Absolutely.

The difficulty with contraception is that the less you can afford, the less likely you are to avoid an unintended pregnancy. You're more likely to get pregnant with condoms.

When you go to prescription contraception, the baseline is birth control pills. Six to nine people per year using birth control pills, and twice that many if you're a teenager, will become pregnant with an unintended pregnancy. People have a reproductive lifespan of 30 to 35 years, from about age 15 to 45 or 50, and they plan to be pregnant or have a child for maybe a year or two years out of that. For over 30 years, they are using methods with a 6% to 9% failure rate. This is where our unintended pregnancies are coming from.

It's more expensive to use the more effective methods. With a copper IUD, you have a 1% chance per year of getting pregnant. With a hormone-bearing IUD, you have a 0.1% chance—one person per 1,000—per year. These and the small little matchstick devices that can be inserted underneath the arm, a subdermal implant, are the most expensive up front at $300 or $400, but they last for three to five to seven years. Some of the IUDs now last up to 10 years. These methods are more effective than female sterilization, yet they're completely reversible. The month you take it out, you can become pregnant again.

Investing in these upfront methods means a person has to choose between rent and food for the children already in the home or has to put out $300 or $400 to get a five- to seven-year method that's going to be as effective as sterilization but is reversible. That's just not accessible for people, but it's most important.

If governments were providing only IUDs, implants and the most effective contraceptive methods, this would offer the best chance for people to avoid unintended pregnancy. People need a wide range of choices because the context is different in everybody's life. People are able to adjust to different methods as different things are working in their lives. This is why it's important to have the full range.

From a health economic and health system perspective, the better you are able to support somebody to achieve their goal for pregnancy and become pregnant only when they want to and are preparing for it, the better a child will be raised and the better our health system and economy will be. IUDs and implants are what give you that chance.

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