Advancing Sexual and Reproductive Health and Rights

In Pakistan, nearly half of all pregnancies are unintended

During the past decade, unmet need for family planning has remained high in Pakistan and increases in contraceptive use have been low. A new study, “Induced Abortions and Unintended Pregnancies in Pakistan,” by Zeba Sathar of the Population Council and Susheela Singh of the Guttmacher Institute, found that in 2012, of the approximately nine million pregnancies that occurred in Pakistan, 4.2 million were unintended. Of these unintended pregnancies, 54% resulted in induced abortions and 34% in unplanned births. Click here for more information.

Additional resources:
Fact sheet in Urdu


Unintended pregnancy rates vary widely by state

In 2010, more than half of all pregnancies were unintended in 28 states; in the remainder of states, a minimum of 36% of pregnancies were unintended. The states with the highest unintended pregnancy rates were Delaware (62), Hawaii and New York (61 each), and the lowest rate was in New Hampshire (32)...more


Teen pregnancy rates decline in many countries; U.S. lags behind

In recent decades, despite a considerable decline in teen pregnancy rates in most of the 21 countries with complete statistics, the United States still has the highest teen pregnancy rate among these countries, while the lowest rate is found in Switzerland. The proportion of teen pregnancies that end in abortion varies widely across the 21 countries, even though legal abortion is available on broad grounds in all of them…more


Unplanned births linked to worse infant health outcomes

Compared with women having planned births, those who have unplanned births are less likely to recognize their pregnancy early, to receive early prenatal care or to breast-feed, and are more likely to have low-birth-weight babies. Enabling women to prevent an unintended pregnancy can improve the health of children...more


Three new resources make the case for investing in U.S. family planning services

In the United States, publicly funded family planning services yield numerous positive health outcomes while saving taxpayer dollars. Three new resources—a new policy analysis, a series of state fact sheets and a web tool—which draw on research published by the Guttmacher Institute, make clear the public health and fiscal benefits resulting from this investment...more


Health care providers in Senegal restrict young women’s access to modern contraception

International Perspectives on Sexual and Reproductive Health While there are no official eligibility requirements for obtaining modern contraceptives in Senegal, health care providers often impose age and marital status restrictions on women seeking family planning services, according to a new African Population and Health Research Center study. More than half of the public-sector providers surveyed set age criteria for provision of the pill and slightly fewer than half did so for provision of the injectable―the two methods most often used by young women in urban Senegal...more

REMINDER: As of the March 2015 issue, IPSRH will be published online only. In 2015, IPSRH will be available free to all readers through no-cost online institutional subscriptions from the JSTOR/Current Scholarship Program (CSP) and through our Web site.


In just the last four years, states have enacted 231 abortion restrictions

In just the last 4 years, states have enacted 231 abortion restrictions During the 2014 state legislative session, 15 states enacted 26 new abortion restrictions. Including these new provisions, states have adopted 231 new abortion restrictions since the 2010 midterm elections swept abortion opponents into power in state capitals across the country. Despite the myriad actions to restrict abortion access, some states did take positive steps on abortion as well as other sexual and reproductive health and rights issues, including requiring insurance coverage for contraceptive methods, protecting confidentiality for individuals insured as dependents; and facilitating STI treatment for a patient’s partner...more


The December 2014 issue of Perspectives on Sexual and Reproductive Health is now available

PSRH logo Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. Click here to find out what's in our December 2014 issue.

Call for papers on understudied populations
Perspectives on Sexual and Reproductive Health will dedicate a special section of its December 2015 issue to exploring the sexual and reproductive health needs of understudied populations—individuals with disabilities, incarcerated persons, homeless men and women, military personnel and transgender people, to name but a few. The journal will consider original research and review articles (with a maximum length of 6,000 words), as well as commentaries (up to 3,500 words). The deadline for submission is January 31, 2015. Click here to learn more.


Conflating contraception with abortion is part of a strategic campaign to restrict access to both

Leading U.S. antiabortion organizations promote the falsehood that some common methods of contraception—in particular, emergency contraception and intrauterine devices (IUDs)—constitute abortion. However, they have done so in a deceptive manner, making the claim forcefully in some contexts, most notably when arguing that employers should not be required to cover contraceptive care, but staying silent when the claim would seem too radical...more


Use of highly effective contraceptives in the U.S. continues to rise

Guttmacher calculations based on new U.S. government data document an ongoing shift in the contraceptive method mix toward more effective methods. Significantly, use of LARC methods, such as intrauterine devices (IUDs) and contraceptive implants, jumped to almost 12%, the highest level ever recorded in the United States. These changes not only underscore women’s desire to use the contraceptive method that best meets their needs but likely also have implications for declines in unintended pregnancy and abortion...more


Preventive health fact sheets by federal agency fail to include key sexual and reproductive health services

A series of fact sheets from the U.S. Department of Health and Human Services giving Americans advice on “staying healthy” leaves out many effective sexual and reproductive health–related preventive services. This troubling omission needs to be corrected, argues a new Guttmacher commentary published in Women’s Health Issues...more


Sexual and reproductive health services fall far short of needs in developing regions

Adding It Up cover Our new report finds a staggering lack of basic sexual and reproductive health services in developing countries. Adding It Up: The Costs and Benefits of Investing in Sexual and Reproductive Health 2014, finds that currently 225 million women in developing countries want to avoid pregnancy, but are not using modern contraceptives. In addition, tens of millions of women do not receive the basic pregnancy and delivery care they need to protect their health and that of their newborns. The report documents the number of women who lack services, what it would cost to meet their needs, and the benefits of meeting these needs...more (español, français)

Click here for additional resources with information on the costs and benefits of investing in sexual and reproductive health, including fact sheets, executive summaries, infographics, videos and a slide show.


