Colorado’s Effort Against Teenage Pregnancies Is a Startling Success

Sabrina Tavernise, New York Times, July 5, 2015

Over the past six years, Colorado has conducted one of the largest experiments with long-acting birth control. If teenagers and poor women were offered free intrauterine devices and implants that prevent pregnancy for years, state officials asked, would those women choose them?

They did in a big way, and the results were startling. The birthrate among 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.

“Our demographer came into my office with a chart and said, ‘Greta, look at this, we’ve never seen this before,’ ” said Greta Klingler, the family planning supervisor for the public health department. “The numbers were plummeting.”

The changes were particularly pronounced in the poorest areas of the state, places like Walsenburg, a small city in southern Colorado where jobs are scarce and many young women have unplanned pregnancies. Taking advantage of the free program, Hope Martinez, a 20-year-old nursing home receptionist here, recently had a small rod implanted under the skin of her upper arm to prevent pregnancy for three years. She has big plans–to marry, to move farther west and to become a dental hygienist.

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{snip} In 2009, half of all first births to women in the poorest areas of the state happened before they turned 21. By 2014, half of first births did not occur until the women had turned 24, a difference that advocates say gives young women time to finish their educations and to gain a foothold in an increasingly competitive job market.

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{snip} About one-fifth of women ages 18 to 44 in Colorado now use a long-acting method, a substantial increase driven largely by teenagers and poor women.

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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 must 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 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.

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Women’s health advocates contend that long-acting birth control is giving American women more say over when–and with whom–they have children. About half of the 6.6 million pregnancies a year in the United States are unintended. {snip}

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