Does Contraceptive Use in the United States Meet Global Goals?

CONTEXT: The United Nations Sustainable Development Goals (SDGs) seek to achieve health equity, and they apply to all countries. SDG contraceptive use estimates for the United States are needed to contextualize U.S. performance in relation to that of other countries.

METHODS: Data from the 2011-2013 and 2013-2015 waves of the National Survey of Family Growth were used to calculate three SDG indicators of contraceptive use for U.S. women aged 15-44: contraceptive prevalence, unmet need for family planning and demand for family planning satisfied by modern methods. These measures were calculated separately for married or cohabiting women and for unmarried, sexually active women; differences by sociodemographic characteristics were assessed using t tests from logistic regression analysis. Estimates for married women were compared with 2010-2015 estimates from 94 other countries, most of which were low- or middle-income.

RESULTS: For married or cohabiting women, U.S. estimates for contraceptive prevalence, unmet need and demand satisfied by modern methods were 74%, 9% and 80%, respectively; for unmarried, sexually active women, they were 85%, 11% and 82%, respectively. Estimates varied by sociodemographic characteristics, particularly among married or cohabiting women. Five countries performed better than the United States on contraceptive prevalence, 12 on unmet need and four on both measures; seven performed better on demand satisfied by modern methods.

CONCLUSIONS: There is a need to continue efforts to expand access to contraceptive care in the United States, and to monitor the SDG indicators so that improvement can be tracked over time.