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The Contraceptive Equity Initiative

The History Behind It All

The Contraceptive Equity Initiative is a new effort from Power to Decide to use our expertise, tools, and assets to address barriers to birth control access.

The Contraceptive Equity Initiative honors three pioneers in the field of reproductive health, each with a deep commitment to the mission of Power to Decide: Belle Sawhill, Sarah Brown, and Andrea Kane.

Belle Sawhill co-founded Power to Decide in 1996 and served as President of the organization for 21 years. It was her vision that shaped the organization and provided intellectual leadership. Throughout the years Belle also provided mentorship and guidance to both Sarah and Andrea and served as Board President until 2019. She has authored or edited numerous books, including The Forgotten Americans, An Economic Agenda for a Divided Nation; Generation Unbound; Creating an Opportunity Society (co-authored with Ron Haskins); and, along with co-author Richard V. Reeves, A New Contract with the Middle Class. She is currently a Senior Fellow in Economic Studies at The Brookings Institution. 

Founding Power to Decide CEO, Sarah Brown, led the organization for its first 20 years. Her leadership was critical to the organization’s success in reducing teen and unplanned pregnancy in the US. Her strategic vision, her commitment, and her wisdom were critical to the organization’s achievements, including contributing to a 74% reduction in teen pregnancy between 1990 and 2017. Sarah was Senior Study Director at the Institute of Medicine, where she authored The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families

In 2021, sadly, we lost Andrea to cancer. An outstanding professional and a friend to all she met, Andrea dedicated more than 20 years of her career to developing and nurturing Power to Decide’s public policy efforts. Before Power to Decide, Andrea was affiliated with the Brookings Institution's Center on Children and Families and served at the White House Domestic Policy Council as a special assistant to President Clinton. Andrea was co-author of the book Welfare Reform and Beyond

This trio had a lot in common: a rock-solid commitment to evidence-based policy solutions, a willingness to push past conventional wisdom in search of innovative solutions, and an ability to pitch a big tent and navigate both sides of the aisle for the benefit of people across the country. We will seek to embody these attributes in the Initiative. 

What is the Contraceptive Equity Initiative?

More than 19 million women of reproductive age living in the US are in need of publicly funded contraception and live in contraceptive deserts. Living in a contraceptive desert means that they lack reasonable access in their county to a health center that offers the full range of contraceptive methods.

The Contraceptive Equity Initiative aims to address birth control access barriers by expanding research efforts to elucidate and further describe the nature of these barriers and further define the preferences of people and communities regarding contraceptive access. This project also seeks to bolster policy efforts regarding contraceptive access and convene leaders from state and regional contraceptive access projects to foster shared learning, synergy, and efficiency among these initiatives.  

The three core aspects of the project include:

Expand Research Efforts Related to Contraceptive Access

We will seek to understand the current practices, barriers, and facilitators to clinics offering the full range of methods (focusing on contraceptive deserts). We will then apply what we learn to design technical assistance and training programs for clinical partners, advance policy change, and increase contraceptive access for those most in need.

We will also conduct and disseminate research to inform and support access to an over-the-counter (OTC) contraceptive pill among populations with the most barriers to traditional access points.

Bolster Policy Efforts to Support Contraceptive Access

We will seek to increase capacity for federal policy efforts to improve implementation of the Affordable Care Act’s (ACA) contraceptive coverage provision and to expand no co-pay contraceptive coverage to additional populations.

Specifically, we will provide information about legislation that expands pharmacist prescribing and extended supply coverage of contraception and codifies or goes beyond the ACA’s contraceptive coverage provision. We will also expand our state telehealth tool, which provides information on telehealth policies for contraception in all 50 states.

Convene a Shared Learning Collaborative of Regional and State-Based Contraceptive Access Projects

Currently there are multiple state and regional projects taking place around the country to expand access to contraceptive options locally.

We will seek to use our broad experience with the Shared Learning Collaborative (SLC) model to serve as the convener, facilitator, and catalyst for a learning collaborative among interested place-based projects. The goal of this SLC will be to support research, share learnings and best practices across organizations, reduce inefficiencies, and measure impact across regions and initiatives. 

While we celebrate a quarter century of success, we acknowledge that progress isn't victory. We are continuing our journey to improve reproductive well-being and increase agency until all young people have the power to decide their destiny. 

Founded in 1996 as The National Campaign to Prevent Teen Pregnancy, Power to Decide works to ensure that all young people have the power to decide if, when, and under what circumstances to get pregnant and have a child.