Trends in levonorgestrel emergency contraception use, births, and abortions: the Utah experience

Published reports to date have failed to demonstrate a decrease in abortion rates with increased dispersal of levonorgestrel emergency contraception (LNG EC).

To evaluate whether there is an association between statewide increases in LNG EC use and birth, fertility, and abortion rates.

Ecological study. The number of LNG EC doses dispensed at all Planned Parenthood Association of Utah (PPAU) sites (n = 6) were obtained for 2000-2006. For this time period, birth and abortion data were obtained from the Utah Department of Health.

State of Utah.

Women of childbearing age.

Birth rates were calculated as the number of live births per 1000 population; general fertility rates, abortion rates, and LNG EC rates were calculated per 1000 women of childbearing age (15-44 years).

Between 2000 and 2006, yearly distribution of LNG EC increased from 11,263 to 52,083 doses. Over this period, the rate of Plan B use per 1000 women age 15-44 years increased from 21.30 doses/1000 to 87.82 doses/1000, an increase of 312%. During the same period, there were corresponding changes in the statewide birth rate (-2.94%), general fertility rate (0.73%), and abortion rate (-6.36%). Pearson correlation coefficients were statistically significant for the association between the LNG EC rate and the birth rate (-0.9053; P = .0050) and the abortion rate (-0.8749; P < .001), but not between the Plan B rate and the general fertility rate (0.2446; P = .5970).

This ecological study represents, to the authors' knowledge, the first statistically significant association between increasing rates of LNG EC distribution and decreasing abortion rates.