Family planning
United States

In the US, family planning is more expiclitly associated with contraception. It is defined as "the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility."

Despite the availability of highly effective contraceptives, about half of U.S. pregnancies are unintended. Highly effective contraceptives, such as IUD, are underused in the United States. Increasing use of highly effective contraceptives could help meet the goal set forward in Healthy People 2020 to decrease unintended pregnancy by 10%. Cost to the user is one factor preventing many American women from using more effective contraceptives. Making contraceptives available without a copay increases use of highly effective methods, reduces unintended pregnancies, and may be instrumental in achieving the Healthy People 2020 goal.

In the United States, contraceptive use saves about $19 billion in direct medical costs each year. Title X of the Public Health Service Act, is a U.S. government program dedicated to providing family planning services for those in need. But funding for Title X as a percentage of total public funding to family planning client services has steadily declined from 44% of total expenditures in 1980 to 12% in 2006. Current funding for Title X is less than 40% of what is needed to meet the need for publicly funded family planning. Title X would need $737 million annually to meet the need for family planning services. Only 6.2 million women accessed publicly funded services from 10,700 clinics in 2015, despite an estimated 20 million women who could benefit.

Clinics funded by Title X served 3.8 million of these women with access to services.In 2015, publicly funded contraceptive services helped women prevent 1.9 million unintended pregnancies; 876,100 of these would have resulted in unplanned births and 628,000 abortions. Without publicly funded contraceptive services, the rates of unintended pregnancies, unplanned births and abortions would have been 67% higher. The rates for teens would have been 102% higher. Title X funded programs saw 1.2 million fewer patients in 2015 compared to 2010 as funding decreased by $31 million. In 2015, an estimated 2.4 million additional women received Medicaid-funded contraceptive services from private doctors.

Medicaid has increased from 20% to 71% from 1980 to 2006. In 2006, Medicaid contributed $1.3 billion to public family planning. The $1.9 billion spent on publicly funded family planning in 2008 saved an estimated $7 billion in short-term Medicaid costs. Such services helped women prevent an estimated 1.94 million unintended pregnancies and 810,000 abortions.

About 3 out of 10 women in the United States have an abortion by the time they are 45 years old.

A 2017 paper found that parents' access to family planning programs had a positive economic impact on their subsequent children: "Using the county-level introduction of U.S. family planning programs between 1964 and 1973, we find that children born after programs began had 2.8% higher household incomes. They were also 7% less likely to live in poverty and 12% less likely to live in households receiving public assistance. After accounting for selection, the direct effects of family planning programs on parents' incomes account for roughly two thirds of these gains." A 2021 study found disparity among racial groups in the perceived quality of family planning care received, with white women (72%) more likely to rate their experience with their providers as excellent than Black (60%) and Hispanic women (67%).
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