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Yes, it’s easier to get birth control than it was in the 1970s – but women still need abortion care

The Supreme Court is considering a case that could restrict abortions. One argument is that birth control eliminates the need for abortion. But contraception doesn’t offer an easy fix.

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A historic ruling on abortion is likely to emerge from the U.S. Supreme Court this year as justices consider whether Mississippi can, in fact, impose a ban on abortions after 15 weeks of pregnancy.

The case, Dobbs v. Jackson Women’s Health Organization, challenges the landmark 1973 Roe v. Wade decision that protects women’s right to abortion. Meanwhile, Texas enacted its own restrictive abortion law in September – and other states are working to follow suit.

Mississippi Solicitor General Scott G. Stewart argued before the Supreme Court in December that abortion is not necessary.

“I would emphasize that contraception is more accessible and affordable and available than it was at the time of Roe or Casey,” Stewart said, in reference to Roe v. Wade and Planned Parenthood v. Casey, two landmark abortion court decisions. “It serves the same goal of allowing women to decide if, when and how many children to have.”

So, is it actually easier than ever to get contraception in the U.S. – and does that mean that abortion is no longer necessary?

The short answers are, “no” and “no.”

Even if every person who needed it could obtain contraception, it wouldn’t completely eliminate the need for abortion.

Why getting birth control in America isn’t always easy

Total protection from unwanted pregnancy is impossible to achieve, even with multiple, highly effective modern methods of contraception available.

No contraceptive method is 100% effective, and a need for abortion will always exist for several reasons.

First, most contraceptive methods still require a prescription and at least an initial visit to a clinic or a doctor’s office to initiate or maintain treatment. This step alone can be prohibitive for the 21 million American women who cannot afford to pay for family planning services.

This figure marks a 25% increase over the past two decades – in 2000, 16.4 million American women and girls needed help paying for contraception. This increase is outpacing the growth of the total number of sexually active women and teens who need contraception since 2000.

Second, not all health care providers are up to date on the latest evidence-based guidelines for contraceptive use in people with particular medical conditions. As a result, patients may be unnecessarily denied their chosen contraceptive method or asked to return for multiple visits.

Third, many young people do not receive adequate sex education, which would include information about contraception and how to get it. This is especially true among low-income or marginalized populations, including people of color and nonnative English speakers.

In the 1970s, when Roe v. Wade was decided, oral contraception was one of the few effective methods of birth control available in the U.S. UPI wb/jl

The evolution of birth control

In 1973, the year of the Roe decision, doctors could offer only pills, diaphragms, IUDs or sterilization. Traditional methods, such as penile withdrawal, have been around since long before 1960 but are undeniably less effective than more modern methods.

As a primary care doctor and researcher at the University of Washington Departments of Family Medicine and Obstetrics and Gynecology, I have two decades of experience providing and teaching about full-spectrum contraceptive care.

I have been fortunate to offer my patients an increasing number of highly effective modern contraceptive methods. Today there are 18 different methods of contraception, ranging from intrauterine devices to vaginal rings.

Although almost all people in the U.S. use birth control at some point, not everyone is consistently using it all the time. On average, fertile women in the U.S. need effective birth control for 30 years to avoid unwanted pregnancies.

Measuring birth control availability

While the number of birth control options has grown, it remains difficult for many women and teens to get contraception.

Today, an estimated 65% of women and teenage girls use contraception, marking a 10 percentage-point increase from 1982 rates.

And today, 34% of women and teens are using the most effective forms of birth control, compared with 23% of women who did so in 1982.

Approximately 17% of women and teens are using moderately effective methods, compared with 15% in 1982. The remainder are using less effective contraception, or none at all.

While the percentage of women and teenagers using contraception has increased since the 1980s, a closer look at data reveals an uneven picture.

Teenage girls ages 15 to 19 are much less likely to get contraception than older women (only 38.7% of surveyed girls this age use it). Latina and Black women also have lower rates of contraception use than white women.

