The Association of Emergency Contraception Legislation with Adolescent Births from 2000 to 2014

Abstract

Study ObjectiveThe objective of the study was to examine the association of state-specific emergency contraception (EC) legislation and adolescent births. Design, Setting, and ParticipantsThis was an observational cohort study of adolescents aged 15-19 years in the United States from 2000 through 2014 to determine the association of adolescent birth estimates with EC legislation. Main Outcome MeasuresState-specific birth and abortion estimate data were obtained from the Centers for Disease Control and Prevention's National Vital Statistics and Abortion Surveillance for the years 2000 through 2014. ResultsAfter controlling for year, abortion estimates, and oral contraception pill utilization, estimated adolescent births for states with an expansive EC policy was 14% lower as compared with states without an expansive policy. Estimated adolescent births were 43% higher in states with a restrictive EC policy as compared with states without a restrictive policy. ConclusionRestrictive EC policies are associated with increased adolescent birth estimates, whereas expansive EC policies are associated with decreased adolescent birth estimates. Targeted advocacy strategies to reduce legislation that aims to restrict access to contraception may prove to be most beneficial to reducing unintended pregnancies.