ContraceptivesEvery year, 85 million pregnancies worldwide are unplanned. In the US, almost half of all pregnancies are unintended. Unintended pregnancies are a public health concern, as they are linked with less prenatal care and higher chances of a preterm birth. One cause of unintended pregnancies is lack of access to contraceptive services. An estimated 220 million women worldwide lack such services.

The Bixby Center is at the forefront of clinical and social research to improve contraceptive options and services globally.

Investigating new contraceptives

The Bixby Center has decades of experience evaluating the safety, efficacy and acceptability of new birth control methods, and our researchers have played a part in testing every contraceptive method currently approved by the US Food and Drug Administration (FDA). For example, Bixby Center studies were critical to the FDA’s decisions to approve the first emergency contraceptive (EC), and then to allow EC to be sold without a prescription to people of all ages. Our research demonstrated that giving young women EC does not negatively affect their contraceptive use, sexual risk behaviors or sexually transmitted infections. The Bixby Center is a member of the National Institutes of Health Contraceptive Clinical Trials Network, and we are currently conducting a clinical trial of a low dose of ulipristal acetate as a daily contraceptive.  We are also participating in the long-term study of a levonorgestrel-releasing intrauterine device.

Improving access to contraception

The Bixby Center has a successful track record of identifying and testing ways to improve access to contraception for women in the US and abroad. Our research on the impact of California's Medicaid family planning expansion program – known as Family Planning, Access, Care and Treatment (PACT) – demonstrated reduced unintended pregnancy and substantial fiscal savings. Bixby Center studies have consistently shown that Family PACT improves women’s access to family planning and the efficiency and quality of care. The program has become a model for other states. The Bixby Center also monitors the provision of contraception to mothers who have recently given birth. We have shown that provision of postpartum contraception encourages healthy spacing between pregnancies and decreases the rate of subsequent preterm births.

The Bixby Center’s longtime partnership with California’s Family PACT program has demonstrated the value of public funding for contraceptive programs. We have shown that every dollar spent on family planning services saves over $9 in public sector expenditures.

We showed that providing a year's worth of birth control pills resulted in more women sticking with the method over time, and health systems around the country have adopted this practice. Other research has shown that a pelvic exam is not necessary to initiate most contraceptives, including the pill. Removing the requirement of a pelvic exam has changed clinical protocols nationally. Our Beyond the Pill program trains healthcare providers, supporting the integration of intrauterine devices and implants into routine contraceptive care.

Bixby researchers also are improving access to contraception around the world through services, training and advocacy. In Kenya, the FACES program is integrating contraceptive and HIV care for its patients. All Family Planning Fellows must participate in an international rotation, and many have developed ongoing professional collaborations with their host institutions. The Bixby Center’s advocacy work includes making the case for increased investment in , and showing that meeting the demand for voluntary family planning has many societal benefits.