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Access to contraception https://www.acog.org/clinical/clinical…
Access to contraception
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/01/access-to-contraception
Unintended Pregnancy in The United States and the Case for Contraceptive Acces
Unintended pregnancy and abortion rates
Higher than in most other developed countries
Low-income women show high rates
49% of pregnancies in US are unintended
Consequence
Abortion
Carry unintended pregnancy to term
Adoption
$12.5 billion in government expenditures in 2008
Solution
Affordable acces to contraception
Reduce health care costs
Knowledge Defecits
Barriers to contraceptive use
Sexual education
What would be effective
Comprehensive sexuality education
Improve acces and allow safer use
Ineffective
Other risky behavior
Decreasing number of partners
Increasing age of sexual debut
Widespread misperception
Contraceptive effectivenes
Mechanisms of action
Safety
Misperception
Certain types of contraception to be abortifacients
Contraceptives do not interfere with pregnancy
Cost and Insurance Coverage
37 million US woman in need of contraceptive services
Also in need of publicly funded services
Increased by 17%
Expanding acces to these services
Produces cost savings by reducing unintended pregnancy
Federal and State Governaments saved (estimated) 7.6 billion because of this in 2010
Still high out-of-pocket costs
Limit acces contraceptives
Limits on number of contraceptive products dispended
Limited acces on contraceptive refills
Some pharmacies requirements
Fail certain contraceptive methods
before more expensive method
Patients choice and efficacy should be principal factors
Objection to Contraception
Efforts to frame access as an issue of conscience or religious belief
Grave consequences in terms of:
receiving prescriptions from health care providers
obtaining medications from pharmacists
obtaining insurance coverage
receiving care at hospitals
10/25 largest health systems are Catholic-sponserd facilities
Decreased acces to contraception
Barriers (especially for women who live in rural areas)
Pharmacist refusals to fill contraceptive prescriptions
pharmacies that refuse to stock contraceptives,
Health Care Inequities
Rates of adverse reproductive health
higher among low-income and minority women
Unintended pregnancy rates are also the highest
More likely to be uninsured
Has increased substentionally