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Irregular Bleeding Due to Contraceptives
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Big “yes” (with caveats) to CHCs during perimenopause
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Hope for ovarian cancer screening test
Breast cancer still a small risk with some hormonal contraceptives
Record rate of HPV-related throat cancer
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Breast cancer risk when there is a family history
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Family Planning in 2017 and Beyond
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Managing implant users’ bleeding and spotting
Zika: Updated guidance for providers
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Emergency Contraceptive Pill Efficacy and BMI/Body Weight
Handout on Unintended Pregnancy and Contraceptive Choice
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Rules to Practice By: Safety First and Cleanliness is Close to. . .
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Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative
Applying the “New” Cervical Cytology Guidelines in Your Practice
Acute Excessive Uterine Bleeding: New Management Strategies
Medical indications for IUD use in teens

Did the worst U.S. economic recession in 70 years contribute to an increase in the rate of unintended pregnancy? In 2001, the rate of unintended pregnancies was 49 per 1,000 women aged 15 to 44, but in 2008, that rate increased to 54 per 1,000.[1] At the same time, the rate of intended pregnancies dropped, from 54 to 51.
The shift toward more unintended pregnancies was largely driven by women in their 20s and women who were poor. The twenties represent an age generally more at risk of unintended pregnancy. Following the onset of the recession, the proportion of unintended pregnancies among women age 25 to 29 climbed from 40% to 45%. The rate of unintended pregnancies rose while the rate of intended pregnancies remained stable. Among women age 20 to 24, the proportion of unintended pregnancies also rose, but for a different reason. For these younger adults, the unintended rate remained stable while the rate of intended pregnancies shifted downward.
For poor women, below 200% of the federal poverty level, rate of unintended pregnancy was five times that for all other women. For women at 100% poverty level or below, the rate of unintended pregnancy increased from 197 to 209 per 1,000; for women at 100% to 199%, the rate increased from 145 to 152. The unintended pregnancies among poor women were considerably more likely to result in an unintended birth in 2008 (70%) than in 2001 (63%).
According to The Guttmacher Institute, many women have altered their contraceptive use as a result of the recession.[2] While some women switch to more effective methods or plan to be more careful, other women report trying to save money by switching to a less costly method or using their current method inconsistently or with planned gaps. These behaviors are known to increase the risk of unintended pregnancy. Economic hardship correlates with increased numbers of low-income women and men attending Title X providers.[3] Unfortunately, as demand has grown, funding for Title X services has been cut in many states.
During economic declines, women tend to report being more likely to want to delay having a child. A recent report indicated that the number of births declined 8% in the five years following the onset of the recession.[4] Young women age 20 to 34 were responsible entirely for this decline, as their fertility rate dropped 12% in just three years. Whether the young families will later make up for the foregone births, or will have fewer children, remains to be determined.
–Deborah Kowal, MA, PA, President & CEO, Contraceptive Technology Communications, Inc
[1] Finer LB, Zolna MR. Shifts in intended and unintended pregnancies in the Unites States, 2001-2008. Am J Public Health 2014;104:S43-48.
[2] Gold RB. Recession taking its toll: family planning safety net stretched tin as service demand increases. Guttmacher Policy Review 2010;13 (1).
[3] National Family Planning $ Reproductive Health Association. Title X: recession increased demand for services while shrinking funding. Factsheet 2011.
[4] Johnson KM. Deaths exceed births in record number of U.S. Counties. The Carsey Institute at the Scholars’ Repository. Paper 191.