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Health Reports & Data

Family Planning

Goal

Improve pregnancy planning and spacing, and prevent unintended pregnancy.

Overview

Family planning is one of the 10 great public health achievements of the 20th century.1 The availability of family planning services allows individuals to achieve desired birth spacing and family size, and contributes to improved health outcomes for infants, children, women, and families.1

Family planning services include:

  • Contraceptive and broader reproductive health services, including patient education and counseling
  • Breast and pelvic examinations
  • Breast and cervical cancer screening
  • Sexually transmitted infection (STI) and human immunodeficiency virus (HIV) prevention education, counseling, testing, and referral
  • Pregnancy diagnosis and counseling2, 3, 4

Abstinence from sexual activity is the only 100 percent effective way to avoid unintended pregnancy. For individuals who are sexually active and do not want to become pregnant or cause a pregnancy, correct and consistent contraceptive use is highly effective at preventing unintended pregnancy. The most effective methods to prevent unintended pregnancy include long-acting reversible contraceptives such as intrauterine devices (IUDs) and contraceptive implants. Condoms protect against both unintended pregnancy and STIs, and their use should be encouraged. Both men and women should be counseled about using condoms at every act of sexual intercourse, when not in a long-term, mutually monogamous sexual relationship.

Why is Family Planning Important?

For many women, a family planning clinic is the entry point into the health care system and one they consider their usual source of care.2, 5 Each year, publicly funded family planning services prevent 1.94 million unintended pregnancies, including 400,000 teen pregnancies.3 These services are cost-effective, saving nearly $4 in Medicaid expenditures for pregnancy-related care for every $1 spent. 2, 6

Unintended pregnancies are associated with many negative health and economic consequences. Unintended pregnancies include pregnancies that are reported by women as being mistimed or unwanted. Almost half of all pregnancies in the United States are unintended.7 The public costs of births resulting from unintended pregnancies were $11 billion in 2006. (This figure includes costs for prenatal care, labor and delivery, post-partum care, and 1 year of infant care).8

For women, negative outcomes associated with unintended pregnancy can include:

  • Delays in initiating prenatal care.
  • Reduced likelihood of breastfeeding, resulting in less healthy children.
  • Maternal depression.
  • Increased risk of physical violence during pregnancy.9, 10, 11, 12

Births resulting from unintended pregnancies can have negative consequences including birth defects and low birth weight.13 Children from unintended pregnancies are more likely to experience poor mental and physical health during childhood, and have lower educational attainment and more behavioral issues in their teen years.9

The negative consequences associated with unintended pregnancies are greater for teen parents and their children. Eighty-two percent of pregnancies to mothers ages 15 to 19 are unintended.7 One in five unintended pregnancies each year is among teens.7 Teen mothers:

  • Are less likely to graduate from high school or attain a GED by the time they reach age 30.
  • Earn an average of approximately $3,500 less per year, when compared with those who delay childbearing until their 20s.
  • Receive nearly twice as much Federal aid for nearly twice as long.14, 15

Similarly, early fatherhood is associated with lower educational attainment and lower income.14, 16

The average annual cost of teen childbearing to U.S. taxpayers is estimated at $9.1 billion, or $1,430 for each teen mother per year.15 Moreover, children of teen parents are more likely to have lower cognitive attainment and exhibit more behavior problems.14, 15, 16 Sons of teen mothers are more likely to be incarcerated, and daughters are more likely to become adolescent mothers.16

