Substance use disorder: contraceptive options counseling

What’s New in Contraception?

Contraceptive Technology Conference!

Biologic sexism of STIs

Excess breast cancer deaths after COVID-19

Contraception for patients with medical conditions

Pelvic Floor Dysfunction

Treating vulvodynia

Puzzling Over the Hurt Down-Under

Serious Mental Illness and Contraception

New 13-Cycle Vaginal Contraceptive System

The Future of Family Planning in Post-COVID America

New ASCCP Guidelines: Implications for FP

On the alert: mood disorders during 2020 stressors

Sex in the Time of COVID-19

Challenges old and new during the pandemic

Reproductive health in the time of Covid-19

Talking about toys

Missed Pills: The Problem That Hasn’t Gone Away

Find the “yes! . . . and” rather than “no” or “but”

Digital Family Planning: the Future is Now

Irregular Bleeding Due to Contraceptives

When she’s low on libido…

Ouch! Best approaches to menstrual pain

Contraceptive efficacy: understanding how user and method characteristics play their part

Strategizing treatment for chronic heavy menstrual bleeding


Untangling the literature on obesity and contraception

High tech apps for no-tech FABM

Menstrual exacerbation of other medical conditions

From Princeton University: Thomas James Trussell (1949-2018)

The Short and Long of IUD Use Duration

Selecting a Method When Guidance Isn’t Clear-cut

Healthcare in the Time of Digital Expansion

The Scoop on Two New FDA-Approved Contraceptive Methods

Pregnancy of unknown location—meeting the challenge

Big “yes” (with caveats) to CHCs during perimenopause

The role of IUDs (LNG IUDs, too!) in emergency contraception

Combined pills’ effect on mood disorders

Abortion in the U.S.: safe, declining, and under threat

Hope for ovarian cancer screening test

Breast cancer still a small risk with some hormonal contraceptives

New treatment modality for BV

Record rate of HPV-related throat cancer

Viruses in semen potentially transmissible

Don’t Abstain from Your Role in Abstinence

Teens births declining but geographic ‘hotspots’ defy trend

Online Medical Abortion Service Effective and Safe

Do Women Really Need to Wait That Long?

Reassuring news on depression and OC use

PMDD: Genetic clues may lead to improved treatment

Breast cancer risk when there is a family history

Body weight link to breast and endometrial cancers (and 11 others)

Family Planning in 2017 and Beyond

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm


Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use

Alcohol consumption when pregnancy is unwanted or unintended

Latest Data on Contraceptive Use in the United States

LateBreaker sampler from Contraceptive Technology conference

Emergency Contraceptive Pill Efficacy and BMI/Body Weight

Handout on Unintended Pregnancy and Contraceptive Choice

Ask About Withdrawal (Really!)

Rules to Practice By: Safety First and Cleanliness is Close to. . .

What’s Vanity Fair Got Against the NuvaRing?

Promising New Treatment for Hepatitis C

Numbers matter, so make them simple for patients

The Recession’s Effect on Unintended Pregnancies

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

Whatever happened to PID?

Update on Emergency Contraception New and Improved

Good news on the family planning home front!
May 2016


For so long, we have heard that half of all pregnancies in the United States are unintended. The good news is that the statement may no longer hold true. In the most recent analyses by the Guttmacher Institute, the proportion of unintended pregnancies decreased by 18%.[1] This decrease can be seen across a broad swath of demographic groups, including the most vulnerable sub-populations of women.

In 2011, the unintended pregnancy rate was 45%, which was lower than rates reported since 1981. In 2008, just three years earlier than the most recent assessment, the rate was 51%. Teen women ages 15-19 exhibited the greatest reduction since 2008: their rate dropped 28%. In the group with the highest risk of unintended pregnancy, young adult women ages 20-24, the rate dropped 22%.

Not only does age influence the risk for having an unintended pregnancy, but so do income and education levels. Women who were poor and had lower levels of education showed the greatest drop in unintended pregnancy levels, though they continued to have the highest rates of unintended pregnancy. Compared to white women, minority women also continued to have the higher rates despite the dramatic decline between 2008 and 2011. The substantial decrease in rates among these most vulnerable women erased some of disparities generally seen when the unintended pregnancy rates of these women are compared to rates of women with higher education and income and who are non-minority.

The researchers examined abortion rates, but found that these rates had held steady. Despite there being no change in the abortion rate, unintended birth rates decrease due to the decrease in the rate of unintended pregnancies. However, disparities increased in the rates of unintended births among those less likely to afford abortion—the poor and less educated.

Why the downward shift in unintended pregnancies? Sexual behaviors appeared not to change in any way that could account for the decreases. It appears that small changes added up as more women had intended pregnancies, used contraception, and selected highly effective long-acting methods, especially IUDs. Of note, the increase in contraceptive use and the shift to greater use of more effective methods took place before the Affordable Care Act took full effect. What effect will we see once the increased ACA coverage of contraception is measured?

Still, the unintended pregnancy rate is higher than we would like to see it. About 60% of unintended pregnancies occur to women who do not use any contraceptive method.[2] Most likely not to use a contraceptive are women who think they will not get pregnant, perhaps because they believe themselves infertile or are in a phase of the menstrual cycle that they believe places them out of risk. Cohabiting women and women newer to sex are more likely to choose not to use a contraceptive than are women who are married or more sexually experienced. Fear of side effects from contraceptives were a reason for non-use for about 10% of women. Twice that percentage of women (20%) chose not to use a method because although they did not intend to get pregnant, they “did not mind getting pregnant.”

Providers can offer effective contraception, but the most at-risk women, those who use no contraceptive, could benefit from targeted counseling and education about their misconceptions regarding their fertility and risk of pregnancy, their low risk of serious contraceptive side effects, and the need to be in a state of health conducive to a healthy pregnancy should they find themselves with an unintended pregnancy. The Centers for Disease Control and Prevention recommends that all women of reproductive age adopt the following healthy behaviors:[3]

—Submitted by Deborah Kowal, MA, PA, executive editor of Contraceptive Technology

[1] Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008-2011. N Engl J Med 2016;374:843-52.

[2] Mosher W, Jones J, Abma J. Nonuse of contraception among women at risk of unintended pregnancy in the United States.  Contraception 2015;92:170-6.

[3] Centers for Disease Control and Prevention. Unintended pregnancy prevention. Accessed May 2, 2016 at