1. Hope for Women
June 30, 2015 - June 30, 2022
United Way of Greater St. Louis
Amount: $1,104,290.12
Hope Clinic for Women, Ltd.
1602 21st Street
Granite City, IL 62040
2. Agency Description
Agency Missionand Description
The Hope Clinic for Women Ltd. is a privately owned agency that has been in operation
since 1974. The Hope Clinic for Women Ltd. strives to serve and protect women, both physically
and emotionally, in matters concerning reproductive health and pregnancy (“Hope Clinic for
Women,” 2014). The clinic offers birth control, pregnancy testing, the morning after pill, RU
486 (the abortion pill), surgical abortions, and private counseling for women. The specially
trained staff is composed of obstetricians, gynecologists, registered and licensed nurses, and
educated counselors. While the clinic serves only women, they do offer multiple sources of
information to men concerning how abortions may affect them emotionally and where to receive
help. This information can be ordered through the website or may be issued over the phone,
number provided on website. The clinic is a well respected facility in the Midwest and is visited
regularly by women who travel from the neighboring communities as well as the surrounding
states. The services offered are greatly appreciated by women who have visited the establishment
(“Hope Clinic for Women,” 2014).
Present Services
Birth control counseling
o oral contraceptive education, samples, and prescriptions
o NuvaRing education and prescriptions
o DMPA (Depo Provera) shots and education
o implant (Nexplanon and Implanon) education
o intrauterine device (IUD) (Mirena and ParaGard) education
Pregnancy testing
Pregnancy ultrasounds
The morning after pill (emergency contraception)
Medical abortions with RU-486 (the abortion pill)
Surgical abortions
Private counseling for women
Private waiting and recovery rooms
3. Community Problem
Unintended pregnancy is a broad term used to describe a pregnancy that occurs at an
inconvenient time, is unplanned, or is not desired at the time of conception (Centers for Disease
Control [CDC], 2013). In 2006, 49% the pregnancies in the U.S. were unintended (Guttmacher
Institute, 2015). There are more than 3.5 million unintended pregnancies each year in this
country (Frost, 2010). Between 2001 and 2006, women in their late teens experienced an
increase in the rate of unintended pregnancies from 79% to 83%, while women in their early
twenties also encountered an increased rate from 59% to 64% (CDC, 2013). In 2012, nearly 40
million women were in need of contraceptive help, while half of those 40 million required public
assistance care (Frost, 2010). Almost 75% of the women that required public assistance were
low-income individuals (Frost, 2014). In 2010, over 2 billion dollars was devoted to public
assistance for family planning care (Sonfield, Gold, Frost, & Darroch, 2002). In the same year,
over 250,000 unintended births were prevented through public financial aid programs and the
government was able to save over 13.5 billion dollars (Frost, 2014). Unintended pregnancies
affect the population and society as a whole. The influence that unintended pregnancy plays on
society includes higher crime rate, higher prison populations, more children in foster care, higher
dropout rates for high school education, as well as a hefty sum of money spent on supplying
public aid, WIC, and food stamps. For instance, public insurance programs such as Medicaid
paid for approximately 68% of the unplanned births in 2010 (Guttmacher Institute, 2015).
In terms of effects on individuals, women who experience an unintended pregnancy have
a higher risk of unsafe behaviors such as drinking, smoking, and drug abuse, as well as a
likelihood for compromised physical and mental health. These women may also be less likely to
sustain their own health or seek a clinicians help, such as getting vaccinations, eating healthy
foods, or utilize prenatal care. According to the World Health Organization, women who have
unintended pregnancies at a younger age, such as teenagers, are more likely to drop out of high
school and, in turn, will have difficulty finding a job (World Health Organization [WHO], 2014).
As for the children who are affected by unintended pregnancies, they are more likely to
experience poor mental health, have a higher risk of developing aggressive behavior, and are less
likely to receive higher education. Children of teen mothers have a higher likelihood of being
incarcerated as adolescents and are also more likely to end up in foster care (Friedman, 2013).
As health care laws are changing and more preventive services are being covered by
insurance, the rates of unintended pregnancies and births should change. In particular, one policy
that influences unintended pregnancy outcomes is the over-the-counter sale of emergency
contraception that was approved in 2013 (Food and Drug Administration. 2014). This was a huge
step since if emergency contraception is only available by prescription, women are less likely to
visit a doctor to receive a prescription and then buy the medication. This process is often
overwhelming and too expensive, since one must take off work to go to the doctor’s office, pay
the appointment fee, and then purchase the medicine at a pharmacy, thus leaving few
5. unintended pregnancy within the first year of use. Compare this method to oral contraceptives
(the combined pill and progestin-only pills) that have a typical use rate of 8.0% and a perfect use
rate of 0.3% for women experiencing an unintended pregnancy within the first year of use (CDC,
2010). From these numbers, it is clear that the possibility of having an unintended pregnancy
while imperfectly using pills is much higher than the chances of becoming pregnant while using
this particular LARC because there is simply less room for human-error. Overall, LARCs are not
the most popular form of contraception due to cost, availability, and misinformation, but they
have high success rates at preventing unintended pregnancies (Rose, Cooper, Baker, & Lawton,
2011).
