Family Planning

Goal

Improve pregnancy planning and spacing, and prevent unintended pregnancy.

Overview

Family planning is one of the 10 great public health achievements of the 20th century.¹ The availability of family planning services allows individuals to achieve desired birth spacing and family size, and contributes to improved health outcomes for infants, children, women, and families.¹

Family planning services include:

• Contraceptive and broader reproductive health services, including patient education and counseling
• Breast and pelvic examinations
• Breast and cervical cancer screening
• Sexually transmitted infection (STI) and human immunodeficiency virus (HIV) prevention education, counseling, testing, and referral
• Pregnancy diagnosis and counseling^{2, 3, 4}

Abstinence from sexual activity is the only 100 percent effective way to avoid unintended pregnancy. For individuals who are sexually active and do not want to become pregnant or cause a pregnancy, correct and consistent contraceptive use is highly effective at preventing unintended pregnancy. The most effective methods to prevent unintended pregnancy include long-acting reversible contraceptives such as intrauterine devices (IUDs) and contraceptive implants. Condoms protect against both unintended pregnancy and STIs, and their use should be encouraged. Both men and women should be counseled about using condoms at every act of sexual intercourse, when not in a long-term, mutually monogamous sexual relationship.

Why is Family Planning Important?

For many women, a family planning clinic is the entry point into the health care system and one they consider their usual source of care.2, 5 Each year, publicly funded family planning services prevent 1.94 million unintended pregnancies, including 400,000 teen pregnancies.³ These services are cost-effective, saving nearly $4 in Medicaid expenditures for pregnancy-related care for every $1 spent. ^{2, 6}

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. Almost half of all pregnancies in the United States are unintended.⁷ The public costs of births resulting from unintended pregnancies were $11 billion in 2006. (This figure includes costs for prenatal care, labor and delivery, post-partum care, and 1 year of infant care).⁸

For women, negative outcomes associated with unintended pregnancy can include:

• Delays in initiating prenatal care.
• Reduced likelihood of breastfeeding, resulting in less healthy children.
• Maternal depression.
• Increased risk of physical violence during pregnancy.^{9, 10, 11, 12}

Births resulting from unintended pregnancies can have negative consequences including birth defects and low birth weight.¹³ Children from unintended pregnancies are more likely to experience poor mental and physical health during childhood, and have lower educational attainment and more behavioral issues in their teen years.⁹

The negative consequences associated with unintended pregnancies are greater for teen parents and their children. Eighty-two percent of pregnancies to mothers ages 15 to 19 are unintended.⁷ One in five unintended pregnancies each year is among teens^.7 Teen mothers:

• Are less likely to graduate from high school or attain a GED by the time they reach age 30.
• Earn an average of approximately $3,500 less per year, when compared with those who delay childbearing until their 20s.
• Receive nearly twice as much Federal aid for nearly twice as long.^{14, 15}

Similarly, early fatherhood is associated with lower educational attainment and lower income.^{14, 16}

The average annual cost of teen childbearing to U.S. taxpayers is estimated at $9.1 billion, or $1,430 for each teen mother per year.¹⁵ Moreover, children of teen parents are more likely to have lower cognitive attainment and exhibit more behavior problems.^{14, 15, 16} Sons of teen mothers are more likely to be incarcerated, and daughters are more likely to become adolescent mothers.¹⁶

Additional Resources

HP2020's National Objectives for Family Planning
HHDW Reports on Family Planning

References

1. Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: Family planning. MMWR Weekly. 1999 Dec 3;48(47):1073-80. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htm
2. Gold RB, Sonfield A, Richards C, et al. Next steps for America’s family planning program: Leveraging the potential of Medicaid and Title X in an evolving health care system. New York: Guttmacher Institute; 2009. Available from: http://www.guttmacher.org/pubs/NextSteps.pdf
3. Guttmacher Institute. In brief: Facts on publicly funded contraceptive services in the United States. Washington; Guttmacher Institute; 2010 April. Available from: http://www.guttmacher.org/pubs/fb_contraceptive_serv.pdf
4. Lindberg L, Frost J, Sten C, et al. Provision of contraceptive and related services by publicly funded family planning clinics, 2003. Perspect Sex Reprod Health. 2006 Sep;38(3):139-47.
5. Frost J. US women’s reliance on publicly funded family planning clinics as their usual source of medical care. Paper presented at National Survey of Family Growth Research Conference; 2008 Oct; Hyattsville, MD.
6. Frost J, Finer L, Tapales A. The impact of publicly funded family planning clinic services on unintended pregnancies and government cost savings. J Health Care Poor Underserved. 2008 Aug;19(3):778-96.
7. Finer L, Henshaw S. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health. 2006 Jun;38(2):90-6.
8. Sonfield A, Kost K, Gold RB, et al. The public costs of births resulting from unintended pregnancies: National and state-level estimates. Perspect Sex Reprod Health. 2011 Jun;43(2):94-102. Available from: http://www.guttmacher.org/pubs/psrh/full/4309411.pdf
9. Logan C, Holcombe E, Manlove J, et al. The consequences of unintended childbearing: A white paper [Internet]. Washington: Child Trends, Inc.; 2007 May. Available from: http://www.childtrends.org/Files//Child_Trends-2007_05_01_FR_Consequences.pdf
10. Cheng D, Schwarz E, Douglas E, et al. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009 Mar;79(3):194-8.
11. Kost K, Landry D, Darroch J. Predicting maternal behaviors during pregnancy: Does intention status matter? Fam Plann Perspect. 1998 Mar–Apr;30(2):79-88.
12. D’Angelo D, Gilbert BC, Rochat R, et al. Differences between mistimed and unwanted pregnancies among women who have live births. Perspect Sex Reprod Health. 2004 Sep–Oct;36(5):192-7.
13. Centers for Disease Control and Prevention. Preconception and interconception health status of women who recently gave birth to a live-born infant—pregnancy risk assessment monitoring system (PRAMS), United States, 26 Reporting Areas, 2004. MMWR Weekly. 2007 Dec 14;56(SS-10):1-40. Available from: http://www.cdc.gov/mmwr/pdf/ss/ss5610.pdf
14. Hoffman S, Maynard R, eds. Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy, 2nd ed. Washington: Urban Institute Press; 2008.
15. Hoffman S. By the Numbers: The Public Costs of Teen Childbearing. Washington: National Campaign to Prevent Teen Pregnancy; 2006. Available from: http://www.thenationalcampaign.org/costs/pdf/report/BTN_National_Report.pdf
16. Elfenbein DS, Felice ME. Adolescent pregnancy. Pediatr Clin North Am. 2003 Aug;50(4):781-800, viii.

Objectives

Download all Family Planning Objectives