News reports for the last couple weeks have been glowing about a new study that purports to lower abortion rates by offering contraception for free. "Free contraception cuts abortion rates dramatically" is an example from NBC news. This sounds promising, but as usual a closer look at this study tells a very different story.
The study itself is part of the Contraceptive Choice Project in St. Louis. The preliminary results of the study can be found here, and a pdf presentation from the study's main author can be found here. The claim is that this study has shown that increasing access to contraceptives by making them free shows a general decrease in the unplanned pregnancy and the abortion rates. There are a number of reasons to indicate that the study does very little to support that claim.
First, it is important to look at the goals of the study. According to the author the goal were "(1) To increase the acceptance and use of long-term reversible contraceptive (LARC) methods among women of childbearing age and (2) To measure acceptability, satisfaction, side-effects, and rates of continuation across a variety of contraceptive methods, including long-term reversible methods." It was not an attempt to study whether increased access to traditional contraceptives would increase their use and effectiveness, but an attempt to convince women to change the type of contraception that was used. This is very important, and almost never mentioned in the news reports.
Second, the study group itself is very interesting. Dr. Michael New has mentioned that there was no control group to compare the study group to. However, even more important is the characteristics of the group itself. Women who volunteered for the project were recruited mainly from Washington University and various abortion and family planning clinics. In order to be involved in the program, the women had to be desiring contraception and be willing to change the type of contraception that they were presently using (if any). 66% of the women in the program had previously experienced an unintended pregnancy, and 40% of them had a previous abortion. 39% of the women had a history of an STD, and 6% presently had an STD.
Is it possible that this group, who were already seeking contraception and most have experienced an unintended pregnancy, may be more willing and motivated to change their contraceptive method for this study? Data extrapolated from this group of women cannot be accurately applied to the public at large, yet that is exactly what the news media would have us believe.
Anyone who doesn't think this won't be a significant barrier hasn't been paying attention to the other side. For years, family planning clinics have been looking to stop requiring pelvic exams for women who are seeking contraception.
Indeed, according to a consortium of health-care providers and researchers, called Oral Contraceptives Over-the-Counter Working Group (OC-OTC), the annual pelvic exam is still a major barrier to access to contraception for many American women.