Programs that broaden access to long-acting reversible contraceptive (LARC) methods for young, low-income women could reduce their rates of unintended pregnancy and abortion, according to a new study, "Game Change in Colorado: Widespread Use of Long-Acting Reversible Contraceptives and Rapid Decline in Births Among Young, Low-Income Women," by Sue Ricketts, of the Colorado Department of Public Health and Environment, et al. The researchers found that a program that provided Title X–funded clinics in Colorado with additional financial support to facilitate patients’ access to LARC methods (IUDs and implants) and expand clinic capacity may have contributed to considerable declines over a three-year period in birthrates and abortion rates among low-income 15–24-year-old women.

The study analyzed data from 28 Title X–funded agencies in Colorado that began receiving funds in 2009 to train providers, finance the provision of LARC methods and increase the number of patients the clinics could see. LARC use among 15–24-year-old clinic clients quadrupled between 2008 and 2011, going from less than 5% to more than 19%. By 2011, in counties where the program was implemented, birthrates among low-income 15–19-year olds were 29% lower than expected on the basis of prior trends, and birthrates among 20–24-year-olds were 14% lower than expected. During the same period, abortion rates in these counties fell 34% and 18%, respectively, among all women aged 15–19 and 20–24.

"Expanded LARC access greatly increases women’s ability to avoid unplanned pregnancy," Ricketts says. "By allowing young women to determine for themselves when to start a family, it enables them to confidently pursue their personal, educational and career goals."

The authors highlight that the expansion of insurance coverage under the Affordable Care Act and its contraceptive coverage guarantee will increase women’s access to the full range of methods, including LARC methods, making these contraceptive options available to women who might otherwise not be able to obtain them because of cost.

"Game Change in Colorado: Widespread Use of Long-Acting Reversible Contraceptives and Rapid Decline in Births Among Young, Low-Income Women," by Sue Ricketts, of the Colorado Department of Public Health and Environment, et al., is currently available online in Perspectives on Sexual and Reproductive Health.