Contraception's Role In Fighting Poverty

Contraception. (Photo by: MediaForMedical/UIG via Getty Images)
Contraception. (Photo by: MediaForMedical/UIG via Getty Images)

By Phil Harvey and Lisa Conyers

Obscured by the noise and heat of current pronouncements on income inequality, one option for combating poverty would have a quick and major impact. That option is providing young women with long acting reversible contraceptives, a.k.a. LARCs. As we learned in the course of interviews with welfare recipients across the country, if all young women had the tools they need to avoid unwanted pregnancies, there would be a marked drop in single motherhood, and since poverty is a major side effect of single motherhood, there would be fewer impoverished mothers and children.

The young unmarried women we talked with who had had children while they were still in their teens told us about this connection as they reported on their lives. The penalties they paid for their pregnancies were predictable - delayed graduation or no graduation from high school, no way to acquire job skills, and no time to do paid work, all of which adds up to being poor, having to depend on welfare programs, and knowing you've lost any chance to realize the American dream.

"I used to have that American dream of having a nice house, a car, a career, my kids in a good school," Juakea, a young mother of two in Beacon, Georgia, told us. "Now all that is gone. I'm just surviving. Those dreams are gone."

Multiply Juakea's experience by the millions of unmarried mothers who now depend on welfare and it is no surprise that the poverty rate for families headed by single mothers is disturbingly high -- 40%, compared to 8% for two-parent families.

LARCs give the young single women who are most likely to end up on welfare a better way forward, as studies have shown.

Research by Isabel Sawhill -- a sociologist with the Brookings Institution who has spent decades studying single mothers -- reveals that most young single women today are not making conscious decisions to plan their childbearing. Instead, they are sliding into motherhood without any planning, losing the chance to finish school and start careers because they have to care for unplanned children.

Like our interviews, Sawhill's research highlights facts that we need to accept: Young women are going to be sexually active, and they don't rely enough on current contraceptive choices, at least partly because those contraceptive choices require repeated action, often in the heat of the moment.

LARCs are different. Providing effective contraception for an extended period without requiring any action by users, LARCs include intrauterine devices (IUDs) and subdermal contraceptive implants. They are unquestionably the most effective reversible methods of contraception.

Sawhill's research results are affirmed by two important studies done in Colorado. Using funds from an anonymous donor, the state ran a pilot study in 2009 to see what would happen if teenage girls were given free-of-charge access to LARCS, primarily the IUD and hormonal implants.

What happened then surprised many observers. Teen pregnancies were reduced by 26 percent, and that reduction measurably reduced welfare dependence. Participation in the Women, Infants and Children (WIC) welfare program fell by 23 percent, for example, and every dollar the state spent on LARCs saved an estimated six dollars in welfare costs.

A second Colorado study produced even more promising results. This one involved unmarried women who used LARCs after having had a first child. Only 2.6% of these mothers got pregnant again within a year while 19% of the mothers in the control group without LARCs got pregnant again in that time.

Although long-acting reversible contraceptives are safe and effective, they do present some challenges. For one thing, they won't prevent sexually transmitted diseases, so condom use should still be encouraged. For another, the initial cost averages $1,000 for the device and insertion, and young women may find it daunting to start on LARCs because they have to visit a clinic. On the other hand, LARCs have no continuing costs, while other contraceptive devices do. And, like all FDA-approved contraceptives, LARCs are covered by medical insurance under the ACA, and by Medicaid.

The main point, clearly, is that LARCs are an effective anti-poverty tool. When young women are given access to long acting reversible contraceptives, they are able to choose when to get pregnant, able to exert more control over their own lives, able to reduce the incidence of single motherhood, and therefore almost certainly able to alleviate the stubborn poverty that now afflicts so many families headed by single women.

Phil Harvey and Lisa Conyers are co-authors of The Human Cost of Welfare: How the System Hurts the People It's Supposed to Help.