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Here’s what’s new from Guttmacher:
- State Medicaid family planning expansions drive an increase in public funding for contraceptive services
- Increasing IUD use in the United States to European levels poses challenge
- A new analysis shows a decline in contraceptive failure rates
- Degree of happiness about pregnancy may correlate to risk of adverse infant health outcomes for some black women
- A review of studies on the quality of family planning services identifies client preferences and barriers
- Young Asian and Pacific Islander women are at higher risk of STDs than their male counterparts
1. State Medicaid family planning expansions drive an increase in public funding for contraceptive services
Public funding for family planning services nationwide reached $1.85 billion in fiscal year 2006, 63% more than the 1994 funding level, in inflation-adjusted terms. However, inflation-adjusted spending decreased or stagnated in one-third of the states between 1994 and 2006, while other states saw substantial increases, according to "Public Funding for Family Planning, Sterilization and Abortion Services, FY 1980–2006." The growth in overall funding at the national level was driven largely by significant spending increases in the 14 states that had implemented Medicaid family planning expansions by the time of the survey. The number of Medicaid family planning clients in these 14 states grew from 1.8 million to 2.9 million (a 60% increase) between 2000 and 2005.
2. Increasing IUD use in the United States to European levels poses challenge
Both the copper- and hormone-releasing intrauterine devices (IUDs) are considered by experts to have comparatively few side effects, to be relatively inexpensive over the long term, and to be highly effective and safe for women regardless of age and parity. But IUDs are used by only 2% of American women who practice contraception, while usage rates in Europe can rival those of the birth control pill. Increasing the method’s use and accessibility in the United States would require increased IUD insertion training for physicians, up-to-date education efforts for new and midcareer providers, and better public education, according to "Popularity Disparity: Attitudes About the IUD in Europe and the United States," published in the Fall 2007 issue of the Guttmacher Policy Review. An additional challenge is posed by the lingering impact of perceptions of the method from a spate of deaths from septic miscarriage in the early 1970s resulting from the poorly designed Dalkon Shield IUD.
3. A new analysis shows a decline in contraceptive failure rates
Between 1995 and 2002, the probability of contraceptive failure of all reversible methods combined declined by almost 20%. Still, about one in every eight uses of a reversible method resulted in a contraceptive failure during the first year of typical use, including incorrect and inconsistent use, according to "Estimates of Contraceptive Failure from the 2002 National Survey of Family Growth," published in the January 2008 issue of Contraception. Failure rates remain high for users of the condom, withdrawal and fertility-awareness methods, but for all methods, the risk of failure is greatly affected by socioeconomic characteristics of the users. Women older than 30 were significantly less likely to experience a contraceptive failure than were younger women. Also, black women were significantly more likely to experience a contraceptive failure than women of other races and ethnicities.
4. Degree of happiness about pregnancy may correlate to risk of adverse infant health outcomes for some black women
A woman’s level of happiness about her pregnancy may be a better predictor of risky behavior than whether she had intended to become pregnant, with unhappy women at greater risk for smoking, being depressed, drinking and using illicit drugs. According to "Pregnancy Intentions and Happiness Among Pregnant Black Women at High Risk for Adverse Infant Health Outcomes," published in the December 2007 issue of Perspectives on Sexual and Reproductive Health, simple screening questions to assess a woman’s feelings about her pregnancy, the quality of partner relationships and her perceptions of the father’s desire for the pregnancy could help prenatal care providers identify women who are at increased risk for adverse infant health outcomes. The authors caution, however, that the study is based on a nonrepresentative sample of low-income black women and cannot be generalized to other groups.
5. A review of studies on the quality of family planning services identifies client preferences and barriers to good service
Although family planning service quality has received scant attention in the United States, 29 studies conducted over the last two decades help identify service features that enhance women’s care-seeking experiences and features that impede them from receiving quality care. According to "The Quality of Family Planning Services in the United States: Findings from a Literature Review," published in the December 2007 issue of Perspectives on Sexual and Reproductive Health, the most important aspects of family planning service delivery are receiving personalized attention; having staff who spend enough time explaining issues; being able to see the same provider at different visits; receiving care that is technically appropriate; and receiving affordable care. Barriers to services include long waits, inconvenient hours of operation, difficulty reaching providers by phone and unavailability of appropriate language interpretation services.
6. Young Asian and Pacific Islander women are at higher risk of STDs than their male counterparts
A history of STDs is much more common among Asian and Pacific Islander young women (13%) than among young men of the same racial group (4%). Other Asian and Pacific Islander subgroups with a relatively high likelihood of having had an STD are those who have ever been paid money for sex, those who had sex before age 15, those who have had multiple sex partners in the previous 12 months, those who believe that STDs are responsive to treatment and those who believe that STDs have negative effects on relationships, according to "Predictors of STDs Among Asian and Pacific Islander Young Adults," published in the December 2007 issue of Perspectives on Sexual and Reproductive Health. The authors suggest that providers working with Asians and Pacific Islanders focus on their clients’ number of sexual partners and health-related beliefs. The authors also recommend raising public awareness of the risks of STDs among Asian and Pacific Islanders—especially among young women and among communities with large numbers of sex workers—and tailoring interventions for the populations at greatest risk.
“News Providers Can Use” is a quarterly electronic newsletter funded by the Office of Population Affairs of the U.S. Department of Health and Human Services. Visit http://www.guttmacher.org/
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