Provision of Contraception in New York City School‐Based Health Centers: Impact on Teenage Pregnancy and Avoided Costs, 2008–2017

Rebecca Fisher, New York City Department of Health and Mental Hygiene Phoebe Danza, New York City Department of Health and Mental Hygiene James McCarthy, The City University of New York Lorraine Tiezzi, New York City Department of Health and Mental Hygiene

First published online:

| DOI: https://doi.org/10.1363/psrh.12126
Abstract / Summary

Since 2008, the School‐Based Health Center Reproductive Health Project (SBHC RHP) has supported SBHCs in New York City (NYC) to increase the availability of effective contraception; however, its impact on teenage pregnancy and avoided costs has not been estimated.


The impact of the SBHC RHP on patterns of contraceptive use and on the numbers of pregnancies, abortions and births averted in 2008–2017 was estimated using program data and public data from the NYC Bureau of Vital Statistics and Youth Risk Behavior Survey. Data from the Guttmacher Institute on the cost of publicly funded births and abortions were used to estimate costs avoided; NYC–specific teenage pregnancy outcome data were employed to estimate the proportion of overall declines attributable to the SBHC RHP.


Between 2008 and 2017, the SBHC RHP supported a substantial increase in the proportion of sexually active female clients using effective contraceptives. Most dramatically, 14% of clients in the SBHC RHP method mix used LARCs in 2017, compared with 2% in the non–SBHC RHP mix. The project averted an estimated 5,376 pregnancies, 2,104 births and 3,085 abortions, leading to an estimated $30,360,352 in avoided one‐time costs of publicly funded births and abortions. These averted events accounted for 26–28% of the decline in teenage pregnancies, births and abortions in NYC.


When comprehensive reproductive health services are available in SBHCs, teenagers use them, resulting in substantially fewer pregnancies, abortions and births, and lower costs to public health systems.

Author's Affiliations

At the time the article was written, Rebecca Fisher was director of evaluation, Phoebe Danza was research and evaluation analyst, and Lorraine Tiezzi was director of adolescent health—all in the Office of School Health, New York City Department of Health and Mental Hygiene, New York. James McCarthy is distinguished lecturer, Marxe School of Public and International Affairs, Baruch College, The City University of New York, New York.


The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.