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Comment & Response
September 25, 2013

Controversy Over Contraception Coverage—Reply

Author Affiliations
  • 1Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2013;310(12):1288-1289. doi:10.1001/jama.2013.276773

In Reply We wish to respond to Dr Manhart’s assertions and correct several misrepresentations of the literature regarding the safety and efficacy of modern contraception.

First, Manhart states that providing no-cost contraception will not eliminate undesired pregnancy due to method failures and other factors. Although this is certainly true, we would not expect any public health policy measure to prevent 100% of the outcome in question. Folic acid supplementation of grains and fluoride supplementation of water do not prevent 100% of neural tube defects or dental caries, yet both are public health successes. Excellent data demonstrate that no-cost contraception prevents unwanted pregnancy, reducing teen pregnancy by more than 80% and reducing women seeking abortion by at least 20%.1 These are impressive improvements, and we believe Manhart would find reductions in abortion to be a mutually desirable outcome.