title: Number of oral contraceptive pill packages dispensed and subsequent unintended pregnancies.
abstract: OBJECTIVE
  To estimate how number of oral contraceptive pill packages dispensed relates to subsequent pregnancies and abortions.
  
  
  METHODS
  We linked 84,401 women who received oral contraceptives through the California family planning program in January 2006 to Medi-Cal pregnancy events and births conceived in 2006. We compared pregnancy rates for women who received a 1-year supply of oral contraceptive pills, three packs, and one pack.
  
  
  RESULTS
  Women who received a 1-year supply were less likely to have a pregnancy (1.2% compared with 3.3% of women getting three cycles of pills and 2.9% of women getting one cycle of pills). Dispensing a 1-year supply is associated with a 30% reduction in the odds of conceiving an unplanned pregnancy compared with dispensing just one or three packs (confidence interval [CI] 0.57-0.87) and a 46% reduction in the odds of an abortion (95% CI 0.32-0.93), controlling for age, race or ethnicity, and previous pill use.
  
  
  CONCLUSIONS
  Making oral contraceptives more accessible may reduce the incidence of unintended pregnancy and abortion. Health insurance programs and public health programs may avert costly unintended pregnancies by increasing dispensing limits on oral contraceptives to a 1-year supply.
authors.affiliation: From the Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco General Hospital, University of California, San Francisco, San Francisco, California.
authors.forename: Diana Greene
authors.initials: DG
authors.lastname: Foster
authors.forename: Denis
authors.initials: D
authors.lastname: Hulett
authors.forename: Mary
authors.initials: M
authors.lastname: Bradsberry
authors.forename: Philip
authors.initials: P
authors.lastname: Darney
authors.forename: Michael
authors.initials: M
authors.lastname: Policar
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002140:California; D002648:Child; D003276:Contraceptives, Oral / Q000600:supply & distribution*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D049168:Pregnancy, Unplanned; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral