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Research shows millions of women lack 'reasonable access' to full range of contraception

November 3, 2016 — Many low-income women lack "reasonable access" to contraception, according to new research released Tuesday by the National Campaign to Prevent Teen and Unplanned Pregnancy, The Atlantic reports (Khazan, The Atlantic, 11/2).

Study details

The researchers defined "reasonable access" as the presence of at least one publicly funded clinic per every 1,000 low-income women (National Campaign to Prevent Teen and Unplanned Pregnancy press release, 11/2).

For the study, the researchers cross-referenced an internal database of family planning providers who are willing to treat women without health insurance against the number of low-income women who have an unmet need for birth control (The Atlantic, 11/2).

Key findings

The researchers found that nearly 20 million women eligible for publicly funded contraceptives in the United States live in a "contraceptive desert," meaning an area that lacks reasonable contraceptive access. The National Campaign noted that the findings "brin[g] to light how limited access is to the full range of methods -- especially the [intrauterine device (IUDs)] and Implant -- for women eligible for publicly funded contraception."

According to The National Campaign, just one in 50 women eligible for publicly funded contraception has reasonable access (National Campaign to Prevent Teen and Unplanned Pregnancy press release, 11/2). Further, the researchers noted that 3,115,910 low-income women live in a county that lacks a single clinic offering the full range of contraceptive methods (National Campaign to Prevent Teen and Unplanned Pregnancy map, accessed 11/3).

Ginny Ehrlich, CEO of The National Campaign, said, "Over the past few years, we have seen tremendous gains in cost coverage for contraception, which is a huge win. However, coverage does not equal access." She continued, "When women have the full range of access to all contraceptive methods, rates of [unintended] pregnancy plummet. That is why we need to ensure that all women can easily access the contraceptive method right for them -- no matter who they are or where they live."

Factors that limit access

According to The National Campaign, time and transportation costs are "ongoing barriers" for low-income women seeking contraceptives, particularly the most effective methods (National Campaign to Prevent Teen and Unplanned Pregnancy press release, 11/2). Further, long-acting reversible contraception (LARC) is not available at all clinics, The Atlantic reports.

Ehrlich said, "This isn't a matter of building new clinics, it's a shift in terms of perspective in what providing contraceptive services means, and focusing on [the] most effective methods."

Kinsey Hasstedt, a senior policy manager at the Guttmacher Institute, noted that clinics might lack staff members who know how to insert IUDs. According to a 2012 study, less than half of family physicians were trained to offer IUDs.

Moreover, some providers who have been trained on how to provide LARC might "forget how or not have the confidence to offer them," according to Eve Espey, chair of the University of New Mexico School of Medicine's Department of Obstetrics and Gynecology. Further, according to The Atlantic, some providers might have misconceptions about IUDs. The 2012 study found that 69 percent of family doctors "would consider" an IUD for an unmarried woman, compared with 87 percent of OB-GYNs, and even fewer family practice physicians would provide an IUD for a woman who just delivered or had an abortion (The Atlantic, 11/2).

Public opinion poll findings

In related news, a separate poll released on Tuesday by The National Campaign found that 81 percent of respondents said they would support efforts or advocate for women to have access to the full range of contraceptive methods. The poll, conducted between Sept. 28 and Oct. 2, surveyed a nationally representative sample of 1,019 participants.

According to the poll, 45 percent of respondents believe that women in their community already have full access to the full range of contraceptive methods, while 48 percent do not think women have such access (National Campaign to Prevent Teen and Unplanned Pregnancy press release, 11/2).