Department of Epidemiology and Biostatistics, Michigan State University, 939 Fee Road, East Lansing, MI 48825, United States.
Department of Epidemiology and Biostatistics, Michigan State University, 939 Fee Road, East Lansing, MI 48825, United States.
Contraception. 2020 Jan;101(1):34-39. doi: 10.1016/j.contraception.2019.09.003. Epub 2019 Oct 23.
OBJECTIVE(S): The Affordable Care Act contraception mandate could reduce unintended pregnancies by increasing access and affordability of contraceptive resources, e.g., long-acting reversible contraceptives (LARCs). We assessed: (1) whether unintended pregnancies decreased post-mandate, and (2) whether this decrease differed by demographic characteristics.
We used data from the National Survey of Family Growth (unweighted n = 7409) in logistic regression analyses to compare odds of unintended pregnancy pre-mandate (2008-2010) vs post-mandate (2013-2015), overall and stratified by demographic characteristics.
Paralleling an increase in long-acting reversible contraceptive use (p < 0.01), post-mandate, the odds of experiencing unintended pregnancy in the prior year decreased 15% overall (OR: 0.85, 95% CI: 0.62, 1.17), with the greatest reduction observed among women with government-sponsored insurance (OR: 0.63, 95% CI: 0.41, 0.97).
Unintended pregnancy decreased following the contraception mandate, although possibly due to chance. The short study period relative to the mandate could under-estimate the mandate's effect.
平价医疗法案的避孕强制令可以通过增加避孕资源的可及性和可负担性，例如长效可逆避孕措施（LARCs），来减少意外怀孕。我们评估了：（1）避孕令颁布后意外怀孕是否减少，以及（2）这种减少是否因人口统计学特征而有所不同。
我们使用了国家家庭增长调查（未加权 n=7409）的数据，通过逻辑回归分析比较了避孕令颁布前（2008-2010 年）和颁布后（2013-2015 年）的意外怀孕的可能性，总体上以及按人口统计学特征进行分层。
与长效可逆避孕措施使用的增加相一致（p<0.01），避孕令颁布后，过去一年意外怀孕的几率总体上降低了 15%（OR：0.85，95%CI：0.62，1.17），其中政府赞助保险的女性减少幅度最大（OR：0.63，95%CI：0.41，0.97）。
尽管可能是偶然的，但避孕令颁布后意外怀孕的情况有所减少。与避孕令相比，研究期间相对较短可能低估了避孕令的效果。
