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The Association of Emergency Contraception Legislation with Adolescent Births from 2000 to 2014
Jordee M Wells1, Junxin Shi2, Andrea E Bonny3
1Department of Pediatrics, Division of Emergency Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205; Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205; The Ohio State University College of Medicine, 370 W 9th Avenue, Columbus, Ohio 43210.
Study Objective:
The objective of the study was to examine the association of state-specific emergency contraception (EC) legislation and adolescent births.
Design, Setting, And Participants:
This was an observational cohort study of adolescents aged 15-19 years in the United States from 2000 through 2014 to determine the association of adolescent birth estimates with EC legislation.
Main Outcome Measures:
State-specific birth and abortion estimate data were obtained from the Centers for Disease Control and Prevention's National Vital Statistics and Abortion Surveillance for the years 2000 through 2014.
Results:
After controlling for year, abortion estimates, and oral contraception pill utilization, estimated adolescent births for states with an expansive EC policy was 14% lower as compared with states without an expansive policy. Estimated adolescent births were 43% higher in states with a restrictive EC policy as compared with states without a restrictive policy.
Conclusion:
Restrictive EC policies are associated with increased adolescent birth estimates, whereas expansive EC policies are associated with decreased adolescent birth estimates. Targeted advocacy strategies to reduce legislation that aims to restrict access to contraception may prove to be most beneficial to reducing unintended pregnancies.
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