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Reducing unintended pregnancies in Pennsylvania: increasing access to long-acting reversible contraceptives in Title X clinics

Stransky, Olivia (2019) Reducing unintended pregnancies in Pennsylvania: increasing access to long-acting reversible contraceptives in Title X clinics. Master's Thesis, University of Pittsburgh. (Unpublished)

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INTRODUCTION: Long-acting reversible contraceptives (LARCs) can significantly reduce incidence of teen pregnancy and unintended pregnancy and indirectly reducing the rate of abortion, preterm birth, and low birthweight. A cohort study and two statewide interventions in the United States have demonstrated the impact LARCs have, yet uptake in the United States remains relatively slow, particularly among 15 to 24-year-olds, who have the highest rates of unintended pregnancy. Access to effective forms of birth control is an issue of public health significance as it is linked to negative maternal and neonatal health outcomes. One of the causes of low LARC use is that fewer family planning clinics provide them. The purpose of this work is to examine the reasons why disparities in LARC access persist as well as the ways in which Pennsylvania, and in particular rural communities, could benefit from a statewide initiative to increase LARC access.
METHODOLOGY: Statewide data from the 2017 Family Planning Annual Report was obtained from each of the four organizations responsible for distributing Title X funding in Pennsylvania. Each organization provided reports on the insurance status and primary birth control method of female patients at Title X clinics in their respective region of the state.
RESULTS: Title X clinics in Pennsylvania primarily serve uninsured and publicly insured individuals as compared to statewide insurance proportions. Fewer Title X patients in Pennsylvania use LARCs than patients nationwide, and high disparities exist between rural and urban Pennsylvania counties. The organizations that oversaw Pittsburgh’s two largest cities, Philadelphia and Pittsburgh, had higher rates of LARC use than the organizations that did not include a large urban area.
CONCLUSION: Findings suggest a disparity in LARC access between urban and rural communities, and a clinic-by-clinic assessment of birth control methods offered is a recommended next step. As low-income women are at an increased risk of unintended pregnancy, Title X clinics need to be capable of providing patients with the most effective methods of birth control.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Stransky, Oliviaols25@pitt.eduols25
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairTerry,
Committee MemberHawk,
Committee MemberJarlenski,
Date: 30 January 2019
Date Type: Publication
Defense Date: 3 December 2018
Approval Date: 30 January 2019
Submission Date: 26 November 2018
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 61
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: unintended pregnancy, family planning, Pennsylvania, LARC, birth control, contraception, pregnancy
Date Deposited: 30 Jan 2019 18:43
Last Modified: 30 Jan 2019 18:43


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