New data from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS)

I am pleased to share with you some Delaware data that was recently released by the Centers for Disease Control and Prevention (CDC). This new data, together with earlier CDC reports, indicates that from 2014 (our baseline year in Delaware) to 2017, the state saw a 25% reduction in births from pregnancies wanted later or not wanted. This data is an indicator that more women in Delaware are choosing when and if they want to become pregnant on their own terms.

Graph: Delaware experienced a 25% drop in births from pregnancies wanted later or not wanted
Based on reports by the Centers for Disease Control and Prevention (CDC), using data from the Pregnancy Risk Assessment Monitoring System (PRAMS). Births are categorized as wanted then or sooner, wanted later, not wanted, or mother unsure. Percent unintended shown here includes births reported as wanted later or not wanted, as a percent of all births. About the data.

Our initiative to expand voluntary access to the full range of contraceptive methods across the state of Delaware began in 2014. This new data comes from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS). While it is important to note that these findings do not assess causality, this is a steep decline in the percent of births that women themselves indicated were “wanted later or not wanted” (historically referred to as “unintended”).

For the first time at healthcare providers across the state of Delaware, patients are able to choose from the full range of birth control methods in a single visit. A patient at one of our health center partners, Brittany, recently shared her personal story with us. After seeing two cousins experience unplanned pregnancies, she told us how important it is to have access to birth control that works for her:

I knew from a young age that unplanned pregnancy could affect anyone, and could change the course of your life. I got on birth control pills in high school but by the time I was in college, I wasn’t comfortable with my method. I asked my doctor about getting an IUD. It was not a simple thing to do. First, I’d have to come at another time — during the week — because they couldn’t help me then. Second, I was told it could cost $2,000. None of it was feasible. I can’t just skip my classes. And, it’s not like I could go home and ask my parents for money for books, an extra fee, and oh yeah, I also need an IUD.

I called and made an appointment at [an Upstream-trained] clinic nearby. I had a consultation and an IUD placed that same day. I have goals personally and professionally and, in my own family, I’ve seen first hand what would happen if I were to have an unplanned pregnancy. I do want a child someday. It’s good to know I am in control of when that happens.”

Brittany, 22

When combined with other data, this decline in unintended births further suggests that contraception is becoming more widely available across Delaware following the start of our initiative. Results to date showing improvements in contraceptive use suggest a substantial increase in access to and availability of all methods of birth control.

Importantly, patient survey results indicate that over 99% of patients served by Upstream-trained providers either made their own decisions about contraceptive methods or shared decision-making with their provider. We are deeply committed to patient autonomy and choice.

We are so thrilled to begin 2020 with this exciting news. When all patients have access to patient-centered contraceptive counseling and care, more individuals can achieve their own goals of becoming pregnant only if and when they want to.

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