Estimating the fertility effect of expansions of publicly funded family planning services in California

Womens Health Issues. 2011 Nov-Dec;21(6):418-24. doi: 10.1016/j.whi.2011.05.008. Epub 2011 Jul 30.


Objective: To estimate the number of unintended pregnancies averted through the provision of family planning services to low income women in Family PACT, California's Medicaid waiver program.

Study design: We use a Markov model to estimate the number of pregnancies in the absence of Family PACT based on the contraceptive method mix used before program enrollment, and pregnancies in the presence of the program, based on method dispensing claims.

Results: Nearly 1 million (998,084) women were provided with contraceptives in Family PACT in 2007. Contraceptive services averted over an estimated 286,700 unintended pregnancies including 122,000 abortions, 133,000 unintended births, and over 40,000 births among teens.

Conclusion: This conservative measure of the effect of Family PACT on unintended pregnancies indicates the benefit of expanding access to contraceptive services, an example for other states considering expanding access to family planning services through a state plan amendment under health care reform.

Publication types

  • Evaluation Study

MeSH terms

  • Abortion, Induced
  • Adolescent
  • Adult
  • Birth Rate
  • California
  • Contraception / economics*
  • Contraception / statistics & numerical data
  • Contraception Behavior
  • Contraceptive Agents / economics*
  • Family Planning Services / economics*
  • Family Planning Services / statistics & numerical data
  • Female
  • Fertility
  • Health Care Reform / economics
  • Health Care Reform / statistics & numerical data
  • Humans
  • Medicaid / statistics & numerical data*
  • Models, Statistical
  • Poverty*
  • Pregnancy
  • Pregnancy, Unplanned*
  • Program Evaluation / economics*
  • Program Evaluation / statistics & numerical data
  • United States
  • Young Adult


  • Contraceptive Agents