When cost is not considered, women pick more effective forms of contraception, new research suggests.
Research shows that 62 percent of all women of reproductive age are currently using a contraceptive method, but less than 10 percent of those women are using the most effective forms available, such as intrauterine devices (IUDs) and subdermal implants.
A study by researchers from the University of Utah provided no-cost birth control to 7,400 women and found that when price wasn’t an issue, women were twice as likely to pick the most effective methods available.
The researchers say the findings could be applied to revolutionize contraceptive care across the country.
A study by the University of Utah gave birth control to 7,400 women and found without having cost as an issue, participants were twice as likely to choose the most effective methods such as IUDs (stock image)
The most common method used is the pill, used by 26 percent of American women according to a 2012 survey. When taken perfectly, the pill is 99 percent effective, but because it is nearly impossible to take it perfectly, approximately 9 in 100 pill users will get pregnant every year.
IUDs and implants are considered the most effective methods because they are more permanent and have less chance of human error.
However, only 6.4 percent of birth control users have the IUD and 0.8 percent have the implant.
A key reason for the low rates of IUDs and implants is cost, with both ranging from $0 to $1,300 depending on type and insurance.
Researchers from the University of Utah created the HER Salt Lake Contraceptive Initiative (HER Salt Lake) to evaluate how women choose contraception if cost is not a factor.
HER Salt Lake worked within existing Planned Parenthood clinics, removing all cost obstacles and allowing participants to pick from all effective forms of birth control available with the option to change methods at any time.
There are approximately eight types of reversible female birth control available, and women often have to try several types of birth control before finding the best fit.
‘There really is a contraceptive journey that women go through to find the best fit. There’s not one best option, which is why we wanted women to be able to switch at no cost,’ Jessica Sanders, PhD, a lead author of the study said.
In addition, HER Salt Lake ensured clinics were stocked and had providers on site to facilitate the requested care on the same day.
By eliminating the cost barrier, HER Salt Lake was able to get a more accurate gauge of women’s interest in each method.
‘I was blown away by the number of women who accessed care when cost was removed,’ said Sanders.
‘We thought we might recruit 2,500 women [for the study], but we almost doubled that number.’
In total, the initiative provided no-cost contraception to 7,400 women and enrolled more than 4,400 women in the three-year study.
‘The Family Planning research team at University of Utah has worked for a decade [to] overcome a number of different barriers to help women access different methods of contraception,’ said Turok, senior author on the study.
‘Our research partnership with Planned Parenthood enables us to study the effect of a community-wide intervention that expands the availability of all contraceptive methods to women in Salt Lake County.’
The study was divided into three six-month segments: a control, Intervention 1, and Intervention 2.
The control period set the baseline for what birth control methods women typically selected based on data from Planned Parenthood clinics in Salt Lake County.
For Intervention 1, women seeking services at the same clinics were offered no-cost, same-day access to the contraceptive method of their choice.
In the second intervention, the researchers added an educational component by launching a campaign online.
The study found that women in Intervention 1 were 1.6 times more likely to use an IUD and 2.5 times more likely to use an IUD in Intervention 2 compared to women who enrolled during the control period.
In the next three years, the researchers will send periodic surveys to women enrolled to track the how universal access to family planning influences educational attainment, financial mobility, and sexual satisfaction.
Sanders said the study was based on previous research in Iowa, Colorado and Missouri that found the removal of financial impediments resulted in a higher acceptance of IUDs and implants.
HER Salt Lake is unique because it worked through clinics that were already providing family planning services.
With this study we tried to bolster what clinics in the area were already doing for patients,’ Sanders said.
The team hopes to extent the initiative to other communities in Utah and beyond.
‘Theoretically speaking, this same approach could be used across the country. We’ve learned a lot of different lessons that could be applied to other community initiatives,’ Sanders said.