Additional Resources

HP2020’s National Objectives for Family Planning
HHDW Reports on Family Planning

References

  1. Centers for Disease Control and Prevention. Achievements in public health, 1900–1999: Family planning. MMWR Weekly. 1999 Dec 3;48(47):1073-80. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4847a1.htm
  2. Gold RB, Sonfield A, Richards C, et al. Next steps for America’s family planning program: Leveraging the potential of Medicaid and Title X in an evolving health care system. New York: Guttmacher Institute; 2009. Available from: http://www.guttmacher.org/pubs/NextSteps.pdf
  3. Guttmacher Institute. In brief: Facts on publicly funded contraceptive services in the United States. Washington; Guttmacher Institute; 2010 April. Available from: http://www.guttmacher.org/pubs/fb_contraceptive_serv.pdf
  4. Lindberg L, Frost J, Sten C, et al. Provision of contraceptive and related services by publicly funded family planning clinics, 2003. Perspect Sex Reprod Health. 2006 Sep;38(3):139-47.
  5. Frost J. US women’s reliance on publicly funded family planning clinics as their usual source of medical care. Paper presented at National Survey of Family Growth Research Conference; 2008 Oct; Hyattsville, MD.
  6. Frost J, Finer L, Tapales A. The impact of publicly funded family planning clinic services on unintended pregnancies and government cost savings. J Health Care Poor Underserved. 2008 Aug;19(3):778-96.
  7. Finer L, Henshaw S. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health. 2006 Jun;38(2):90-6.
  8. Sonfield A, Kost K, Gold RB, et al. The public costs of births resulting from unintended pregnancies: National and state-level estimates. Perspect Sex Reprod Health. 2011 Jun;43(2):94-102. Available from: http://www.guttmacher.org/pubs/psrh/full/4309411.pdf
  9. Logan C, Holcombe E, Manlove J, et al. The consequences of unintended childbearing: A white paper [Internet]. Washington: Child Trends, Inc.; 2007 May. Available from: http://www.childtrends.org/Files//Child_Trends-2007_05_01_FR_Consequences.pdf
  10. Cheng D, Schwarz E, Douglas E, et al. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009 Mar;79(3):194-8.
  11. Kost K, Landry D, Darroch J. Predicting maternal behaviors during pregnancy: Does intention status matter? Fam Plann Perspect. 1998 Mar–Apr;30(2):79-88.
  12. D’Angelo D, Gilbert BC, Rochat R, et al. Differences between mistimed and unwanted pregnancies among women who have live births. Perspect Sex Reprod Health. 2004 Sep–Oct;36(5):192-7.
  13. Centers for Disease Control and Prevention. Preconception and interconception health status of women who recently gave birth to a live-born infant—pregnancy risk assessment monitoring system (PRAMS), United States, 26 Reporting Areas, 2004. MMWR Weekly. 2007 Dec 14;56(SS-10):1-40. Available from: http://www.cdc.gov/mmwr/pdf/ss/ss5610.pdf
  14. Hoffman S, Maynard R, eds. Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy, 2nd ed. Washington: Urban Institute Press; 2008.
  15. Hoffman S. By the Numbers: The Public Costs of Teen Childbearing. Washington: National Campaign to Prevent Teen Pregnancy; 2006. Available from: http://www.thenationalcampaign.org/costs/pdf/report/BTN_National_Report.pdf
  16. Elfenbein DS, Felice ME. Adolescent pregnancy. Pediatr Clin North Am. 2003 Aug;50(4):781-800, viii.
ID
OBJECTIVES AND SUB-OBJECTIVES

State Indicator Definition:
Percentage of live births in which the mother reported that she wanted to be pregnant sooner than or at the time of conception. The national indicator is defined differently as women aged 15 to 44 years and uses live births as well as abortions for the denominator.

State Baseline:
54.3% (2010)

Most Recent State Value:
54.8% (2011)

HP2020 Target:
National: 56.0%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Pregnancy Risk Assessment Monitoring Systems

Data Reports:
Hawaii-IBIS
HHM Report

FP-8
Reduce pregnancies among adolescent females
State Indicator Definition:
Number of pregnancies among females aged 15 to 17 years per 1,000 females of the same age. The national indicator is defined in exactly the same way.

