Abstract:
BACKGROUND:Between 2006 and 2008, Iowa increased access to family planning services through a Medicaid expansion and a privately funded initiative. During this same time, Iowa expanded access to abortion through telemedicine provision of medical abortion. Despite increased access to abortion services, abortions in Iowa have declined. This study assessed whether increased provision of long-acting reversible contraception (LARC) may have contributed to the abortion decline. STUDY DESIGN:We analyzed abortion data from Iowa vital statistics and LARC use data from 14 family planning agencies' records (N=544,248) for the years 2005 to 2012. Mixed-effects logistic regression analyses assessed whether changes in the percentage of LARC users were associated with subsequent reductions in abortion across the state. RESULTS:From 2005 to 2012, the number of family planning clients using LARC increased from 539 to 8603 (less than 1% to 15%); the number of resident abortions decreased from 5198 to 3887 (8.7 per 1000 women aged 15-44 to 6.7). There were reduced odds of abortion (adjusted odds ratio, 0.96; 95% confidence interval: 0.94-0.97) with increased LARC use. CONCLUSIONS:Declines in abortion followed increases in LARC use in Iowa.
journal_name
Contraceptionjournal_title
Contraceptionauthors
Biggs MA,Rocca CH,Brindis CD,Hirsch H,Grossman Ddoi
10.1016/j.contraception.2014.10.009subject
Has Abstractpub_date
2015-02-01 00:00:00pages
167-73issue
2eissn
0010-7824issn
1879-0518pii
S0010-7824(14)00733-1journal_volume
91pub_type
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