With tense discussions underway in Congress over publicly funded family planning programs, some long-discredited anticontraception arguments have once again come to the fore. These arguments include claims that contraceptive use is not effective in preventing unintended pregnancy or reducing the abortion rate.
In reality, there is a wealth of evidence demonstrating the obvious: Contraceptive use dramatically reduces unplanned pregnancy. By doing so, it also dramatically reduces abortion, since behind almost every abortion is an unplanned pregnancy.
Guttmacher Institute research shows that the two-thirds of U.S. women at risk of unintended pregnancy who use contraception consistently and correctly throughout the course of any given year account for only 5% of all unintended pregnancies. The 19% of women at risk who use contraception but do so inconsistently account for 44% of all unintended pregnancies, while the 16% of women at risk who do not use contraception at all for a month or more during the year account for 52% of all unintended pregnancies.
It should come as no surprise, then, that most women having abortions were either not using any contraception or were using a method inconsistently. In 2000, the most recent year for which data are available, almost one-half (46%) of abortion patients were not using a contraceptive method in the month they got pregnant. Among the 54% of abortion patients who were using some form of contraception, the overwhelming majority acknowledged that their use was inconsistent, including missing a pill or not using a condom every time. Moreover, this population does not include the large majority of consistent contraceptive users who never became pregnant, and therefore never had a need for abortion services.
The contraceptive method used is also a factor. Users of highly effective methods such as the pill and the IUD are underrepresented among women who have abortions, compared with the general population; users of less effective methods, such as condoms and withdrawal, are overrepresented.
Ensuring that every woman who is sexually active but not seeking pregnancy is able to obtain the contraceptive method that is right for her—meaning the method she will be able to use consistently and correctly—is, therefore, an urgent national priority. In this regard, publicly funded family planning programs such as Title X and Medicaid have a critical role to play, because unintended pregnancy and its consequences, either an abortion or an unplanned birth, are highly concentrated among economically disadvantaged women.
The body of evidence attesting to the effectiveness and cost-effectiveness of publicly funded family planning services is comprehensive and compelling. These services not only improve the health of mothers and babies by helping women time and space their pregnancies, they also prevent almost two million unintended pregnancies each year, which would otherwise result in 860,000 unintended births and 810,000 abortions. Without these services, the number of unintended pregnancies and abortions among poor women in the United States would nearly double, and the number of unintended pregnancies and abortions in the nation as a whole would be nearly two-thirds higher.
That’s why policymakers—including conservatives of all stripes—should strongly support such services. Fiscal conservatives should applaud the fact that, by helping low-income women prevent births they themselves do not want, these services save almost $4 in public expenditures for every $1 invested. Social conservatives should be reassured that without publicly funded family planning services, the U.S. abortion rate would skyrocket. And probusiness conservatives should appreciate the value of enabling women to postpone childbearing while they complete their education, undergo job training or establish themselves in their career.
In short, the message is clear: Contraception works—and consistent, correct use of contraceptives comes close to eliminating the risk of unintended pregnancy. Making contraceptive methods easier to obtain and use is eminently sound public policy. Ultimately, supporting the use of contraceptives reflects the belief that women and their partners—and not politicians or other third parties—know best when the right time is to have children and how many children to have.
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