January 22, 2009, marks the 36th anniversary of Roe v. Wade, the landmark U.S. Supreme Court decision that legalized abortion nationwide. This anniversary comes two days after the inauguration of the first prochoice president in eight years and at the beginning of a new administration and a new Congress whose leaders recognize that behind almost every abortion is an unintended pregnancy.

Although the rate of abortion in the United States has fallen to its lowest level since 1974, slightly more than one in five pregnancies end in abortion, and stark disparities persist in rates of unintended pregnancy and abortion; poor and low-income women are at particularly high risk. Compared with higher income women, poor women are four times as likely to have an unplanned pregnancy, three times as likely to have an abortion and five times as likely to have an unplanned birth. Consequently, the need for publicly funded family planning services is as critical as ever.

Publicly funded family planning clinics provide contraceptive services to about seven million women each year. Without these services, unintended pregnancy rates would be nearly 50% higher for all women and about two-thirds higher among low-income women. According to recent Guttmacher research, 1.4 million unintended pregnancies, which would likely result in about 640,000 unintended births and 600,000 abortions, are averted each year because of these services. Research shows that these services save $4.3 billion in public funds. Nationally, every $1.00 invested in helping women avoid pregnancies they do not want saves $4.02 in Medicaid expenditures that otherwise would be needed—in addition to providing clear benefits to individual women and their families by helping them avoid unintended pregnancies and plan the pregnancies they do want.

Guttmacher research has also found that each $20 million increment in new funding under the Title X family planning services program alone would help women avoid another 17,200 unintended pregnancies, including 7,000 that would end in abortion. Expanding eligibility for Medicaid-covered family planning services nationwide to the same income eligibility levels used for pregnant women would yield even greater results, further reducing unintended pregnancy and abortion by 15%, while achieving an additional $1.5 billion in net savings annually.

While in the Senate, President-elect Obama cosponsored numerous bills, such as the Prevention First Act, aimed at expanding access to contraceptives, health information and preventive services to help women avoid unwanted pregnancies. Senate Majority Leader Harry Reid (NV), himself antiabortion, reintroduced the Prevention First Act in early January, and companion legislation in the House was reintroduced soon thereafter.

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