STUDY: Free Birth Control Leads To Fewer Abortions

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WASHINGTON
(AP) — Free birth control led to dramatically lower rates of abortions
and teen births, a large study concluded Thursday, offering strong
evidence for how a bitterly contested Obama administration policy could
benefit women's health.

The project tracked
more than 9,000 women in St. Louis, many of them poor or uninsured. They
were given their choice of a range of contraceptive methods at no cost -
from birth control pills to goof-proof options like the IUD or a
matchstick-sized implant.

When price wasn't an
issue, women flocked to the most effective contraceptives – the
implanted options, which typically cost hundreds of dollars up-front to
insert. These women experienced far fewer unintended pregnancies as a
result, reported Dr. Jeffrey Peipert of Washington University in St.
Louis in a study published Thursday.

The
effect on teen pregnancy was striking: There were 6.3 births per 1,000
teenagers in the study. Compare that to a national rate of 34 births per
1,000 teens in 2010.

There also were
substantially lower rates of abortion, when compared with women in the
metro area and nationally: 4.4 to 7.5 abortions per 1,000 women in the
study, compared with 13.4 to 17 abortions per 1,000 women overall in the
St. Louis region, Peipert calculated. That's lower than the national
rate, too, which is almost 20 abortions per 1,000 women.

In
fact, if the program were expanded, one abortion could be prevented for
every 79 to 137 women given a free contraceptive choice, Peipert's team
reported in the journal Obstetrics & Gynecology.

The
findings of the study, which ran from 2008 to 2010, come as millions of
U.S. women are beginning to get access to contraception without copays
under President Barack Obama's health care law. Women's health
specialists said the research foreshadows that policy's potential
impact.

“As a society, we want to reduce
unintended pregnancies and abortion rates. This study has demonstrated
that having access to no-cost contraception helps us get to that goal,”
said Alina Salganicoff, director of women's health policy at the Kaiser
Family Foundation.

“It's just an amazing
improvement,” Dr. James T. Breeden, president of the American College of
Obstetricians and Gynecologists, said of the results. “I would think if
you were against abortions, you would be 100 percent for contraception
access.”

The law requires that Food and Drug
Administration-approved contraceptives be available for free for women
enrolled in most workplace insurance plans, a change that many will see
as new plan years begin on Jan. 1.

The policy
is among the law's most contentious provisions because it exempts
churches that oppose contraception but requires religious-affiliated
organizations, such as colleges or hospitals, to provide the coverage
for their workers. The U.S. Conference of Catholic Bishops and many
conservative groups say that violates religious freedom, and Republican
presidential nominee Mitt Romney has voiced similar criticism.

This
week, a federal judge in St. Louis dismissed a lawsuit challenging the
contraception mandate; nearly three dozen similar suits have been filed
around the country.

Thursday's data didn't sway the critics.

Jeanne Monahan of the conservative Family Research Council suggested contraceptive use can encourage riskier sexual behavior.

“Additionally,
one might conclude that the Obama administration's contraception
mandate may ultimately cause more unplanned pregnancies since it
mandates that all health plans cover contraceptives, including those
that the study's authors claim are less effective,” Monahan said.

Here's
why this is a public health issue: Nearly half of the nation's 6
million-plus pregnancies each year are unintended. An estimated 43
percent of them end in abortion. Low-income women are far more likely to
have an unplanned pregnancy than their wealthier counterparts.

“We
shouldn't have, in my view, a tiered system where the women with money
can get family planning and the women without cannot,” said Peipert,
noting that 39 percent of the women in his study had trouble paying
basic expenses.

About half of unplanned
pregnancies occur in women who use no contraception. As for the other
half, condoms can fail and so can birth control pills or other
shorter-acting methods if the woman forgets to use them or can't afford a
refill.

In contrast, you can forget about
pregnancy for three years with Implanon, the implant inserted under the
skin of the arm. An IUD, a tiny T-shaped device inserted into the
uterus, can last for five to 10 years, depending on the brand. Change
your mind, and the doctor removes either device before it wears out.

Only
about 5 percent of U.S. women use long-acting contraceptives, far fewer
than in other developed countries. Peipert said insurance hasn't always
covered the higher upfront cost to insert them, even though years of
birth control pills can add up to the same price.

Yet
three-quarters of his study participants chose an IUD or Implanon, and a
year later 85 percent were sticking that choice – compared to about
half who had initially chosen the pill, patch or other shorter-acting
method.

Cost isn't the only barrier. Doctors
don't always mention long-acting methods, maybe because of a
long-outdated belief that IUDs aren't for young women or just because
they assume women want the most commonly prescribed pill.

That
was the case for Ashley England, 26, of Nashville, Tenn., who enrolled
in the study while in graduate school in St. Louis. She had taken birth
control pills for years but struggled with a $50 monthly copay. She
switched to a five-year IUD, and loves that she and her husband don't
have to think about contraception.

“No one had
ever presented all the options equally,” England said. “It's not
telling you what to do. It's giving you a choice unhindered by money.”

Copyright 2012 by The Associated Press. All rights reserved.

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