In a bracing piece in The Nation, Sharon Lerner explores, with her usual clarity, why it is that primary prevention--simple birth control--now seems so devalued. Read, scratch your head, and be concerned. Sigh.

Women currently account for 51% of the overall U.S. population, according to the U.S. Census Bureau. To be precise, there were 154,135,120 women and 149,924,604 men in the United States in 2008. We also know that women, more often than not, are responsible for making decisions about their families' health care.

While I think it would be hard to make the leap that 51 percent of the programs and benefits of health reform should be directly targeted toward women, it's not a stretch to argue that health reform should address the health care needs of women and their families. That includes pregnancy planning and prevention.

Unplanned pregnancies are closely linked to a number of negative health, social, and economic consequences. Family planning services--counseling, gynecological care and screenings, prescription drugs and devices, and related outpatient services--are a cost-effective way to make progress on preventing unplanned pregnancy and improving health outcomes for women and families. As such, family planning should be classified as a preventive benefit with the same cost-sharing protections afforded to other designated preventive benefits in any essential benefit package that is created within the context of health reform.

For health reform to work, it has to be meaningful for everyone, including 51 percent of the U.S. population.

The 2009 NFPRHA Conference wrapped up with several excellent workshops and presentations yesterday. In a particularly impassioned workshop presentation, Linda Dominguez reminded us that no decision is more important than helping a couple plan when they want to have children, and that making a contraceptive choice can be one of the most important decisions women (and their partners) make. She went on to point out that whatever kind of contraception that a woman chooses at a particular point in time should fit in with her reproductive life plan (do you have a reproductive life plan: how many kids do you want to have? When do you want to have them? With whom? Has a provider ever asked about your plan?).

The goal is to have women and men embrace their contraceptive method, and help them to be satisfied with the method they have selected (or help them find another method that might work better for them).

• How can we work to dispel the myths around contraceptive methods and talk more about the fantastic health benefits that are associated with some methods?

• More than one-third of women report that they are using a method of contraception that they don't like - how can we reach these women and help them find a method that they do like?

• The next question is, how can we help women and men use the method they have selected as effectively as possible?

A presentation by Hieke Thiel de Bocanegra of UCSF's Bixby Center for Global Reproductive Health offered one innovative way to tackle this second question. A pilot project she is leading (full disclosure: funded by the National Campaign) uses text messaging to remind women that it's time to fill their prescription (e.g., if on the NuvaRing) or visit the clinic for a follow-up appointment (e.g., if they need a Depo shot). The project aims include determining 1) the feasibility of this type of reminder system; 2) the acceptability and usage of this system by providers and clients; and 3) the system's effectiveness. More on this to come as the project progresses...

Last month the Obama administration proposed to rescind the "Provider Conscience Regulation" issued by the Department of Health and Human Services (DHHS) just before President Bush left office. We expressed concern about the regulation when it was put forth last fall because of its potential to adversely affect access to contraceptive services, which in turn could exacerbate the nation's high rates of both teen pregnancy and unintended pregnancy.

The Administration has invited the public to comment on the proposed rescission and today is the final day to let your voice be heard. Read the Campaign's official comment and then submit your own.

Terrifically important new research from our friends at the Guttmacher Institute on unplanned pregnancy.  From the press release:

"Publicly funded family planning clinics provide contraceptive services to approximately seven million women each year. Without these services, the annual number of unintended pregnancies and abortions in the United States would be almost 50% higher. In other words, 1.4 million unintended pregnancies and 600,000 abortions are averted each year because of these services... 

In addition to the clear benefits for individual women and their families in helping them avoid the pregnancies they do not want and plan the pregnancies they do, the analysis finds that these services save $4.3 billion in public funds. Nationally, for every $1.00 spent to provide services in the nationwide network of publicly funded family planning clinics, $4.02 in Medicaid expenses on births are averted."

Read the full report here and press release here.