The COVID-19 pandemic has worsened these divides. Black, Latina and queer women reported higher rates of contraception appointment delays and cancellations. Approximately 29% of Black women, 38% of Latinas and 35% of queer women also reported feeling worried about paying for contraception in July 2020.

One in 4 women report not using their preferred method of birth control because they cannot afford it. This matters, because patients are more likely to continue using a birth control method if they like it.

One other way to measure contraceptive care considers the percentage of women ages 15 to 44 who have unintended pregnancies.

The unintended pregnancy rate is 30% higher in the U.S., at 45 per 1,000 women, than the average rate in all high-income countries.

While unintended pregnancies in the U.S. reached the lowest rate in 2011 since at least 1981, lower-income women remain five times more likely than higher-income women to have a pregnancy they did not plan for.

More recent data shows a 47% decrease in unintended pregnancies in Europe and North America, between the five-year period 1990-1994 and the five year-period 2015-2019.

Two women hug outside of a Planned Parenthood clinic, which has a sign that says 'still here' on the side
Pro-choice supporters embrace outside of the last Planned Parenthood location performing abortions in Missouri. Saul Loeb/AFP via Getty Image

Limits to getting birth control

The use of public funds to fully cover family planning, which includes confidential contraceptive services, has long been established as cost-effective intervention in public health.

Family planning reduces unintended pregnancy. Unintended pregnancy contributes to pregnancy-related deaths, preterm births and infant deaths, rates of which are higher in the U.S. than in other developed countries.

Congress passed two key mandates in the 1970s that allowed the use of public funds for no- or low-cost family planning services for adolescents and poor and low-income women.

However, the budget for funding family planning is less than half of what it was in 1980. And the number of women who likely need public support for contraception is increasing.

Past programs in Missouri and Colorado that provided the full range of modern contraceptive methods at no cost reduced unintended pregnancy and abortion rates.

Implementation of the Affordable Care Act in 2010 made contraception more accessible for millions of Americans using private and public health insurance by requiring coverage of all contraceptive methods without a copay.

Contraception is still not accessible to all, however, especially among those who live in states that did not expand their Medicaid family planning services under the Affordable Care Act, which lowered the criteria for low-income women to qualify for medical assistance coverage for contraception.

Additionally, 1 in 5 privately insured women report paying out of pocket for birth control, which is not possible for many women.

Yes, we still need abortion care.

Given the wide range of contraceptive choices available today, some Americans, including Mississippi’s Stewart, wonder whether abortion is still needed.

The short answer is, “yes.”

Despite America’s having the lowest abortion rate in 50 years, abortions in America are not rare.“ Approximately 18% of the estimated 6 million pregnancies in the U.S. each year end in abortion.

Access to contraceptive care from publicly supported providers in 2016 helped delay or avoid nearly 2 million pregnancies. Widespread access to birth control would reduce the number of abortions.

But expanding access will require definitive new federal and state action, including implementing policies that guarantee better health care access.

These changes won’t completely eliminate the need for safe abortions, which will remain a crucial health care service no matter what.

[Get The Conversation’s most important politics headlines, in our Politics Weekly newsletter.]

Emily M. Godfrey receives funding from the Society of Family Planning Research Fund and the Cystic Fibrosis Foundation. She is a Nexplanon Trainer for Organon. She has written an Op-Ed about mifepristone by mail in the Seattle Times.

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Government

Updated: US sees spike in Paxlovid usage as Merck’s molnupiravir and AstraZeneca’s Evusheld are slower off the shelf

New data from HHS show that more than 162,000 courses of Pfizer’s Covid-19 antiviral Paxlovid were administered across the US over the past week, continuing…

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New data from HHS show that more than 162,000 courses of Pfizer’s Covid-19 antiviral Paxlovid were administered across the US over the past week, continuing a streak of increased usage of the pill, and signaling not only rising case numbers but more awareness of how to access it.

