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The Cost of Abortion, When Providers Offer Services, and Harassment of Abortion Providers All Remained Stable Between 2008 And 2012

July 18, 2014 Comments off

The Cost of Abortion, When Providers Offer Services, and Harassment of Abortion Providers All Remained Stable Between 2008 And 2012
Source: Guttmacher Institute

Access to abortion services is affected by a variety of factors, including the cost of the procedure, the gestational age limits at which providers offer services and antiabortion harassment. According to “Secondary Measures of Access to Abortion Services in the U.S., 2011-2012: Gestational Age Limits, Cost and Harassment,” by Jenna Jerman and Rachel Jones of the Guttmacher Institute, there was relatively little change in any of these measures between 2008 and 2011–2012. The new analysis relies on data from the Institute’s 16th census of all known abortion providers in the United States.

In 2011–2012, the median cost of a surgical abortion at 10 weeks’ gestation was $495, and an early medication abortion cost $500. By comparison, the inflation-adjusted charge in 2009 for the same procedures was $503 and $524, respectively. The cost varied by facility size: facilities with the largest caseloads charged the least ($450), while those that performed fewer than 30 procedures per year charged the most ($650). Because women were more likely to obtain abortions at facilities that charged less, on average, women paid $480 for a surgical procedure at 10 weeks in 2011–2012, compared with $483 in 2009 (adjusted for inflation).

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New Study Documents Reasons Married Women in Developing Nations Who Wish To Avoid Pregnancy Do Not Use Contraceptives

June 24, 2014 Comments off

New Study Documents Reasons Married Women in Developing Nations Who Wish To Avoid Pregnancy Do Not Use Contraceptives
Source: Guttmacher Institute

Increasing women’s access to modern contraceptive methods alone will not satisfy their unmet need for contraception, according to “Reasons for Contraceptive Nonuse Among Women Having Unmet Need for Contraception in Developing Countries,” a new study by Gilda Sedgh and Rubina Hussain of the Guttmacher Institute. The most common reasons married women give for not using a contraceptive method—despite wanting to avoid a pregnancy—have less to do with whether they can obtain contraceptives and much more to do with concerns about possible health risks and side effects or their belief that they don’t have sex frequently enough to warrant using a method.

Among married women who were not using contraceptives, on average 4-8% of those in Asia, Africa and Latin America attributed their non-use to lack of access. However, in a few countries, lack of access was a significant barrier. This reason for nonuse was cited by 18–23% of women in Benin, Cameroon, Congo-Brazzaville, Côte d’Ivoire and Guinea, and by 17% of women in the Philippines (more than twice the proportion of women in any other Asian country).

The researchers found that 23–28% of married women in all three regions who had an unmet need for contraception said they were not using a method because they had experienced or were worried about side effects or health risks. These concerns were especially prevalent in Southeastern Asia (36%) and Eastern Africa (32%). Concerns about side effects and health risks were significantly more common in countries with high levels of unmet need than in countries with the lowest levels of unmet need.

Debate on Ways to Reduce U.S. Abortion Rate Intensifies Even as Abortion Rate Continues to Decline

June 18, 2014 Comments off

Debate on Ways to Reduce U.S. Abortion Rate Intensifies Even as Abortion Rate Continues to Decline
Source: Guttmacher Institute

A new Guttmacher policy analysis notes that, paradoxically, the sharp divide over the means to make abortion rare has only grown more pronounced even as the U.S. abortion rate in 2011 reached its lowest level since 1973. The debate centers on whether the United States should strive to reduce abortion at all costs, or focus instead on reducing the need for it.

“The rival policy approaches of the antiabortion and prochoice movements have become mutually exclusive,” says Joerg Dreweke, author of the analysis. “Antiabortion activists, starting in 2011, have enacted an unprecedented wave of coercive state laws that will likely force growing numbers of women to give birth rather than end an unwanted pregnancy. By contrast, reproductive health advocates back policies like the Affordable Care Act that expand access to contraceptive services to help women prevent unintended pregnancies in the first place, along with the abortions that often follow.”

The analysis details the opposing explanations of why the U.S. abortion rate declined 13% between 2008 and 2011. Antiabortion activists argued that state-level abortion restrictions were responsible and dismissed the idea of contraception playing a role. However, not only did the abortion decline mostly predate the wave of new abortion restrictions, but it was also accompanied by a steep drop in the birthrate, indicating that pregnancy was down overall. This leads to the conclusion that improved contraceptive use, including use of highly effective methods like the IUD and implant, was likely the main driver of the abortion decline by helping to reduce women’s need for the service.

Fact Sheet: American Teens’ Sexual and Reproductive Health

June 11, 2014 Comments off

Fact Sheet: American Teens’ Sexual and Reproductive Health
Source: Guttmacher Institute

•Fewer than 2% of adolescents have had sex by the time they reach their 12th birthday. But adolescence is a time of rapid change. Only 16% of teens have had sex by age 15, compared with one-third of those aged 16, nearly half (48%) of those aged 17, 61% of 18-year-olds and 71% of 19-year-olds. There is little difference by gender in the timing of first sex.
•On average, young people have sex for the first time at about age 17, but they do not marry until their mid-20s.[3] This means that young adults may be at increased risk for unintended pregnancy and STIs for nearly a decade or longer.
•Teens are waiting longer to have sex than they did in the recent past. In 2006–2008, some 11% of never-married females aged 15–19 and 14% of never-married males in that age-group had had sex before age 15, compared with 19% and 21%, respectively, in 1995.

Women Wishing to Avoid Pregnancy Often Use Withdrawal in Conjunction with Other Contraceptive Methods

June 10, 2014 Comments off

Women Wishing to Avoid Pregnancy Often Use Withdrawal in Conjunction with Other Contraceptive Methods
Source: Guttmacher Institute

One-third of women at risk of unintended pregnancy used withdrawal as a contraceptive method within the past 30 days, often in combination or rotation with more effective methods, according to “Pull and Pray or Extra Protection? Contraceptive Strategies Involving Withdrawal Among U.S. Adult Women,” by Rachel K. Jones of the Guttmacher Institute et al. The new study, which is currently available online and will appear in a forthcoming issue of Contraception, also found that 13% of women surveyed reported that withdrawal was the most effective contraceptive method they had used in the last 30 days, while 15% reported that the most effective method used was a long-acting reversible method, 21% condoms and 35% the pill.

The study analyzed national data from 3,276 women aged 18–39 in 2012. It found that among the one-third of women who had used withdrawal in the last 30 days, 12% reported using only withdrawal; the majority of women who practiced withdrawal also used a hormonal method (13%) or condoms (11%) within that time frame.

Women aged 18–24 also were the most likely to have used withdrawal at least once in the last 30 days, and reliance on withdrawal generally decreased as women’s age increased. Moreover, younger women were especially likely to use withdrawal in combination or rotation with more effective methods such as IUDs, the injectable, patches and rings, or with condoms. Although 41% of 18–24-year-olds had used withdrawal at least once in the last 30 days, just 10% relied only on this method. Women in dating relationships and those strongly motivated to avoid pregnancy also had some of the highest levels of combining withdrawal use with condoms or highly effective methods.

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.”

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%).

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