Patterns and trends in contraceptive use among women attending Title X clinics and a national sample of low-income women

Abstract

ObjectivesTo describe the types of contraception used by women attending Title X-funded clinics and a comparable group of low-income reproductive-age women at risk of unintended pregnancy. Study designWe estimated the percentage of reproductive aged (15–44 years) women using contraception, by method type and level of effectiveness in preventing pregnancy (i.e., most, moderately, and less effective), using Title X Family Planning Annual Report (2006–2016) and National Survey of Family Growth (2006–2015) data. We divided most effective methods into permanent (female and male sterilization) and reversible (long-acting reversible contraceptives [LARCs]) methods. ResultsAmong Title X clients during 2006–2016, use of LARCs increased (3–14%); use of moderately effective methods decreased (64–54%); and use of sterilization (~2%), less effective methods (21–20%), and no method (8–7%) was unchanged. These same trends in contraceptive use were observed in a comparable group of women nationally during 2006–2015, during which LARC use increased (5–19%, p<.001); moderately effective method use decreased (60–48%, p<.001); and use of sterilization (~5%), less effective methods (19%), and no method (11–10%) was unchanged. ConclusionsThe contraceptive method mix among Title X clients differs from that of low-income women at risk of unintended pregnancy nationally, but general patterns and trends are similar in the two populations. Research is needed to understand whether method use patterns among low-income women reflect their preferences, access, or the conditions of the supply environment. ImplicationsThis study contributes to our understanding of patterns and trends in contraceptive use among two groups of reproductive-age women — Title X clients and low-income women nationally who are at risk of unintended pregnancy. The findings highlight areas for further research.