General Articles

Iowa: Sexual Health Advances in the Hawkeye State

Iowa Initiative Preliminary Research Findings. Preliminary findings from a report by the Bixby Center for Global Reproductive Health and Philliber Research Associates (September 2012).

The Iowa Initiative to Reduce Unintended Pregnancy is a five year project that aims to address the high rates and cost of unintended pregnancy in the state, specifically among women ages 18-30. In 2006, 57% of births from unintended pregnancy were publicly funded in Iowa, with an estimated cost of $120 million.1 The program uses four interventions that focus on community outreach, education, and networking.2 The interventions included reproductive health referrals and information dissemination through hair stylists in salons, educational brochures and posters for patients in pharmacies and pharmacist trainings on talking about unintended pregnancy and family planning, social marketing through humorous print radio, and digital media messaging, as well reproductive health messages in two popular TV series. The Iowa Initiative recently reported its preliminary results, which examined the impact of contraceptive knowledge and behavior, particularly the uptake and use of Long-Acting Reversible Contraceptives (LARC), on reducing unintended pregnancy.

Key Findings:
Since 2007, the number of women in Iowa using an IUD as their primary method of birth control has increased 208% and the number of women using an implant as their primary method of birth control has increased 1,100%.
Women in Iowa are opting for LARC as their primary method of birth control at a faster pace than women elsewhere in the U.S.
Since 2006 Iowa has experienced an 8% decline in unintended pregnancies, which was greater than similar states in the Midwest region.
The percentage of Iowa pregnancies terminated by abortion has decreased by 24% since 2006, a greater decline than experienced in WI, OH, NE, MO, and MN.

High rates of unintended pregnancy have adverse social, health, and economic consequences, and it is estimated that unintended pregnancies cost the US approximately $11 billion per year.3 The Iowa Initiative to Reduce Unintended Pregnancy’s preliminary findings suggest that increasing women’s access to affordable and effective family planning services and contraceptives reduces the number of unintended pregnancies and abortions. The Iowa Initiative also demonstrated the benefits and effectiveness of using a multidimensional model to reduce unintended pregnancies. By educating patients and physicians, supporting family planning clinics, and engaging community members through local businesses, this program was able to reach a broader population of women of varying socioeconomic statuses and ages.

There are various implications to reducing the number of unintended pregnancies. A reduction in unintended pregnancies has been shown to result in substantial savings to tax payers, decreased rates of welfare participation, and an increased number of high school graduates and work-force participants.4 Reducing rates of unintended pregnancies also improves the health of women and children, as unintended pregnancy can result in delayed prenatal care, premature birth, and physical and mental complications for children.5

Further research on this topic could focus on how best to expand the education portion of this program into schools, community colleges and other academic institutions. Also, to help policy makers better understand who was impacted by this program and how, researchers might also analyze the data to identify demographic and socioeconomic trends regarding the uptake of LARC and the populations impacted by each of the implemented interventions. These findings could help programs to target specific populations with high rates of unintended pregnancy, and identify neglected or unaffected populations in need of more effective interventions.

1 Rebecca Wind, “Nation Pays Steep Price for High Rates of Unintended Pregnancy,” Guttmacher Institute, 19 May 2011, accessed 1 October 2012, <>.

2Iowa Initiative to Reduce Unintended Pregnancies, Iowa Initiative Preliminary Research Findings, 27 September 2012, accessed 1 October 2012, <>.

3 Wind, “Nation Pays…”.

4Adam Thomas and Emily Monea, “The High Cost of Unintended Pregnancy,” Center for Children and Families at BROOKINGS, July 2011, accessed 1 October 2012, <>

5Guttmacher Institute fact sheet, “Facts on Unintended Pregnancy in the United States,” January 2012, accessed 1 October 2012, <>.