More Contraception Means Fewer Abortions, Study Finds

More access to long-acting contraception methods resulted in fewer abortions, a study of Iowa women found, adding a new facet to the debate over abortion rights and political efforts to restrict them.

According to a study of more than 500,000 Iowa medical records, from 2005 to 2012, the abortion rate in the state fell by 22 percent, according to research to be published in the medical journal Contraception.

The fall in abortions coincided with two trends in the Midwestern state. While number of abortion facilities actually increased -- from 9 to at least 18 during the study period, the number of patients at family planning agencies using long-acting contraceptives, such as intrauterine devices, or IUDs, rose to 15 percent, from less than 1 percent.

The U.S. abortion rate has been declining since the 1990s - - in 2011 it reached its lowest level since the U.S. Supreme court legalized the procedure in 1973 -- yet researchers have been hard-pressed to pinpoint why.

In recent years, state lawmakers have sought to tighten women’s access to the procedure by enacting record numbers of restrictions on providers and patients, leading to the closure of dozens of clinics. In Texas, for instance, legislation passed last year cut the ranks of providers in half, resulting in a 13 percent reduction in procedures.

In Iowa, the increase in facilities providing abortion services, as well as a state-led campaign and Medicaid expansion to boost the availability of long-acting contraceptives among poor women, made it an ideal place to isolate the effects of more widespread contraception use and its relationship to the falling abortion rate, said the study’s lead author.

Body of Evidence

“To our knowledge, this is the first study to explore the relationship between IUD and implant use and reduction in abortion that was able to control for other factors, such as population density, poverty levels and the number of abortion clinics in a region,” according to M. Antonia Biggs, a researcher from the Bixby Center for Global Reproductive Health at the University of California in San Francisco. “Our research adds to the growing body of evidence that an investment in highly effective family planning is money well spent,” Biggs said in a statement.

The researchers, with assistance from Ibis Reproductive Health, a research and advocacy group, used data from Iowa’s Department of Public Health vital statistics reports and from 14 family planning agencies. The increase in clinics offering abortion was fueled by the state’s adoption of telemedicine, which allows doctors to dispense abortion-inducing drugs via phone and videoconference. Some lawmakers in Iowa and elsewhere have since sought to outlaw that process.

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