Objective Status

  • 11 Baseline only
  • 1 Developmental
  • 0 Research

Learn more about objective types

About the Workgroup

Approach and Rationale

Family planning makes it more likely people can have their desired number of children and helps them determine the spacing between pregnancies. It also helps people prevent pregnancy through a variety of contraceptive methods and services. In addition, it involves infertility treatment and preconception health services that can help people get pregnant.

Family planning can help young women who are at increased risk of health problems and death from early childbearing delay pregnancy. It can also help older women who face increased risks related to pregnancy prevent unintended pregnancies. In addition, family planning services contribute to improved health outcomes not only for women but also for infants, children, and families.

Family planning services include:

  • Contraceptive services
  • Pregnancy testing and counseling
  • Services to help people achieve pregnancy, including preconception health services
  • Basic infertility services
  • Sexually transmitted infection and HIV services, including prevention, education, counseling, testing, and referral
  • Broader reproductive health services, including patient education and counseling
  • Breast and pelvic examinations
  • Breast and cervical cancer screening

Abstinence from sexual activity is the only way to prevent unintended pregnancy that is 100 percent effective. 

The goal of the Family Planning topic and related objectives is to improve pregnancy planning and prevent unintended pregnancy.

The Family Planning objectives align with comprehensive, evidence-informed guidelines for the delivery of family planning and related preventive health services and with Title X regulations.

Understanding Family Planning

Unintended pregnancies are associated with many negative health and economic consequences. Unintended pregnancies include pregnancies that are reported by women as being mistimed or unwanted.

In the United States, 51 percent of all births and 68 percent of unintended births were paid for by public insurance programs in 2010. U.S. government spending related to unintended pregnancies was estimated at $21 billion in 2010. This figure includes costs for prenatal care, labor and delivery, postpartum care, and infant care.1

In 2011, 45 percent of pregnancies were unintended, as compared with 51 percent in 2008. The rates of unintended pregnancies differ among subpopulations. In 2011, the rate of unintended pregnancy was highest among women ages 15 to 17 years and 18 to 19 years (72 percent and 76 percent, respectively), women who were never married and not cohabitating (81 percent), women whose income is below the federal poverty level (60 percent), women with a high school diploma or GED equivalent (54 percent), and black non-Hispanic women (64 percent).2

Women with lower levels of education and income, uninsured women, Latina women, and non-Hispanic black women are less likely to have access to family planning services. In addition, men are less likely than women to have access to and receive family planning services.

For women, negative outcomes associated with unintended pregnancy can include delays in starting prenatal care, depression, and an increased risk of experiencing physical violence during pregnancy. Infants born after unintended pregnancies are also at increased risk for negative outcomes. These include birth defects, preterm birth, and low birth weight. In addition, these infants are less likely to be breastfed, which can increase their risk for some health problems, lower educational attainment, and more behavioral issues in their teen years.

Barriers to people’s use of family planning services include:

  • Cost
  • Limited access to publicly funded services
  • Limited access to insurance coverage
  • Family planning clinics with inconvenient locations and hours
  • Lack of awareness of services
  • No or limited transportation
  • Inadequate services for men
  • Lack of youth-friendly services

Emerging Issues in Family Planning

Emerging topics of particular interest include:

  • Opportunities to address substance use disorders in family planning settings and to empower women with substance use disorders to make informed decisions about contraception
  • Chlamydia screening best practices to prevent infertility, such as including chlamydia screening in routine clinical preventive care
  • Early diagnosis and treatment of chronic diseases that could lead to pregnancy complications

Citations

1.

Sonfield, A. & Kost, K. (2015). Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010. Retrieved from https://www.guttmacher.org/report/public-costs-unintended-pregnancies-and-role-public-insurance-programs-paying-pregnancy

2.

Finer, L.B., & Zolna, M.R. (2016). Declines in Unintended Pregnancy in the United States, 2008-2011. New England Journal of Medicine, 374(9), 843-852.