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New study shows correlation between free contraceptives and decrease in abortions

This article first appeared in the St. Louis Beacon, Oct. 4, 2012 - Providing free contraceptives could significantly lower the rate of abortions, according to a study conducted at Washington University School of Medicine.

Called the Contraceptive Choice Project, this long-term study has been following a diverse group of 9,256 women from the St. Louis area. The nearly 10,000 participants were provided with multiple options for free contraception, including birth control pills, implants, shots, rings and intrauterine devices (IUDs).

During the study, nearly 75 percent of the women opted to use long-term  methods like IUDs and implants. These can last for long periods of time and don’t require repeated treatments or daily pills. Peipert said that these more effective methods should be the first line of options offered to women.

"If I had cancer or if I had heart disease, I would not want my doctor to say ‘here’s a number of different methods, some are 20 fold less effective but you choose which one you want.’ I’d prefer if they tell me what works best," Peipert said.

Study participant Ashley England said that before the study she had always used birth control pills, simply because that was all she had known to ask her doctor about. During the study she chose to recieve an IUD, and said she was much happier with that method of contraception. 

"I feel like the first thing that could be really positive is saying there are options," England said. "Not just 'what pill do you want.'"

To measure the project’s results, Dr. Jeff Peipert, the study’s author, said that researchers monitored two groups. First was the study group itself. The group’s rate of abortions, which was 4-8 per 1,000, is far below the 2008 national average of 20 abortions per 1,000 people.

The second measure was the number of abortions at Reproductive Health Services. That clinic, which Peipert said performs 90 percent of the abortions for the region, showed a significant decrease in abortion rates when compared to the rest of Missouri.

“We saw absolutely no change (in rates of abortion) among other Missouri residents over time. But (there was) a 21 percent decline (in abortion procedures) between 2008 and 2010 limited to the St. Louis city and county residents,” Peipert said. He said that the study showed a significant decrease in repeat abortions as well.

In relation to the teen birth rate, the study found an even larger difference between its participants and the national rates. Within the study group, six teenagers per 1,000 were pregnant compared to the national rate of 34 per 1,000.

A father of four, Peipert said he believes contraception should be offered to teenagers. He also advocates educating them about the risks of early pregnancy and the health benefits of avoiding early sexual contact, which includes avoiding STDs.

According to the Centers for Disease Control and Prevention, young people aged 15-24 “acquire nearly half of all new STDs.” Teens and young adults run a higher risk than adults of getting STDs due to cultural, behavioral and biological reasons.

“We have to recognize that at some point in our lives, our teens are going to be sexually active whether they’re teens or [in their] 20s,” Peipert said. “We need to talk about the health benefits of avoiding early onset of sexual activity, but also for our teens who are going to become sexually active, we need to protect them with contraception.”

The Beacon contacted Missouri Right to Life representatives several times for comment but as of yet they have not responded.

Start of update: Dr. Katie Plax, the director of adolescent medicine at Washington University, said that only positives can come from providing free contraception. Plax says that this would allow women to plan their lives better.

"We want abortion to be as rare as possible," Plax said. "This study really gives us a path for that to be a reality for women. That makes it very exciting for the future of women, and really the future of families." End update.

Peipert said that women at the highest risk for unintended pregnancy in the United States are women who cannot afford contraceptives. This includes women who have trouble paying for basic necessities. Over a third of the women participating in the study struggled to pay rent and buy clothing and food, according to Peipert.

To enlist these women, Peipert and his fellow researchers recruited from a number of clinics, community health centers and the two major abortion facilities in the region. Word of mouth also played a role in finding volunteers for the study.

The study is still ongoing. The complete roster of female participants has been assembled, and the researchers will continue to follow them until September 2013. Peipert said that the next step will be to publicize the findings and educate people on the benefits of free contraception.

“I believe all women, regardless of socio-economic status, should have access to no-cost contraception,” Peipert said. “Wealthier women, women who have insurance can usually get contraception, but it’s the women who are either poor, don’t have insurance or whose insurance won’t cover contraception that will struggle paying for these methods. And when you think that unintended pregnancies or unplanned pregnancies cost our nation $11 billion-12 billion every year, prevention, in my view, is the way to go.”

Dan Fox is a Beacon intern.

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