One US state's public health initiative is transforming the way to think about birth control

Couple skiing happy marriageREUTERS/Rick WilkingTodd and Nathalie Rainville ski together just after being married at Loveland ski area in Georgetown, Colorado February 14, 2006.

Birth control works, and some forms work better than others.

It’s hard to come to any other conclusion after reading the crazy statistics coming out of Colorado, which just emerged from a public health experiment which consisted of giving more than 30,000 women free, long-acting birth control at health clinics throughout the state over a period of six years.

Between 2009 and 2015, “teen births dropped 40 per cent, abortions fell 35 per cent and the state avoided more than $US80 million in Medicaid costs,” according to the Colorado Department of Public Health and Environment’s website.

The New York Times reports that the changes “were particularly pronounced in the poorest areas of the state, places like Walsenburg, a small city in Southern Colorado where jobs are scarce and unplanned births come often to the young.”

This parallels a secular decline in the teen birth rate throughout the country. However, the Times reports that “experts say the timing and magnitude of the reductions in Colorado are a strong indication that the state’s program was a major driver. About one-fifth of women ages 18 to 44 in Colorado now use a long-acting method, a substantial increase driven largely by teenagers and poor women.”

The emphasis on long-acting contraception, like intrauterine devices (IUDs) and implants, is important because the devices are permanent and last for years.

By comparison, a woman who is taking the pill must take it every single day (at the same time each day) and refill the prescription every month. If she forgets just one day, or can’t pick up her prescription on time one month, she is at risk of getting pregnant.

According to a study in the New England Journal of Medicine, about 9% of women using the pill, patch, or ring for three years will get pregnant. Further, teenagers are about twice as likely to get pregnant as adults because they so often miss or skip days.

Long-acting solutions, by contrast, don’t require any action once they are inserted by a doctor. They are just there, and they nearly always work — the same NEJM study found that about 2% of women using an IUD for three years got pregnant.

Even as the program is touting its success, though, it’s in danger of collapsing. The Times notes that until now, it has been funded privately by the Susan Thompson Buffett Foundation (named after Warren Buffett’s late wife).

A release on the Colorado Department of Public Health’s website says it is searching for new funding. Without it, the program will have to shut down.

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