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Texas Women in Community Colleges Want to Use More Effective Birth Control but Face Barriers

Women in Texas community colleges cite cost and lack of insurance as top reasons for not using a more effective form of birth control, according to a new study from the Texas Policy Evaluation Project (TxPEP). Sixty-nine percent of students reported they wanted to use a more-effective method and would use it if they could afford it or had access to insurance that covered it, but only 30 percent were actually using one. 

“More-Effective” contraception, such as the pill, patch, ring, injectable contraception, IUD or implant, means that nine or fewer women out of 100 will become pregnant while using the method over the course of a year. Less-effective methods include condoms, withdrawal, and natural family planning methods.

In addition to cost barriers, women who preferred a more effective birth control method but weren’t using one reported not knowing where to get it. In fact, 41 percent of the women surveyed reported they did not have a usual source of care for reproductive health services. Many women surveyed were either uninsured (38 percent) or had public insurance (20 percent) through programs such as Medicaid/CHIP, the Texas Women’s Health Program (now Healthy Texas Women) and county indigent programs.

“Female students who have a child while in college are 65 percent more likely to drop out than students who don’t have a child during that time,” Kristine Hopkins, TxPEP investigator and lead author of the study, said. “Helping community college students get the more-effective methods of contraception that they want to use could decrease unintended births and help students complete their education.”

The research, based on a survey of almost 1,000 female students aged 18-24 at community colleges in Dallas, South Texas, and West Texas, was recently published online in the Journal of American College Health (https://www.tandfonline.com/doi/full/10.1080/07448481.2018.1431901).

To help their students prevent unintended births, community colleges could provide information about pregnancy prevention and contraceptive methods in campus events, academic courses, and through peer-to-peer and staff-to-student mentoring.

“Some community colleges have included information about pregnancy prevention and contraception in existing programs, such as freshman orientation and coursework,” Kate Coleman-Minahan, study co-author, said. “This can provide students with resources about more-effective birth control without raising administrative costs much—if at all.” 

To further help meet demand for highly effective contraception among community college students, colleges could connect students with local family planning services. Additionally, publicly funded family planning providers could improve outreach to community college students and inform them about available low-cost family planning services.

A five-minute presentation on the findings is available here: https://youtu.be/MRRB3eBgmRY

The full citation for the paper is:

Hopkins K, Hubert C, Coleman-Minahan K, Stevenson A.J., White K, Grossman D, Potter J.E. Unmet demand for short-acting hormonal and long-acting reversible contraception among community college students in Texas, Journal of American College Health. Pp 1-26 Online First 2018.

About the Texas Policy Evaluation Project

The Texas Policy Evaluation Project, or TxPEP, is a comprehensive effort to document and analyze the impact of measures affecting reproductive health passed by the Texas Legislature. The project team includes researchers at the University of Texas Population Research Center; the University of California, San Francisco; Ibis Reproductive Health and the University of Alabama-Birmingham. The project is supported by grants from the Susan Thompson Buffett Foundation and the Society of Family Planning. Infrastructure support for the Population Research Center is provided by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Funders of the Texas Policy Evaluation Project have no role in the design and conduct of the research, interpretation of the data, approval of the final manuscript or decision to publish.

Editor’s note: For more information or to request a copy of the study, contact Laura Dixon (ldixon@prc.utexas.edu) or call 512.788.2653.