This story is both encouraging and depressing at the same time. Colorado got some money to give free long-term contraception to teens and poor young women, and discovered that both teenage pregnancy and abortion have plummeted. But they can't get the funding to carry on, so it's not clear how much more they can do, though they will certainly be able to do some more.
The birthrate for teenagers across the state plunged by 40 percent from 2009 to 2013, while their rate of abortions fell by 42 percent, according to the Colorado Department of Public Health and Environment. There was a similar decline in births for another group particularly vulnerable to unplanned pregnancies: unmarried women under 25 who have not finished high school.
But the experiment in Colorado is entering an uncertain new phase that will test a central promise of the Affordable Care Act: free contraception.
The private grant that funds the state program has started to run out, and while many young women are expected to be covered under the health care law, some plans have required payment or offered only certain methods, problems the Obama administration is trying to correct. What is more, only new plans are required to provide free contraception, so women on plans that predate the law may not qualify. (In 2014, about a quarter of people covered through their employers were on grandfathered plans, according to the Kaiser Family Foundation.) Advocates also worry that teenagers — who can currently get the devices at clinics confidentially — may be less likely to get the devices through their parents’ insurance. Long-acting devices can cost between $800 and $900.
“There’s no lifeboat with the Affordable Care Act,” said Liz Romer, a nurse practitioner who runs the Adolescent Family Planning Clinic at Children’s Hospital Colorado, which went from giving out 30 long-acting devices a year in 2009 to more than 2,000 in 2013.
The state failed to get additional funding through the General Assembly this spring, a shortfall Ms. Klingler said would slow, but not stop, the state’s progress.
The state health department estimated that every dollar spent on the long-acting birth control initiative saved $5.85 for the state’s Medicaid program, which covers more than three-quarters of teenage pregnancies and births. Enrollment in the federal nutrition program for women with young children declined by nearly a quarter between 2010 and 2013.
Seems like such a no brainer to not only fully fund this, but to roll it out nationwide. But there's so much obtuseness around contraception -- well, sex in general, really -- here that this is likely to go comletely ignored.
Attitudes to women who have more than one abortion need to change
This piece highlights just how complex and multifaceted contraception and abortion can be.
What some may find most surprising is that most women in our study were using contraception when they became pregnant – particularly those who had undergone a previous abortion. For most interviewees it was the failure of condoms or the pill that resulted in their most recent pregnancy. Many had tried other “long acting” methods, such as contraceptive implants or intrauterine devices in the past, but had experienced problems. What this suggests is that women are not treating abortion “like contraception”, but are having problems finding a method that suits and works for them and their partner.