In comparison to this week, about 670,000 courses of the Pfizer pill have been administered across the first five months since Paxlovid has been on the US market, averaging about 33,000 courses administered per week in that time.

A Pfizer spokesperson told Endpoints News the company does “not have any concerns nor foresee any supply issues in our ability to support if [usage] rates increase.”

Cumulatively, as of May 24, almost 3.8 million doses of Paxlovid have been made available to states so far by the federal government, and about 2.4 million of those have been ordered by states, with more than 831,000 courses administered.

Signs for such a spike in usage were evident earlier this month, as in a call with reporters senior HHS officials credited the surge in the use of Paxlovid to their outreach, and through the Biden administration’s Test to Treat initiative, which allows for use of Paxlovid with a positive test at participating pharmacies.

“We have seen more than a 315% increase in Paxlovid use over the past four weeks. In the first week of May, nearly 115,000 courses were dispensed,” an official said at the time.

Meanwhile, outside of Paxlovid, few other treatment options are really in wide use.

Merck’s molnupiravir, known commercially as Lagevrio, has struggled to make its way out of the inventory closet, according to the latest numbers posted by HHS.

Only about 20,000 courses of the Merck pill were used in the past week, and only about 13% of the total US inventory of molnupiravir has been used to date. That compares with about 35% of overall usage of Paxlovid courses ordered by states so far, and the bulk of those orders have come within the last several months.

But for AstraZeneca’s preexposure mAb Evusheld, only about 16,000 courses were administered in the past week. About 38% of all Evusheld ordered by states has been administered so far, according to the latest HHS numbers.

For Eli Lilly’s bebtelovimab, which is a monoclonal antibody that’s supposed to be used ahead of molnupiravir if both are on hand, about 100,000 courses in total have been administered of 379,526 courses ordered (542,330 courses available). Bebtelovimab is the follow-on mAb after Lilly’s former combo mAb (850,000+ courses distributed earlier in the pandemic) that lost efficacy against the latest variant.

Meanwhile, HHS has become less and less transparent with its data and information on its distribution of Covid-19 therapeutics.

After the Trump administration, and the beginning of the Biden administration allowed for the public posting of weekly calls between HHS and states on Covid-19 therapeutic distribution, those calls have since been made private and the prior recordings have been deleted from the ASPR website.

In addition, each week’s therapeutic administration numbers have to be tallied independently because HHS now deletes the previous week’s numbers.

Editor’s note: Article updated to add Pfizer comment and note the stats for Lilly’s Covid-19 treatments bebtelovimab too.

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Economics

EUR/GBP price prediction: is the bears’ pain over?

Ever since Brexit happened, the British pound gained against the common currency, the euro. Despite many analysts calling for the pound’s decline, it…

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Ever since Brexit happened, the British pound gained against the common currency, the euro. Despite many analysts calling for the pound’s decline, it gained ground in a relentless bearish trend.

The downtrend was so strong that even in 2022, some analysts believe that the EUR/GBP exchange rate will still hover around 0.84 in March 2023 – about 10 months from now.

Currently, EUR/GBP trades at 0.85, bouncing from its lows and looking constructive from fundamental and technical perspectives. So, where will the exchange rate go next?

Here is a price prediction considering both the technical and fundamental aspects.

The two central banks’ policies are set to diverge

Let’s start with the fundamental perspective. A currency pair moves based on the monetary policy differences between the two central banks.

In this case, the Bank of England was one of the first major central banks in the world that decided to increase the interest rate in the aftermath of the COVID-19 induced recession. Moreover, it did so not once but multiple times.

At the same time, the European Central Bank did nothing. It couldn’t do so, as a war started in Eastern Europe (Russia invaded Ukraine) in February.

In order to shelter European economies from the war’s economic impact, the European Central Bank preferred a wait-and-see stance. However, inflation is running way higher than the central bank’s target, and one of the causes is just the war.