U.S. law and policy should uphold and support a woman’s personal decisions about her pregnancy

On December 3, the U.S. Supreme Court will hear Young v. United Parcel Service to determine whether the company violated the 1978 Pregnancy Discrimination Act. Writing in the Huffington Post, Guttmacher president and CEO Ann Starrs illustrates the often hostile legal and policy environment U.S. women confront on issues surrounding pregnancy—whether they are looking to have a healthy birth, prevent an unplanned pregnancy or obtain an abortion...more


Health Affairs Blog: The case for advancing access to health coverage and care for immigrant women and families

A web of policy barriers to public and private insurance options effectively keeps millions of immigrant women and their families from affordable health coverage. This in turn makes them less able to obtain the basic health care—including sexual and reproductive health services—they need. Our new post on the Health Affairs Blog argues that removing these barriers would advance the health and economic well-being of immigrant women, their families and society as a whole...more


In Zimbabwe, adolescents lack access to essential health services

Significant numbers of adolescent women in Zimbabwe do not have the essential sexual and reproductive health information and services they need to prevent pregnancy and protect themselves from HIV. A new study released today in Harare by the Centre of Population Studies, University of Zimbabwe and the Guttmacher Institute, finds that approximately 57,000 Zimbabwean adolescents who are sexually active but want to avoid pregnancy are not using contraception and fewer than half of adolescents have comprehensive knowledge about HIV and AIDS...more


Religious exemptions in insurance coverage and the patient-clinician relationship

Religious exemptions to insurance coverage—like those enshrined by the Supreme Court’s Hobby Lobby decision—pose a serious threat to quality medical care, warns our new analysis published in the American Medical Association’s ethics journal, Virtual Mentor. For instance, from the perspective of physicians, such exemptions throw into question whether the services they provide and the prescriptions they write will actually be covered...more


Despite improvements, high levels of unintended pregnancy persist in Malawi

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Although substantial progress has been made, use of modern family planning is still low in Malawi: 40% of women who want to avoid pregnancy do not use modern contraception. This results in high levels of unintended pregnancy—more than half of all pregnancies were unintended in 2013—and a broad range of negative consequences for women, their families and the country’s healthcare system, according to a new report released today by the Guttmacher Institute and the Center for Social Research in Zomba, Malawi...more


U.S. publicly funded family planning effort provides critical preventive care

A new analysis shows just how vital publicly funded family planning care is to ensuring the long-term health of women and their families. The public investment in family planning services not only helps women and couples avoid unintended pregnancy and abortion, but also helps them avoid cervical cancer, HIV and other STIs, infertility, and preterm and low-birth-weight births—all while saving substantial public dollars...more

Click here for detailed appendix tables with state-level data.


Contraception drives decline in teen pregnancy—and expanded access to LARC methods could accelerate this trend

The American Academy of Pediatrics now recommends that pediatricians consider long-acting reversible contraceptive (LARC) methods—IUDs and hormonal implants—as first-line contraceptive choices for adolescents. Contraception is driving the long-term decline in U.S. teen pregnancy and highly effective LARC methods have the potential to help even more teens avoid unintended pregnancy...more


Privately insured women increasingly able to obtain contraceptives with no out-of-pocket costs

The Affordable Care Act’s contraceptive coverage guarantee has had a substantial and rapid impact on eliminating out-of-pocket costs, thereby improving access to a range of methods. A new Guttmacher study shows that the proportion of privately insured U.S. women who paid zero dollars out of pocket for oral contraceptive pills increased from 15% in the fall of 2012 to 67% in the spring of 2014. Similar increases were seen for the vaginal ring, the injectable and the IUD...more

Also see our analysis on the Health Affairs Blog: "Birth Control Pills Should Be Available Over The Counter, But That’s No Substitute For Contraceptive Coverage."


Fully informed patient choice and consent must be central to expanding access to highly effective contraceptive methods

A new analysis in The Guttmacher Policy Review argues that efforts to expand access to highly effective long-acting, reversible contraceptive (LARC) methods in the United States must be grounded in the fundamental principle that all women and couples should be able to make fully informed childbearing decisions freely and for themselves. To do so, it is critical that we ensure unfettered access without unduly steering method choice. Achieving this delicate balance is especially important given the historical context of coercive practices related to contraception that most often targeted disadvantaged groups...more

For the full issue of the Guttmacher Policy Review, click here.

The Guttmacher Institute gratefully acknowledges the general support it receives from individuals and foundations—including major grants from The William and Flora Hewlett Foundation and The David and Lucile Packard Foundation—which undergirds all of its work.