressure.

A large body of literature shows that family planning, including planning and spacing pregnancies, is linked to early initiation of prenatal care, more prenatal care visits, increased likelihood of breast-feeding and longer duration of breast-feeding by a mother; these healthy behaviors in pregnant women lead to better outcomes for their children. Additionally, adequate spacing between a birth and the conception of a subsequent pregnancy is linked to improved birth outcomes and a reduction in the number of babies born premature, at a low birth weight or small for their gestational age.

Use of contraceptives also yields a number of noncontraceptive health benefits. For example, contraceptive use can reduce women’s risk of developing certain reproductive cancers, and contraceptive methods can be used to treat many menstruation-related symptoms and disorders.

New U.S. study highlights need to include men in strategies to prevent unintended pregnancy

July 17, 2013 Comments off

New U.S. study highlights need to include men in strategies to prevent unintended pregnancy
Source: Guttmacher Institute

About 40% of births are reported as unintended by men, mirroring rates of unintended births among women, according to “Exploring U.S. Men’s Birth Intentions,” by Laura Lindberg and Kathryn Kost of the Guttmacher Institute. Roughly two-thirds of unintended births are mistimed, according to the fathers, while about one-third are unwanted.

The authors’ analysis of data from the 2006–2010 National Survey of Family Growth found that rates of unintended births vary significantly by fathers’ union status, age, education level, and race and ethnicity. For example, three out of four births reported by single men were unintended, compared with only one of four births reported by married men. Surprisingly, more than one in ten single men indicated that they did not know about the pregnancy until after the child was born.

Unintended births were more common among younger men and men with lower levels of education than among older and more educated men, respectively. Racial and ethnic disparities were also apparent. Unintended births were especially prevalent among black men, the majority of whose births were unintended (51%), while smaller proportions were unintended among Hispanic men (38%) and white men (34%).

State-Level Assault on Abortion Rights Continues in First Half of 2013

July 8, 2013 Comments off

State-Level Assault on Abortion Rights Continues in First Half of 2013
Source: Guttmacher Institute

In the first six months of 2013, states enacted 106 provisions related to reproductive health and rights; issues related to abortion, family planning funding and sex education were significant flashpoints in several legislatures. Although initial momentum behind banning abortion early in pregnancy appears to have waned, states nonetheless adopted 43 restrictions on access to abortion, the second-highest number ever at the midyear mark and is as many as were enacted in all of 2012.

However, this year is notable also for positive action on other reproductive health issues in a handful of states, with important new provisions enacted to expand access to comprehensive sex education, expedited partner treatment for STIs and emergency contraception for women who have been sexually assaulted.

U.S. Women’s Use of Sexual and Reproductive Health Services:Trends, Sources of Care and Factors Associated wit h Use, 1995–2010

June 12, 2013 Comments off

U.S. Women’s Use of Sexual and Reproductive Health Services:Trends, Sources of Care and Factors Associated with Use, 1995–2010 (PDF)

Source: Guttmacher Institute

From press release:

Seven in 10 U.S. women of reproductive age—44 million women—make at least one medical visit to obtain sexual and reproductive health (SRH) services each year, and approximately 25 million make a visit for contraceptive services, according to "U.S. Women’s Use of Sexual and Reproductive Health Services: Trends, Sources of Care and Factors Associated with Use, 1995–2010," by Jennifer Frost. Over the last decade, publicly supported safety net clinics have become increasingly important in giving young and low-income women access to care; the proportion of women receiving SRH services at this type of clinic rose from 17% of those receiving care in 1995 to 23% each year between 2006 and 2010.

An analysis of data from the National Survey of Family Growth showed that clinics that receive funding through the Title X national family planning program are critical in providing access to care, serving 14% of women who received contraceptive services in 2006–2010. This includes 25% of poor women and 36% of uninsured women. Nearly one in five women (18%) who obtained testing or treatment for STIs did so at a clinic that receives Title X funds, as did 14% of women who received an HIV test. Moreover, women who visited Title X-funded clinics for their annual gynecologic exams were nearly twice as likely to have a conversation about birth control with their clinician as women going to private doctors.

Perceptions Of Young Adolescent Sexual Activity Are Greatly Exaggerated

April 2, 2013 Comments off

Perceptions Of Young Adolescent Sexual Activity Are Greatly Exaggerated

Source: Guttmacher Institute

Sexual activity is and has long been rare among the youngest adolescents, according to "Sexual Initiation, Contraceptive Use and Pregnancy Among Young Adolescents," by Lawrence B. Finer and Jesse M. Philbin of the Guttmacher Institute, published online in the journal Pediatrics. Very few early adolescents (both boys and girls) have had sex (0.6% of 10-year-olds, 1.1% of 11-year-olds and 2.4% of 12-year-olds), and the incidence of pregnancy among girls aged 12 or younger is minuscule. But adolescence is a time of rapid change, and sexual activity is more common among older teens, including one-third (33%) of those aged 16, nearly half (48%) of those aged 17, and 61% and 71% of 18- and 19-year-olds, respectively.

Moreover, this pattern has prevailed for decades: A low level of sexual activity among young adolescents has long been the norm, while sexual initiation later in adolescence has been and remains a normal part of teens’ development process. At the same time, however, recent cohorts have delayed starting sex; in the current cohort of adolescents, the likelihood of sexual activity at any given age is lower than at any time in the past 25 years.

2012 Saw Second-Highest Number of Abortion Restrictions Ever

January 7, 2013 Comments off

2012 Saw Second-Highest Number of Abortion Restrictions Ever
Source: Guttmacher Institute

Reproductive health and rights were once again the subject of extensive debate in state capitols in 2012. Over the course of the year, 42 states and the District of Columbia enacted 122 provisions related to reproductive health and rights. One-third of these new provisions, 43 in 19 states, sought to restrict access to abortion services. Although this is a sharp decrease from the record-breaking 92 abortion restrictions enacted in 2011, it is the second highest number of new abortion restrictions passed in a year.

Survey of Countries with Liberal Abortion Laws Finds Abortions Concentrated Among Women in Their 20s

October 24, 2012 Comments off

Survey of Countries with Liberal Abortion Laws Finds Abortions Concentrated Among Women in Their 20s
Source: Guttmacher Institute

A new study of countries with liberal abortion laws finds that abortion is more common among women in their 20s than among women of other ages, according to "Legal Abortion Levels and Trends by Woman’s Age at Termination," by Gilda Sedgh et al. of the Guttmacher Institute. A large body of research has shown that this group often wants to postpone childbearing, which would interrupt their ability to work or complete their schooling; in addition, many young adult women have yet to establish stable partner relationships. The current study found that recent declines in the teen abortion rate in the United States (now at 20 abortions per 1,000 women aged 15–19) have put the United States on par for the first time with several other industrialized countries, including England and Wales, Scotland, Sweden and New Zealand. This marks a considerable change from the mid-1990s, when the U.S. teen abortion rate was substantially higher than that of any other industrialized nation.

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