A quarter of pregnancies in New Jersey last year were unplanned.

That percentage would likely be much lower, advocates say, if Garden State residents had better access to quality contraceptive care. The need for increased access, they add, is even more pressing today as the state attempts to bounce back from the coronavirus pandemic.

"Family planning needs don't stop during a public health emergency — people always need access to birth control," said Brittany Lee, policy associate at the New Jersey Health Care Quality Institute. "But the barriers to contraceptive care, like insurance coverage and out-of-pocket costs, as well as childcare and time off of work needed to attend doctor's appointments, are really all exacerbated by COVID-19."

Not all providers offer the forms of contraception considered most effective, such as an intrauterine device, Lee noted, due to the complexity and expense involved. Other providers may require a two-visit experience in order to provide the most detailed services.

"When a patient has to return for multiple visits to get their form of contraception, it's going to be more and more likely that they don't return at all or they're going to get pregnant between those first two visits," Lee said.

It was determined by the Guttmacher Institute that in 2017, 27% of individuals in New Jersey used what are considered the least effective forms of contraception, including condoms, sponges, spermicides and withdrawal.

The Quality Institute recently launched a toolkit specifically aimed at increasing access to contraceptive services in New Jersey. It focuses on educating providers about best practices that can be implemented to increase this access.

"Now more than ever, it is critical that we support health care workers in delivering essential medical services, including contraceptive care," said first lady Tammy Murphy in a written statement. "By ensuring all forms of birth control are accessible to New Jerseyans, we are empowering individuals to plan for their future, leading to healthier outcomes for mothers, babies and families."

As of March 2020, more than 430,000 women lived in areas considered "contraceptive deserts," which are counties with no reasonable access to a health center offering the full range of contraceptive methods, according to Power to Decide. The United Health Foundation found 25.3% of 2019 pregnancies in New Jersey were unintended.

Leslie Kantor, a sexual and reproductive health researcher at Rutgers School of Public Health, said access to care, including contraception and abortion, can be extremely problematic for young adults and adolescents who are still physically close to their partners during the COVID-19 emergency. But some services, including obtaining many forms of contraception and receiving testing and treatment for sexually transmitted diseases, are being handled through telemedicine.

"If telemedicine remains as widely available as it has been during the coronavirus pandemic, access to sexual and reproductive health care may actually improve for young people," Kantor said. "However, we know that lack of privacy and confidentiality, which many adolescents and young adults are experiencing while living at home with family, can also hinder the ability to get necessary sexual and reproductive health care."

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