Foster Diana Greene, Biggs M Antonia, Amaral Gorette, Brindis Claire, Navarro Sandy, Bradsberry Mary, Stewart Felicia
Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA, USA.
Perspect Sex Reprod Health. 2006 Sep;38(3):126-31. doi: 10.1363/psrh.38.126.06.
During its first year of operation (1997-1998), California's family planning program, Family PACT, helped more than 750,000 clients to avert an estimated 108,000 pregnancies. Given subsequent increases in the numbers of clients served and contraceptive methods offered by the program, updated estimates of its impact on fertility are needed.
Claims data on contraceptives dispensed were used to estimate the number of pregnancies experienced by women in the program in 2002. Medical record data on methods used prior to enrollment were used to predict client fertility in the absence of the program. Further analyses examined the sensitivity of these estimates to alternative assumptions about contraceptive failure rates, contraceptive continuation and contraceptive use in the absence of program services.
Almost 6.4 million woman-months of contraception, provided primarily by oral contraceptives (57%), barrier methods (19%) and the injectable (18%), were dispensed through Family PACT during 2002. As a result, an estimated 205,000 pregnancies-which would have resulted in 79,000 abortions and 94,000 births, including 21,400 births to adolescents-were averted. Changing the base assumptions regarding contraceptive failure rates or method use had relatively small effects on the estimates, whereas assuming that clients would use no contraceptives in the absence of Family PACT nearly tripled the estimate of pregnancies averted.
Because all contraceptive methods substantially reduce the risk of pregnancy, Family PACT's impact on preventing pregnancy lies primarily in providing contraceptives to women who would otherwise not use any method.
在其运营的第一年（1997 - 1998年），加利福尼亚州的计划生育项目“家庭生育计划”（Family PACT）帮助超过75万名客户避免了约10.8万次意外怀孕。鉴于该项目后续服务客户数量和提供的避孕方法有所增加，需要对其对生育率影响的估计进行更新。
使用所发放避孕药具的申领数据来估计2002年该项目中女性经历的怀孕数量。利用登记前使用避孕方法的医疗记录数据来预测在没有该项目情况下客户的生育情况。进一步分析检验了这些估计对避孕失败率、避孕持续时间以及在没有项目服务时避孕使用情况等替代假设的敏感性。
2002年通过“家庭生育计划”发放了近640万妇女 - 月的避孕措施，主要包括口服避孕药（57%）、屏障法（19%）和注射剂（18%）。结果，估计避免了20.5万次意外怀孕，这些意外怀孕原本会导致7.9万次堕胎和9.4万次生育，其中包括2.14万次青少年生育。改变关于避孕失败率或方法使用的基础假设对估计结果影响相对较小，而假设在没有“家庭生育计划”的情况下客户不使用任何避孕措施，会使避免怀孕的估计数几乎增加两倍。
由于所有避孕方法都能大幅降低怀孕风险，“家庭生育计划”对预防怀孕的影响主要在于为那些否则不会使用任何避孕方法的女性提供避孕药具。
