Disparities in Contraceptive Access and Provision
Abstract and Introduction
Even though contraceptive coverage expands under the Patient Protection and Affordable Care Act, reducing disparities in contraceptive access and provision requires that all providers assess their patient's reproductive life plans and that health systems work to minimize institutional and socioeconomic barriers. In this article, the challenges of providing equal access to contraceptive care, as well as recommendations for encouraging the use of effective contraception among all reproductive age women are reviewed.
More than 43 million women in the United States are at risk for an unintended pregnancy. Among women at risk, those who use contraception consistently and correctly year-round account for only 5% of unintended pregnancies. In keeping with The Healthy People 2020 family planning objectives and the Centers for Disease Control recommendation that "every woman, man, and couple should be encouraged to have a reproductive life plan," passage of the Patient Protection and Affordable Care Act (ACA) expands contraceptive coverage as preventative care. Meeting these objectives will require providers to address disparities in contraceptive access and usage among diverse groups of women. This will include adolescents, women with military careers, women of older reproductive age, various sexual orientations, across ethnicities, as well as patients with medical conditions for whom reproductive health is often overlooked. Just as menstrual history has become a fifth vital sign, contraceptive history should be considered an important part of the initial intake information. To address the unacceptably high unintended pregnancy rates in this country, it is imperative that health systems work to minimize institutional and socioeconomic barriers.