Specialized family planning clinics in the United States: why women choose them and their role in meeting women's health care needs.

Background: Publicly funded family planning clinics provide contraceptive care to millions of poor and low-income women every year. To inform the design of services that will best meet the contraceptive and reproductive health needs of women, we conducted a targeted survey of family planning clinic clients, asking women about services received in the past year and about their reasons for visiting a specialized family planning clinic.

Methods: We surveyed 2,094 women receiving services from 22 family planning clinics in 13 states; all sites included in the survey were clinics that specialize in contraceptive and reproductive health services and were located in communities with comprehensive primary care providers.

The public costs of births resulting from unintended pregnancies: national and state-level estimates.

Context: Births resulting from unintended pregnancies are associated with substantial maternity and infant care costs to the federal and state governments; these costs have never been estimated at the national and state levels.

Methods: The proportions of births paid for by public insurance programs in 2006 were estimated, by pregnancy intention status, using data from the Pregnancy Risk Assessment Monitoring System and similar state surveys, or were predicted by multivariate linear regression. Public costs were calculated using state-level estimates of the number of births, by intention status, and of the cost of a publicly funded birth.

Role of medicaid family planning waivers and Title X in enhancing access to preconception care.

Purpose: This article identifies the ways in which Medicaid eligibility expansions for family planning services and the Title X network of family planning clinics provide opportunities to introduce preconception care. The introduction of family planning eligibility expansions brought in populations heretofore ineligible for Medicaid. Family planning clinics serve a large number of low-income and young women and would play an important part in introducing preconception care.

U.S. insurance coverage of contraceptives and the impact of contraceptive coverage mandates, 2002.

Context: In 1993, coverage of reversible contraception by U.S. health insurance plans was extremely low.

Overhauling welfare: implications for reproductive health policy in the United States.

The overhaul of the welfare system in 1996 broke the historic link between eligibility for welfare benefits and eligibility for Medicaid, ended a longstanding requirement that welfare recipients be given access to family planning services, and, at the same time, included a number of controversial features directed at reducing out-of-wedlock childbearing and promoting abstinence-only education. Five years later, the number of women enrolled in Medicaid is down, the number not covered by insurance is up, and abstinence-only education has become a prominent feature of the government's effort to decrease the incidence of out-of-wedlock pregnancies. Very little is known about how well these interventions are working and what impact, positive or negative, they have had.