MMWR Morb Mortal Wkly Rep. 2021 Jun 25;70(25):910-915. doi: 10.15585/mmwr.mm7025a2.
Ensuring access to contraceptive services is an important strategy for preventing unintended pregnancies, which account for nearly one half of all U.S. pregnancies (1) and are associated with adverse maternal and infant health outcomes (2). Equitable, person-centered contraceptive access is also important to ensure reproductive autonomy (3). Behavioral Risk Factor Surveillance System (BRFSS) data collected during 2017-2019 were used to estimate the proportion of women aged 18-49 years who were at risk for unintended pregnancy* and had ongoing or potential need for contraceptive services. During 2017-2019, in the 45 jurisdictions from which data were collected, 76.2% of women aged 18-49 years were considered to be at risk for unintended pregnancy, ranging from 67.0% (Alaska) to 84.6% (Georgia); 60.7% of women had ongoing or potential need for contraceptive services, ranging from 45.3% (Puerto Rico) to 73.7% (New York). For all jurisdictions combined, the proportion of women who were at risk for unintended pregnancy and had ongoing or potential need for contraceptive services varied significantly by age group, race/ethnicity, and urban-rural status. Among women with ongoing or potential need for contraceptive services, 15.2% used a long-acting reversible method (intrauterine device or contraceptive implant), 25.0% used a short-acting reversible method (injectable, pill, transdermal patch, or vaginal ring), and 29.5% used a barrier or other reversible method (diaphragm, condom, withdrawal, cervical cap, sponge, spermicide, fertility-awareness-based method, or emergency contraception). In addition, 30.3% of women with ongoing or potential need were not using any method of contraception. Data in this report can be used to help guide jurisdictional planning to deliver contraceptive services, reduce unintended pregnancies, ensure that the contraceptive needs of women and their partners are met, and evaluate efforts to increase access to contraception.
确保获得避孕服务是预防意外怀孕的重要策略,美国近一半的怀孕(1)都属于意外怀孕,而且与母婴健康不良后果有关(2)。公平、以人为中心的避孕服务获取对于确保生殖自主权也很重要(3)。2017-2019 年期间收集的行为风险因素监测系统(BRFSS)数据用于估计 18-49 岁女性中意外怀孕风险*高且持续或潜在需要避孕服务的比例。在 2017-2019 年期间,在所收集数据的 45 个司法管辖区中,76.2%的 18-49 岁女性被认为有意外怀孕的风险,范围从 67.0%(阿拉斯加)到 84.6%(佐治亚州);60.7%的女性有持续或潜在的避孕服务需求,范围从 45.3%(波多黎各)到 73.7%(纽约)。对于所有司法管辖区的总和,意外怀孕风险高且有持续或潜在避孕服务需求的女性比例按年龄组、种族/族裔和城乡地位而有显著差异。在有持续或潜在避孕服务需求的女性中,15.2%使用长效可逆方法(宫内节育器或避孕植入物),25.0%使用短效可逆方法(注射、药丸、经皮贴片或阴道环),29.5%使用屏障或其他可逆方法(子宫帽、避孕套、撤出、宫颈帽、海绵、杀精剂、基于生育意识的方法或紧急避孕)。此外,30.3%有持续或潜在避孕服务需求的女性未使用任何避孕方法。本报告中的数据可用于帮助指导司法管辖区规划以提供避孕服务,减少意外怀孕,确保妇女及其伴侣的避孕需求得到满足,并评估增加避孕服务的努力。