How We Could Be Preventing Unwanted Pregnancies—And Aren't

A new medical study indicates that it's safe for a woman to have an IUD inserted immediately after an abortion or miscarriage. Researchers say it could prevent more than 70,000 unintended pregnancies annually, but there's a non-medical reason that isn't happening: The Hyde Amendment.

The study, published in the New England Journal Of Medicine, found no significant risk of tearing or infection to IUD insertion for women whose pregnancies ended between 5 and 12 weeks. Though some women expelled the IUD, it was at a lower rate than those women in the study who waited for a longer period after their pregnancy ended.

But because the Hyde Amendment requires a strict separation between federally-funded family planning services and abortion care, in practice low-income women are forced to make a separate appointment if they want an IUD, an extremely effective form of contraception. Per Reuters' interview with the study's lead author, Dr. Paula Bednarek:


The requirement that no federal money be used for abortion services effectively blocks clinics from giving those women any kind of contraceptive on the same day and in the same facility where their abortion is performed, Bednarek told Reuters Health.

The study found that within six months, "more than 90 percent of the women who had immediately gotten their IUD were still using it, versus about three quarters who received a delayed insertion."

Six out of ten of women who visit federally-funded family planning clinics describe it as their only source of medical care; the circumstances of their lives are often such that a repeat appointment constitutes a burden. "Our results show that women who would like to receive an IUD after an abortion, but are asked to make an appointment for a later date, may not return to actually receive the IUD, and, therefore are at higher risk to have another unintended pregnancy," says Bednarek.


This bind for women extends to all forms of contraception, not just the IUD, for women who have had abortions and want to prevent future pregnancies. According to a Guttmacher study on repeat abortions,

This "wall of separation" has been counterproductive: Its purported purpose has been to prevent Title X funds from being used indirectly to facilitate access to abortion services, but it is also prevents abortion providers from facilitating access to contraceptive services for those women who wish to prevent subsequent unintended pregnancies.

"It's more convenient, it's less expensive, it's less painful all around, it's good for the individual and it's good for society," says Bednarek. "We just need to create a system that makes it more doable." Unfortunately, this is the same funding that Republicans have been playing politics with, trying to deny Planned Parenthood these funds. And while the final budget this year kept Planned Parenthood's funding, it also cut Title X funding by $18.1 million. So you'd be forgiven for being pessimistic about any good faith efforts to prevent unplanned or unwanted pregnancies.

Update: For more on the IUD, check out Jenna's handy user's guide.

Immediate IUD Insertion After Abortion Found Safe [Reuters]
Immediate Use Of An IUD Following Abortion More Likely To Prevent Unintended Pregnancies [Eureka Alert]
Related: Repeat Abortion In The United States [Guttmacher]