Tuesday, April 27, 2010

Fifty Years and a Long Way to Go

Next month marks the 50th birthday of the birth control pill in the United States, prompting a TIME Magazine cover story, various histories of contraception, and the looming question: why, after half a century, are almost half of all pregnancies in the U.S. still unplanned?

Of the 3.1 million unintended pregnancies per year, almost half (48%) involve contraceptive failures. In 52% of the cases, couples used no birth control at all. As Melinda Beck of the Wall Street Journal points out, to begin to answer this question, we must untangle a complex web of cultural, religious, behavioral, educational and economic factors.

Contraception still presents a financial barrier for many people, complicated by culture and religion. Though most insurers now cover contraceptives, co-pays and deductibles can still present obstacles, and as was drilled into our heads earlier this year, before the reform bill, over 49 million Americans were uninsured.

Yet more importantly, Beck points to the behavioral tendencies which have failed to stop unplanned pregnancies:
And many young people are in "the fog zone" in which their beliefs about pregnancy don't match their behaviors, according to a 2009 report by the National Campaign to End Teen and Unplanned Pregnancy. In a survey conducted by the Guttmacher Institute of 1,800 single men and women aged 18 to 29, more than 80% of both sexes said it was important to them to avoid pregnancy right now, yet 43% of those who are sexually active said they used no contraception or used it inconsistently.

This is where we come in.

Though we've gone a long way in the 50 years since the pill's FDA approval, it's clear that the need for education, support, and resources is still immense.

There is no doubt that sex education works and yet CT is one of only a few states that does not require a graduation requirement of one credit in health education. According to the Guttmacher Institute:
Connecticut has the 33rd highest teenage pregnancy rate of any state.
432,000 women are in need of contraceptive services and supplies. Of these, 165,960 women need publicly supported contraceptive services because they have incomes below 250% of the federal poverty level (106,520) or are sexually active teenagers (59,440).
Publicly funded family planning clinics in Connecticut help women prevent 16,400 unintended pregnancies each year.


So why, in a world of countless pills, the ring, the patch, implants, and condoms for women and men, do women still get pregnant unintentionally? Because without the availability of comprehensive services, adequate public funding, or supportive laws and policies, a victory fifty years ago can only take us so far.

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