title: Estimates of pregnancies averted through California's family planning waiver program in 2002.
abstract: BACKGROUND
  During its first year of operation (1997-1998), California's family planning program, Family PACT, helped more than 750,000 clients to avert an estimated 108,000 pregnancies. Given subsequent increases in the numbers of clients served and contraceptive methods offered by the program, updated estimates of its impact on fertility are needed.
  
  
  METHODS
  Claims data on contraceptives dispensed were used to estimate the number of pregnancies experienced by women in the program in 2002. Medical record data on methods used prior to enrollment were used to predict client fertility in the absence of the program. Further analyses examined the sensitivity of these estimates to alternative assumptions about contraceptive failure rates, contraceptive continuation and contraceptive use in the absence of program services.
  
  
  RESULTS
  Almost 6.4 million woman-months of contraception, provided primarily by oral contraceptives (57%), barrier methods (19%) and the injectable (18%), were dispensed through Family PACT during 2002. As a result, an estimated 205,000 pregnancies-which would have resulted in 79,000 abortions and 94,000 births, including 21,400 births to adolescents-were averted. Changing the base assumptions regarding contraceptive failure rates or method use had relatively small effects on the estimates, whereas assuming that clients would use no contraceptives in the absence of Family PACT nearly tripled the estimate of pregnancies averted.
  
  
  CONCLUSIONS
  Because all contraceptive methods substantially reduce the risk of pregnancy, Family PACT's impact on preventing pregnancy lies primarily in providing contraceptives to women who would otherwise not use any method.
authors.affiliation: Bixby Center for Reproductive Health Research and Policy, University of California, San Francisco, CA, USA. greened@obgyn.ucsf.edu
authors.forename: Diana Greene
authors.initials: DG
authors.lastname: Foster
authors.forename: M Antonia
authors.initials: MA
authors.lastname: Biggs
authors.forename: Gorette
authors.initials: G
authors.lastname: Amaral
authors.forename: Claire
authors.initials: C
authors.lastname: Brindis
authors.forename: Sandy
authors.initials: S
authors.lastname: Navarro
authors.forename: Mary
authors.initials: M
authors.lastname: Bradsberry
authors.forename: Felicia
authors.initials: F
authors.lastname: Stewart
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D003267:Contraception / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D005193:Family Planning Services / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government; D006801:Humans; D011247:Pregnancy; D011275:Pregnancy, Unwanted