USA (Utah): Trends in levonorgestrel emergency contraception use, births, and abortions

This study, from the Medscape Journal of Medicine, set out to evaluate whether there is an association between statewide increases in LNG EC use and birth, fertility, and abortion rates. 

The authors note that published reports to date have failed to demonstrate a decrease in abortion rates with increased dispersal of levonorgestrel emergency contraception (LNG EC).

This was an ecological study, set in the State of Utah. The number of LNG EC doses dispensed at all Planned Parenthood Association of Utah (PPAU) sites (n = 6) were obtained for 2000-2006. For this time period, birth and abortion data were obtained from the Utah Department of Health. The patients were women of childbearing age. Birth rates were calculated as the number of live births per 1000 population; general fertility rates, abortion rates, and LNG EC rates were calculated per 1000 women of childbearing age (15-44 years).

Between 2000 and 2006, yearly distribution of LNG EC increased from 11,263 to 52,083 doses. Over this period, the rate of Plan B use per 1000 women age 15-44 years increased from 21.30 doses/1000 to 87.82 doses/1000, an increase of 312%. During the same period, there were corresponding changes in the statewide birth rate (-2.94%), general fertility rate (0.73%), and abortion rate (-6.36%). Pearson correlation coefficients were statistically significant for the association between the LNG EC rate and the birth rate (-0.9053; P = .0050) and the abortion rate (-0.8749; P < .001), but not between the Plan B rate and the general fertility rate (0.2446; P = .5970).

The authors conclude that this ecological study represents, to the authors' knowledge, the first statistically significant association between increasing rates of LNG EC distribution and decreasing abortion rates.

Department of Obstetrics and Gynecology, University of Utah, Utah, USA.

Trends in levonorgestrel emergency contraception use, births, and abortions: the Utah experience. Turok DK, Simonsen SE, Marshall N. Medscape Journal of Medicine. 2009;11(1):30. Epub 2009 Jan 29.