As such, the central bank recently announced that it plans to end negative rates by September. Considering that the deposit facility rate is at negative 50bp, it means that a couple of rate hikes are on the table during the summer.

Yet, the Bank of England is now in a wait-and-see mode. Therefore, the fundamentals favor a move higher in the EUR/GBP exchange rate over the summer.

An inverse head and shoulders shows EUR/GBP struggling to overcome resistance

From a technical perspective, the market may have bottomed with the move to 0.82. It was quickly retraced, suggesting the presence of an inverse head and shoulders pattern.

A close above 0.86 should put the 0.90 area in focus. That is where the pattern’s measured move points to, and the move also implies that the lower highs series would be broken, thus ending the bearish bias.

All in all, EUR/GBP looks bullish here. Both technical and fundamental aspects favor more strength in the months ahead.

The post EUR/GBP price prediction: is the bears’ pain over? appeared first on Invezz.

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International

The UK’S Rich Are Getting Richer

The UK’S Rich Are Getting Richer

The UK’s richest people were announced in The Sunday Times’ annual roundup this week, including the…

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The UK'S Rich Are Getting Richer

The UK’s richest people were announced in The Sunday Times’ annual roundup this week, including the founder of Dyson vacuum cleaners, as well as JK Rowling and Elisabeth Murdoch. As Statista's Anna Fleck notes, the list comes at a time when the majority of Brits are feeling the burden of the cost of living crisis.

You will find more infographics at Statista

At the top of the list came billionaire brothers Sri and Gopi Hinduja, who own the Mumbai-based conglomerate Hinduja Group. They were reported to own £28.47 billion together. Other key names to make it onto the list, albeit further down, included Chancellor of the Exchequer Rishi Sunak and his wife Akshata Murty, ranking at 222nd place out of 250 with a joint £730m of wealth. Sunak is reportedly the richest serving MP in history.

Chelsea manager Roman Abramovich dropped 20 places on the newspaper’s list this year, after his wealth was believed to have been cut from £12 billion down to £6 billion. He was one of the Russian figures to have been hit with sanctions in light of the Russian war in Ukraine. Alisher Usmanov also saw a fall, from sixth to eleventh place, with an estimated wealth of £10bn this year.

In terms of demographics, only seven of the people on the list were women, while 116 of the richest were men, and a further 78 were listed under the grouping “man with family.”

Income from property was the most common primary source of wealth, with 43 percent of people on the list benefiting from it.

Additionally, as Statista's Fleck details below, the UK’s top ten richest people are wealthier than the group has ever been, with their cumulative wealth having grown from £47.77 billion in 2009 to £182 billion in 2022 - an increase of 281 percent.

Infographic: The UK'S Rich Are Getting Richer | Statista

You will find more infographics at Statista

As this chart shows, following the 2008 crash, the UK’s billionaires have seen a steady, and fairly steep, incline in their wealth.

The upward trend continued despite the pandemic, which saw the UK’s economy shrink by 20.4 percent in the second quarter of 2020, as most industries suffered, and 30.5 million people in Europe were expected to be pushed into poverty. This is a stark contrast to the UK’s 250 ultra wealthy, who saw their collective wealth surge to a record high of £653 billion in 2022.

George Dibbs, the head of the Center for Economic Justice at the Institute for Public Policy Research, explains how we are seeing a widening wealth gap, as the rich are getting richer:

“As we enter a once-in-a-generation cost of living crisis, the Sunday Times rich list shows us again that vast wealth often begets more wealth. That has proved particularly true during the pandemic, when the wealthiest accumulated more wealth than poorer people, who saved nothing,” he tells The Guardian.

“Now there are more billionaires in the UK than ever before and the collective wealth of the richest has grown again.”

According to the article, Dibbs is now calling on Sunak to bring in taxes in order to “redistribute the wealth gains of the richest to pay for higher social security benefits for those who most need them.”

Tyler Durden Thu, 05/26/2022 - 04:15

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