Contraception is the Ultimate Prevention

Written by Christine Vaccaro, DO, FACOG, FPMRS

SHE+ Medical Advisory Board Member

My name is Dr. Christine Vaccaro, a member of the SHE+ Medical Advisory Board, and double board-certified and fellowship trained urogynecologist and reconstructive pelvic surgeon with advanced training in sexual medicine. I am incredibly passionate about women’s pelvic health and sexuality - both because it is integral in the clinical and surgical management of pelvic floor disorders and because it is essential to women’s overall quality of life. 

When we talk about preventative care in women’s health, we often think of your annual checkup, vaccines, or mammograms. 

In my last blog, I wrote, “When we fail to invest in women’s preventative sexual healthcare, we do not just put lives at risk - we waste billions - yes, billions, with a b - of dollars each year.” 

And I meant it. When we think about the benefits of investing in women’s health prevention, we also invest in women’s quality of life long term, including their sexual health. 

But the ultimate form of preventative sexual healthcare? Contraceptives. 

Contraceptive access may be the most cost-effective and transformative preventative care intervention in women’s health today. It prevents unintended pregnancies, reduces maternal mortality, treats reproductive health conditions, and saves billions in healthcare costs every year.

Contraceptives prevent a cascade of health, economic, and social challenges.  They provide peace of mind for women by putting them in control of their reproductive future.   

The Return on Investment

Publicly funded contraceptive services are one of the highest-yielding investments in healthcare. According to the Guttmacher Institute, every $1 invested in publicly funded contraception saves $7.09 in Medicaid expenditures that would otherwise go toward pregnancy-related care (Guttmacher, 2021).

In 2020 alone, this investment prevented:

• 9.4 million unintended pregnancies

• 2.2 million abortions

• 11,000 maternal deaths worldwide (Guttmacher-Lancet Commission, 2018)

In the U.S., where three in ten women will experience an unintended pregnancy by age 45, these numbers are not just statistics—they reflect tangible improvements in population health and economic security.

The Cost of Inaction

Unintended pregnancies place significant strain on public health systems and disproportionately affect low-income women, young people, and communities of color. These pregnancies are associated with:

• Higher rates of maternal and infant complications

• Delayed education and career advancement

• Long-term financial instability

According to the Centers for Medicare & Medicaid Services, Medicaid finances over 40% of all U.S. births, with the average cost of a vaginal delivery totaling more than $14,000, and cesarean births exceeding $26,000 (HCUP, 2020). Each unintended pregnancy avoided translates into thousands of dollars in direct savings—not to mention long-term economic ripple effects.

When people have the tools to decide if and when to have children, they are more likely to pursue education, maintain employment, and build healthier families. It’s not just healthcare — it’s foundational infrastructure for gender equity and reproductive freedom.

More Than Pregnancy Prevention

Beyond preventing pregnancy, contraceptives play a critical role in managing chronic health conditions and improving quality of life:

• Long-acting reversible contraceptives, such as the progestin IUD, reduce heavy menstrual bleeding and menstrual-related pelvic pain.

• Hormonal birth control is a frontline treatment for conditions like endometriosis, PCOS, and heavy menstrual bleeding.

• Long-term use of hormonal contraceptives reduces the risk of endometrial and ovarian cancers (National Cancer Institute).

• For patients with medical conditions where pregnancy could be life-threatening, access to contraception is an essential tool for survival.

The American College of Obstetricians and Gynecologists (ACOG) classifies contraception as a core component of primary care for all people of reproductive age.

Barriers Still Exist 

Despite overwhelming benefits, access remains unequal. Many insurance plans don’t cover the full range of contraceptive methods. Some states limit over-the-counter access to emergency contraception. Rural areas are especially underserved — nearly 19 million U.S. women live in “contraceptive deserts.”

Removing these barriers would reduce healthcare costs, increase bodily autonomy, and prevent suffering.

Contraceptives Are the Ultimate Preventative Care. 

When we invest in contraceptives, we reduce maternal mortality, shrink healthcare spending, improve quality of life and empower individuals to make decisions about their own bodies and reproductive future. It’s time we talk about birth control not as a luxury, or even just a right — but as a critical tool in the future of healthcare.

When we talk about preventative care, most people think of flu shots, cholesterol screenings, or colonoscopies. 

Taking Action

Lawmakers at the state and federal level can take clear, evidence-based steps to make contraception fully accessible and integrated into public health systems:

• Guarantee Comprehensive Coverage 

  • Ensure all FDA-approved contraceptive methods are covered without cost-sharing under both public and private insurance 

  • Eliminate prior authorization for long acting reversible contraception (LARC) like IUDs and Implants 

  • Expand coverage for over-the-counter methods (Plan B, Opill) 

• Expand Access Points 

  • Fund community health centers, school based clinics, and telehealth for contraception delivery

  • Increase Medicaid reimbursement for same-day access and contraceptive counseling. 

Contraceptives aren’t a luxury—they’re a cornerstone of public health and gender equity. They save lives, reduce costs, and give individuals the power to make informed choices about their futures.

From a policy standpoint, the question isn’t whether we can afford to invest in contraception. The real question is: Can we afford not to?

Key Sources:

• Guttmacher Institute. (2021). Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010

• Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights. (2018). Accelerate progress—sexual and reproductive health and rights for all

• Centers for Medicare & Medicaid Services (CMS). Medicaid & CHIP Payment and Access Commission (MACPAC).

• Healthcare Cost and Utilization Project (HCUP). (2020). National Inpatient Sample

• Power to Decide. (2022). Contraceptive Deserts in the U.S.

American College of Obstetricians and Gynecologists. (ACOG). Committee Opinion No. 615: Access to Contraception