Teenagers had 20 percent fewer babies in Colorado after the state made long-acting birth control like the IUD more accessible, a new study reveals.
Colorado allocated more funding to its Title X clinics – federally subsidized family planning clinics – with the specific purpose of making IUs and implants more readily available to low-income patients.
New research from the National Bureau of Economic Research (NBER) indicates just how effective that program was at driving down teen and unwanted pregnancies without reducing birth rates among older women.
But those improvements are in jeopardy after the Trump administration issued a ‘gag rule,’ denying funding to any Title X clinic that provides abortions or even refers patients for abortions.
Planned Parenthood and other Title X clinics are the only resource not only for abortions but for birth control for many women.
And the new study, conducted by Texas A&M University and Miami University scientists, demonstrates just how key funding for these clinics is to reducing teen pregnancy.
Access to free IUDs (pictured, file image) and other long-acting contraception drove a 20 percent reduction in unintended teen pregnancies in Colorado, a new study found
Nearly half of all pregnancies in the US are unintended, and result in about one third of all births.
In 2015, unintended pregnancies cost American taxpayers $21 billion.
Conversely, federal and state investment in family planning – through Title X – saved the US $13.6 billion in spending on health care and outcomes for women and their families.
Although the proportion of women using some form of contraceptive is higher than it ever has been in the US (over one third), most of these women use patently less effective forms of birth control.
Forms like the pill, patches and condoms are between six and 18 percent effective at preventing pregnancy, largely due to inconsistent use by patients, whereas IUDs have a failure rate under one percent.
Plus, these devices provide protection for anywhere from three to 12 years, so even if patients using them are not regularly seeing a doctor, they will continue to be safeguarded from unintended pregnancy.
Yet only a small proportion of women – 12 percent of adults and five percent of teenagers – use IUDs or implants, according to the new study.
In an effort to change that, Colorado instated its progressive Family Planning Initiative in 2009, using $23 million of private donations to give women free access to long-acting contraception at all of its 68 federally funded Title X clinics.
The program was an enormous success, according to the new research (as well as prior reviews of the effort).
‘Distance to a clinic matters because a lot of work shows that distance does effect the take up of services…so there is much more scope to expanding services than maybe has been documented before,’ co-author Andrea Kelly, a Texas A&M University economics PhD candidate, told DailyMail.com.
‘Investment in these programs and access to these devices is a really strong investment in women and children.’
Kelly and her co-authors looked at how birth rates changed among women living in the vicinity of the clinics (and thus most likely to be low-income) and women of different ages.
For area teenagers (between 15 and 19), the program drove birth rates down by 20 percent.
And for both teenagers and young women between 20 and 29 living further from clinics, uptake of IUDs and implants increase significantly.
The researchers also saw that, after the introduction of the Family Planning Initiative, there was a lower incidence of low birth weights and other complications that make pregnancy and childbearing more costly to taxpayers.
‘It speaks to the fact that the pregnancies that are still occurring are less costly that those that would have occurred in the absence of the program,’ said Dr Kelly.
Overall, the program did not change birth rates for women living further from the clinics or for older women.
Those women – who live more than seven miles from Title X clinics – account for nearly 60 percent of Colorado’s population.
So the study suggests that, successful though it was, more women needed more access to such services to see a greater reduction – not less, as will likely be the result of the Trump administration’s gag rule.
Over a dozen organizations pooled together $2 million to keep the program alive temporarily in 2016. Ultimately, a measure to allocate $5 million in state funding to the initiative for that fiscal year did not pass the Colorado legislature.
Ironically, the new study suggests that the availability of IUDs at Title X-funded clinics also reduced the number of teen pregnancies that ended in abortion.
‘We were not able to do a comparison at the zip code level, but when we compared [data] at the county level, for the women that live within seven miles of a clinic, we found some evidence that abortion falls for teenagers,’ by about 20 percent, Kelly said, although she notes that this data is less precise.
Kelly said the Trump Administration’s gag rule is an effort to discourage abortions without overturning Roe v Wade, but could have a ripple effect for other family planning services that could help to prevent unintended pregnancies and drive down abortion rates.
The new rule ‘is probably not going to help women have access [to long-acting birth control] in any way, and it could potentially have significant effects,’ said Kelly.
‘My sense is that these devices are fairly expensive and the structure of Title X clnics in all cases is that they are sliding scale and their purpose is to serve any women, but in particular low-income women and they have a difficult time providing them access to long-acting contraception.
‘So to cut funds might mean that providing that access is going to be even more difficult.’