The Institute of Medicine* (IOM) finds that more pregnancies would be planned,
welcome and prepared. There would be fewer abortions, fewer premature births,
fewer low-birth-weight babies; less depression, less abuse and neglect, less cancer,
less pelvic inflammatory disease, and less breast disease.
We would save an estimated $19.3 Billion a year on healthcare, if all public and
private insurance plans covered contraceptives and family planning services** with
Health literacy would improve, too. Women and couples who obtain counseling and
act on it to decide the number and spacing of their children will be using information
and services to enhance their health and that of their children – that, is parental health
The profound change for women and society is that pregnancy and childbearing would
truly be a choice, not a duty, for all women, not just those who can pay. This baby step
toward women’s health has the potential to be a quantum leap toward the American
ideals of freedom and equal opportunity.
Current Reality About 36 million American women need family planning services.
Already, most health plans cover contraception; 29 states require coverage. But
the co-pay may be up to 90% of the retail price, so cost remains a barrier; professionals
have little training and less time for counseling, and many women do not have insurance.
Half (49%) of all pregnancies in the U.S. are unplanned; of these, 42% end in abortion.
These rates are much higher than other developed countries. Each year, for every 20
American women, one has an unintended pregnancy; most are among the least prepared
for parenting – unmarried, 18-24 year-olds with less than high school education and low
Little progress in prevention has been made, despite the availability of safe and effective
preventive methods, despite our own experience that greater use of contraception within the
U.S. population produces lower unintended pregnancy and abortion rates nationally; and
despite the consensus of medical and public health professional organizations and maternal
child health advocates.
The Affordable Care Act is about to open the healthcare system to millions of poor women,
many of them employed, some working two or three jobs, who have no insurance and cannot
afford doctor visits or contraceptives. It shifts the primary focus of healthcare from treatment
to prevention. The IOM was charged with advising the Secretary of Health on what preventive
services should be made available to all women. Here is what they said: The committee
recommends for consideration as a preventive service for women: the full range of Food and
Drug Administration-approved contraceptive methods, sterilization procedures, and patient
education and counseling for all women with reproductive capacity.
Now is the time for advocacy. So far, this is a recommendation. The next step in making it
reality is acceptance of the recommendation by Secretary of Health, Kathleen Sebelius.
Advocate for your position. If you support IOM recommendation, no co-pay is key.
Email the Secretary Kathleen.Sebelius@hhs.gov
Beginnings Pregnancy Guide includes information to “Plan ahead for birth control”
(Book 6, Page 83).The Guide reminds new mothers that you can get pregnant again before
your period resumes, and breastfeeding is not a reliable method of birth control. Contraception
is a must-discuss topic for home visits with new families and for the mom’s post-partum
Organizations that recommend contraception & family planning as standard preventive
American College of Obstetricians and Gynecologists
American Academy of Family Physicians
American Academy of Pediatrics
Society of Adolescent Medicine
American Medical Association
American Public Health Association
Association of Women’s Health
Obstetric and Neonatal Nurses
March of Dimes
Download free the full report, a summary, or selected chapters:
*The Institute of Medicine was established in 1970 by the National Academy of Sciences to
secure the services of eminent members of appropriate professions in the examination of
policy matters pertaining to the health of the public. The Institute acts under the responsibility
given to the National Academy of Sciences by its congressional charter to be an adviser to the
federal government and, upon its own initiative, to identify issues of medical care, research,
and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
** Family Planning Services Educational, comprehensive medical and social activities which
enable individuals, including minors, to determine freely the number and spacing of their
children and to select the means by which this may be achieved.
References & Resources IOM (Institute of Medicine). 2011.
Clinical Preventive Services for Women: Closingthe Gaps. Washington, DC:
The National Academies Press.