Pregnancy Planning and Prevention: the Big Picture

Health reform must include pregnancy planning and prevention services, which will improve health, strengthen families, improve child well-being, enhance our workforce, and reduce taxpayer burden.

Lisa Shuger is the Director of Public Policy at the National Campaign to Prevent Teen and Unplanned Pregnancy. This piece is cross-posted from the National Campaign’s blog, Pregnant Pause.


Over the past several months Congress has been working at a fast
pace to get comprehensive health reform legislation to the President’s
desk before the end of this year.

Two Senate committees are working on bills which they will
ultimately merge into one and send to the full Senate for a vote
sometime before Congress adjourns for the August recess.

Meanwhile, there are three committees in the House that are working
on health reform. The House committees are collaborating to produce one
bill, which is also expected to be voted on by the full House by early
August. Broad outlines of a "Tri-Committee" draft bill were circulated
last week.

Looking at the various draft proposals that have already been released, it is clear that Congress is making a historic effort to reform health care, as is the Obama administration.
Yet with so many "big picture" issues to grapple with, like spiraling
health care costs, access and affordability, employer mandates, taxing
benefits, and whether to include a public plan option, it’s hard to get
Congress’s attention on some of the "smaller issues," such as pregnancy
planning and prevention. However, pregnancy planning and prevention
affects the lives of most Americans who would benefit from health
reform, and therefore, is very much a part of the "big picture."

Consider this: Half of all pregnancies in the United States are unplanned. We know that family planning services are widely used and broadly supported: 98 percent
of sexually active women have used some form of family planning.
Pregnancy planning and prevention is also cost-effective. Contraceptive
use saves nearly $19 billion in direct medical costs each year. And if politics are the issue, 88 percent of voters support women’s access to contraception, and 72 percent of Republicans and Independents favor legislation that would make it easier for people at all income levels to obtain contraception.

Given the health, economic, and social consequences of unplanned pregnancy,
Congress should pass health reform that: (1) includes pregnancy
planning and prevention as an integral component of any basic benefit
package; (2) complements private sector health initiatives with strong,
publicly-financed family planning services for those individuals who do
not otherwise have access to high quality, affordable family planning;
(3) encourages responsible behavior among men and women by including
pregnancy prevention within the broader scope of prevention and
wellness; (4) strengthens the practitioner workforce through enhanced
education, including education about new long-acting reversible contraceptive methods; and (5) improves young adults’ access to affordable health insurance.

There is also the question of personal responsibility as part of health reform. At a recent town hall meeting
in Green Bay, Wisconsin, President Obama responded to questions about
how health reform would incorporate wellness and encourage people to
take more responsibility for their own health care. The President
affirmed how we all have to do our part – families, government,
employers, insurance companies and others. Although this usually comes
up in the context of smoking, diet, and exercise, the notion of shared
responsibility applies to pregnancy planning and prevention as well.
Reducing unintended pregnancy requires responsible behavior and choices
by both men and women, and responsible policies on the part of the
public and private sectors. Health reform presents an unprecedented
opportunity to make progress on this idea of shared responsibility.

Health reform that leaves out or inadequately addresses an issue
that affects most women and men and families in this country is not
real health reform. And certainly, health reform legislation that
includes women’s health, prevention, and health promotion, but does not
include access to high quality family planning services – gynecological
care, contraceptive counseling, access to all FDA-approved
contraceptive drugs and devices, and related outpatient services –
falls short of real reform.

Health reform must include pregnancy planning and prevention
services, which will improve health, strengthen families, improve child
well-being, enhance our workforce, and reduce taxpayer burden. With
fewer unplanned pregnancies there will be less poverty, more
opportunities for young men and women to complete their education or
achieve other life goals, fewer abortions, and better prospects for
this generation and the next. Isn’t that the "Big Picture?"