Contraceptive methods available to patients of office-based physicians and title X clinics --- United States, 2009-2010

Abstract

Unintended pregnancies, which accounted for an estimated 49% of all pregnancies in the United States in 2001, more often are associated with adverse outcomes for both mother and child than are intended pregnancies. In 2008, an estimated 36 million U.S. women of reproductive age were in need of family planning services because they were sexually active, able to get pregnant, and not trying to get pregnant; this represented a 6% increase from year 2000 estimates. To assess the provision of various reversible contraceptive methods by U.S family planning providers, CDC mailed a survey on contraceptive provision to random samples of 2,000 office-based physicians and 2,000 federally funded Title X clinics. This report summarizes those results, which indicated that a greater proportion of Title X clinic providers than office-based physicians offered on-site availability of a number of methods, including injectable depot medroxyprogesterone acetate (DMPA) (96.6% versus 60.9%) and combined oral contraceptive pills (92.1% versus 48.8%). However, a greater proportion of office-based physicians than Title X clinic providers reported on-site availability of the levonorgestrel-releasing intrauterine device (LNG-IUD) (56.4% versus 46.6%). Less than maximal use of long-acting, reversible contraceptive methods (LARCs), including IUDs and contraceptive implants, might be a contributing factor to high unintended pregnancy rates in the United States. Improving contraceptive delivery by increasing on-site availability in physicians' offices and clinics of a range of contraceptive methods, including LARCs, might increase contraceptive use and reduce rates of unintended pregnancy.