On June 24, the Future of the Middle Class Initiative at the Brookings Institution held an event Improving Opportunity Through Access to Family Planning. The event was based on the recent Brookings report Preventing Unplanned Pregnancy: Lessons from the States by Isabel V. Sawhill and Katherine Guyot. The focus of the event was to highlight the benefits of family planning services and the need for increased access to contraception. The event consisted of three panels: state experiences, new approaches, and research and included doctors, academics, and public officials.

The report found that nearly half of all pregnancies in the U.S. are unplanned. Forty percent of these pregnancies end in abortion, while 60 percent result in birth. The report also found that unintended pregnancies are most common among low-income teen women. When a pregnancy is unintended, children and families experience higher rates of negative outcomes. However, recently increased access to birth control has led to decreased unintended pregnancies, fewer abortions, and healthier families.

The report cites two reasons as the key causes of the decline in unintended pregnancies:

• Changed social norms: women are increasingly receiving postsecondary education and becoming the breadwinner of the family.
• Greater access to contraception, especially to long-acting reversible contraceptives (LARCs). LARCS have increased in access and usage, leading the charge in decreasing unintentional pregnancies and empowering women to make decisions about if and when they want to have children.

The report highlighted that access to contraception is becoming increasingly threatening as funding for Title X family planning and Medicaid have been under attack. However, state advocacy initiatives have prevented this from happening through multifaceted plans. Dr. David K. Turok from the University of Utah discussed two of Utah’s public health initiatives advocating for increased birth control, HER and Family Planning Elevated (FPE). In Utah, legislation was passed in 2018 to require Medicaid to cover contraceptive services for low- income individuals, including birth control pills and other methods. Community health organizations provide no-cost services to Medicaid-eligible and uninsured individuals in Utah and training is provided to Utah healthcare providers. Turok employed these two examples to explain how policy is not the only ingredient to create change, but that a multi-faceted approach is necessary to create comprehensive improvement.

Upstream USA Founder and CEO, Mark Edwards, echoed this sentiment, stating that aside from policy and practice, training is one of the essential steps to impactful change and increased contraception access. Upstream works with health centers to provide training and technical assistance on-site to remove barriers for accessing contraceptive methods, including LARCs. Ginny Ehrlich from Power to Decide described the importance of leveling the playing field for information, access, and opportunities about women and birth control. Power to Decide accomplishes this through their website Bedsider, an information source that enables women from all backgrounds to learn about birth control and family planning.