Are the result of a study being misrepresented by the media for politics?

" Providing birth control to women at no cost substantially reduced unplanned pregnancies and cut abortion rates by a range of 62-78 percent compared to the national rate, a new study shows" (3)

There are several things misleading about this statement. First of all, it neglects to mention who the participants of the study were, the study's objective, and the study's limitations. 

I am no statistician, but I read through the report numerous times and felt as though the statistics were misleading. I could not understand how this study has applications to the entire US population, especially when I reviewed the methods of the study. There are too many factors to account for such as education, income level, state laws regarding abortion and access to it, and, unfortunately, ethnicity. Another question I did not have an answer to was if the study accounts for those who dropped out or did not follow-up, which can skew results.

I am not against access to contraception. As a matter of fact, I strongly support education about it. But I believe that with having sex and using contraception comes personal responsibility- none of which is being advocated for in the ACA. In addition, I am shocked by the push to get women free contraception without any discussion of STD's and STD prevention (which we all know IUD and Deprovera will not prevent). I am fairly certain that I have read that certain STD's are on the increase, but perhaps that information was based on misleading representation of study results as well.


ANYWAYS...here are my observations from reading the ACTUAL study (1)....

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Contraceptive CHOICE Project, a prospective cohort study of adolescents and women desiring reversible contraceptive methods.

Objective:  to promote the use of LARC (long-acting reversible contraceptive- IUD's and implants) methods and to provide no-cost contraception to a large number of women and adolescents in our region in an effort to reduce unintended pregnancies.

Participants: 

• 9,256 adolescents and women at risk for unintended pregnancy 
• recruited from the two abortion facilities in the St. Louis region and through provider referral, advertisements, and word of mouth.

Analysis: 

• abortion rates
• the percentage of abortions that were repeat abortions 
• teenage births.
  

Results: 

• Reduction in the percentage of abortions that were repeat abortions in the St. Louis region compared with Kansas City and nonmetropolitan Missouri (P,.001). 
  
• Abortion rates in the CHOICE cohort were less than half the regional and national rates (P,.001).
  

Interesting notes:

• primary population-based outcomes included teenage births and repeat abortions as proxies for unintended pregnancies.
• intent was to interact with 11% of the population in the region at greatest risk for unintended pregnancy
• one of the primary outcomes
• was the percentage of abortions that were
• repeat abortions.
• estimated abortion rates because the majority of abortions result from unintended pregnancies.
• compared repeat abortion data in the St. Louis region with that in Kansas City,Missouri, and nonmetropolitan Missouri
• The mean age of the total population was 25 years; 51% were black, 35% had a high school education or less, 37% received public assistance, and 39% had trouble paying for basic expenses.
• Participants recruited at the abortion clinics were more likely to be black and to report a high school education or less, trouble paying for basic necessities, receipt of public assistance or no insurance, and greater parity and a history of three or more unintended pregnancies.
• Approximately half of unintended pregnancies are the result of contraceptive failure

Limitations: 

• Intendedness of pregnancy is not captured in the state vital statistics; therefore, the study used proxy markers of unintended pregnancy. 
  
• CHOICE participants were more likely to be black, single, and have a lower income,19 
  
• the CHOICE cohort may not be similar demographically to many other geographic areas, limiting the study’s generalizability
• the analysis comparing repeat abortion in the St. Louis region with that in Kansas City and nonmetropolitan Missouri is essentially an ecological study. There may be several factors that affect the rates of repeat abortion, such as the economic recession, federal changes in Title X funding for family planning, and Missouri state laws that limit access to abortion. It is not possible to conclude that the changes observed in repeat abortion were due solely to the Contraceptive CHOICE Project

References:

(1) Preventing Unintended Pregnancies by Providing No-Cost Contraception (The study)


(2) Abortion rates plummet with free birth control (e! Science News)


(3) Abortion rates plummet with free birth control​​​ (Washington University in St. Louis)