State Baseline:
22.5 pregnancies per females aged 15-17 years (2010)

Most Recent State Value:
13.6 pregnancies per females aged 15-17 years (2013)

HP2020 Target:
National: 36.2 per 1,000 females aged 15-17 years

National Data Source:
National Vital Statistics System

State Data Source:
Hawaii Vital Statistics System

Data Reports:
HHM Report

State Indicator Definition:
Number of pregnancies among females aged 18 to 19 years per 1,000 females of the same age. The national indicator is defined in exactly the same way.

State Baseline:
88.3 pregnancies per females aged 18-19 years (2010)

Most Recent State Value:
60.8 pregnancies per females aged 18-19 years (2013)

HP2020 Target:
National: 105.9 per 1,000 females aged 18-19 years

National Data Source:
National Vital Statistics System

State Data Source:
Hawaii Vital Statistics System

Data Reports:
HHM Report

FP-9
Increase the proportion of adolescents aged 17 years and under who have never had sexual intercourse
State Indicator Definition:
Percentage of female public school students in grades 9 to 12 who report never having had sexual intercourse. The national indicator is restricted to females aged 15 to 17 years, but state-level data are reported by high school grade, and limited to students enrolled in public school in Hawaii.

State Baseline:
54.2% (2009)

Most Recent State Value:
62.3% (2013)

HP2020 Target:
National: 80.2%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Youth Risk Behavior Survey

Data Reports:
Hawaii-IBIS
HHM Report

State Indicator Definition:
Percentage of male public school students in grades 9 to 12 who report never having had sexual intercourse. The national indicator is restricted to males aged 15 to 17 years, but state-level data are reported by high school grade, and limited to students enrolled in public school in Hawaii.

State Baseline:
57.3% (2009)

Most Recent State Value:
66.1% (2013)

HP2020 Target:
National: 79.2%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Youth Risk Behavior Survey

Data Reports:
Hawaii-IBIS
HHM Report

State Indicator Definition:
Percentage of female public school students in grades 6 to 8 who report never having had sexual intercourse. The national indicator is restricted to females aged 15 years and under, but state-level data are reported by middle school grade, and limited to students enrolled in public school in Hawaii.

State Baseline:
88.2% (2009)

Most Recent State Value:
94.7% (2015)

HP2020 Target:
National: 93.9%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Youth Risk Behavior Survey

Data Reports:
Hawaii-IBIS
HHM Report

State Indicator Definition:
Percentage of male public school students in grades 6 to 8 who report never having had sexual intercourse. The national indicator is for males aged 15 years and under, but state-level data are available by grade, and are limited to students enrolled in public school in Hawaii.

State Baseline:
86.7% (2009)

Most Recent State Value:
91.5% (2015)

HP2020 Target:
National: 90.7%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Youth Risk Behavior Survey

Data Reports:
Hawaii-IBIS
HHM Report

FP-10
Increase the proportion of sexually active persons aged 15 to 19 years who use condoms to both effectively prevent pregnancy and provide barrier protection against disease
State Indicator Definition:
Percentage of female public school students in grades 9 to 12 who were sexually active in the 3 months prior to the survey and report having used a condom the last time they had sex. The national indicator is restricted to females aged 15 to 19 years, but the state-level data are reported by high school grade, and are limited to students enrolled in public school in Hawaii.

State Baseline:
34.2% (2009)

Most Recent State Value:
44.8% (2015)

HP2020 Target:
National: 55.6%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Youth Risk Behavior Survey

Data Reports:
Hawaii-IBIS
HHM Report

State Indicator Definition:
Percentage of male public school students in grades 9 to 12 who were sexually active in the 3 months prior to the survey and report having used a condom the last time they had sex. The national indicator is for males aged 15 to 19 years, but the state-level data are available by grade, and are limited to students enrolled in public school in Hawaii.

State Baseline:
65.4% (2009)

Most Recent State Value:
53.9% (2015)

HP2020 Target:
National: 85.7%

National Data Source:
National Survey of Family Growth

State Data Source:
Hawaii Youth Risk Behavior Survey

Data Reports:
Hawaii-IBIS
HHM Report