Report: Delaware’s unplanned pregnancy rate likely declining, thanks to IUDs

March 15, 2018

A new report found that Delaware’s unplanned pregnancy rate — one of the worst in the nation — could be on the decline, which health officials attribute to the rise of intrauterine device implantation among Delaware women.

Data has shown that 57 percent of pregnancies are unplanned in Delaware, particularly for women in their 20s.

An unplanned pregnancy is defined as a situation when a woman who is sexually active and not seeking pregnancy becomes pregnant.

The rate is expected to decline about 15 percent among some women because the state partnered with the nonprofit Upstream USA — which helps increase access to birth control, according to a report by Child Trends, a nonpartisan research center.

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Dr. Karyl Rattay, director of the Delaware Division of Public Health, said she is “cautiously optimistic about the numbers” from the report. She said the state has been focused on reducing unplanned pregnancies since they can often result in infant mortality and preterm births. Delaware has historically had high rates in these areas.

“You’re more likely to see a child growing up in poverty and a mother struggling economically,” Rattay said of unplanned pregnancies.

The report is based on estimations made from a simulation model that analyzes fertility rates and the state’s family planning and preventive health services. It looked specifically at patients of Title X providers, including federally qualified health centers, clinics and public school wellness centers.

The report projects that between 2014 to 2016, this rate for people aged 20 to 39 will go from 106 pregnancies per 1,000 women to 89.7 pregnancies per 1,000 women.

That’s because of the dramatic increase in IUD and implant use, said Jennifer Manlove, co-author of the report.

“It indicates that policies can help influence the consistency and effectiveness of contraception use,” she said.

Upstream has helped establish the $10 million Delaware Contraceptive Access Now initiative in 2014. It provides training and technical assistance to 165 health centers on how to provide all forms of contraception, specifically long-acting reversible contraceptives like IUDs and implants.

The organization also launched a website, called Be Your Own Baby, that coordinates rides to nearby health centers for women, both insured and uninsured, to get free birth control.

Mark Edwards, co-founder of Upstream USA, credits the decrease to more women having access to birth control and choosing more effective options. Unplanned pregnancy often happens to women who are using less-effective birth control like the pill or condoms, he said.

The report, commissioned by Upstream, estimated that use of IUDs and implants doubled from 13.7 to 27 percent among women, ages 20 to 39, who are not pregnant or interested in becoming pregnant.

An IUD, a T-shaped piece of plastic that is put into a woman’s uterus to avoid sperm fertilizing an egg, is considered the most effective form of birth control, about 20 times more so than the pill.

This type of contraception can cost up to $1,000, but it lasts up to five years. Many health officials and women like IUDs because a woman doesn’t have to remember to take a pill daily or otherwise rely on medication.

Edwards said hospitals have also started to provide contraception, typically an IUD or implant, to women shortly after they give birth. Instead of women having to come back for an additional appointment, medical staff will do it while women are still in the hospital recuperating from childbirth.

The nonprofit piloted this initiative in Delaware, largely because of its small size and high unplanned pregnancy rate. The goal is to bring a similar program to other states and will reach 1.6 million women over the next five years, Edwards said.

Since Upstream’s work in Delaware will likely come to an end in the next year, Rattay said the state is working on ways to maintain these efforts. It’s very promising that the state could see improvements in a short amount of time, she said.

“It’s been a true gift they chose Delaware,” she said.