It is reported that 96% of abortion-providing facilities offer contraception of some kind
and contraception counseling following an abortion, but only about one third of those are able to
offer IUDs (Kavanuagh, Jones, & Finer, 2010). In the area, the Planned Parenthood Federation is
one well-known organization that offers abortion care as well as LARCs, including IUDs,
Implanon®, and Nexplanon®, at their clinics (Planned Parenthood Federation, 2014a). Although
it is unclear when Planned Parenthood will schedule women to get an IUD or implant, there are
sixty-four independent local affiliates that operate roughly seven hundred clinics in the country.
There are six located within 25 miles of Hope Clinic for Women, Ltd., allowing women basic
access to these contraceptive services (Planned Parenthood Federation, 2014b). Increasing the
access to LARCs would reduce the likelihood of unwanted pregnancies and even the likelihood
of women seeking a repeat abortion (Rose, Cooper, Baker, & Lawton, 2011). . In recent years,
intrauterine devices and contraceptive implants have been approved for immediate post-abortion
insertion (Grimes, Lopez, Schulz, & Stanwood, 2010). This could be very meaningful to clinics
with goals to take care of women and prevent repeat abortions and unintended pregnancy.
According to one estimate, if one fifth of U.S. women accessing abortion care had the immediate
placement of an IUD, roughly 43,000 unintended pregnancies could be avoided each year
(Morse, Freedman, Speidel, Thompson, Stratton, & Harper, 2012). The facts that LARCs,
including intrauterine devices and implants, are appropriate for women of all ages, regardless of
pregnancy history, and are reversible needs to be stressed to women attempting to improve their
reproductive health and control and ultimately decrease rates of unintended pregnancy (Yoost,
2014). More clinics need to be able to offer these services to women of all socioeconomic
statuses as soon as possible in order to encourage women to be more in control of their
reproductive health
In addition to encouraging women to use LARCs, some agencies have begun to work on
ending abortion stigma and enabling women with a low socioeconomic status to receive abortion
care, regardless of the cost. The group Advocates for Youth recently launched a grassroots
campaign encouraging women to speak out about their abortion experiences with the hopes that
the stigma of abortion can end in the near future. They are calling the campaign the “1 in 3
Campaign” since 1 in 3 women will have an abortion in her lifetime (1 in 3 Campaign, 2015).
Working towards similar goals is the National Abortion Federation. The agency works to
6. promote education, support professionals in the field, provide means for women to make
informed decisions, and offers financial assistance to women who would not be able to pay for
abortion care otherwise (National Abortion Federation, 2014). Another cause is the Fund
Abortion Now project by the National Network of Abortion Funds. This group helps women find
sources of funding in their area and encourages women to take action when fighting for their
reproductive rights (National Network of Abortion Funds, 2014).
7. Program Summary
This proposal seeks to fund multiple programs, which will expand the services offered at Hope
Clinic, allow the clinic to provide services to more women in need of reproductive care, and
increase awareness of women’s health throughout the St. Louis Metro Area.
Target Population: Hope Clinic for Women, Ltd. serves roughly 7000 patients each year from
many surrounding states and communities (“Hope Clinic for Women,” 2014). The Hope Clinic
routinely provides services for women between the ages of 15 and 44, which reside in the St.
Louis Metro East Area. The Hope for Women Project is centered on the improvement of
women’s reproductive health and will offer services to some 320,000 women from the Metro
Area (web source).
Activities
5K Hope Walk:
The Hope Clinic will host an annual 5K Hope Walk, for six consecutive years, to raise awareness
of women’s reproductive health, the Hope Clinic, and the services offered at the clinic. Each
registered participant at the 5K events will receive a bag including a flyer, with information
about the Hope Clinic, a custom labeled (with Hope Clinic information) bottle of water, a Hope
Walk t-shirt, and a coupon for reduced fee for service at the Hope Clinic. The coupon may be
used towards obtaining any method of birth control offered at the clinic. Other local businesses
may choose to rent booth space at the Hope Walk events for $100, where they may distribute
information and giveaways. In addition, the Heath Educator staff members, along with volunteer,
of the Hope Clinic, will distribute 2,000 Hope Walk flyers (per year) to local businesses such as
grocery stores, convenient stores, pharmacies, drug stores, Obstetrician and Gynecologists
Offices, Planned Parenthood, as well as residential areas within the Metro East area. These flyers
will provide registration information such as the date, time, location, fee for registration, and list
of additional vendors. Included at the bottom will be the web address for the Hope Clinic, a
phone number to call for question, and the address of the Hope Clinic. These flyers will be
distributed throughout the month preceding open registration for the event.
Hope Walk (5K) Program Timeline
Activity Time Frame
Hire Volunteers and Health Educators June 2015
Order tote bags, water bottles, flyers,
coupons, condoms, and T-shirts
April 1, 2016 (annually for perishable items
and flyers)
Hire DJ/reserve walk venue January- annually (2016-2022)
Hope Walk booth rental registration January-May (2016-2022)
Early registration for Hope Walk participants April 1- May 31 (2016-2022)
Assembly of Hope Walk totes May (2016-2022)
Rent tents, tables, and chairs for event booths May 1- annually (2016-2022)
Hope Walk promotional flyer distribution May-June annually (2016-2022)
8. Expanded Services:
Using the funding provided by the United Way grant, we will expand the services offered at
Hope Clinic for Women, Ltd. In addition to the Physicians trained in obstetrics and gynecology,
we will hire a nurse practitioner, whose sole responsibility is to provide women information
concerning a variety of contraceptive methods. Currently the Hope Clinic only offers medical
abortions, birth control pills, and the NuvaRing. Therefore, with the addition of expanded
services, the clinic will begin offering contraception education relating to male condoms,
spermicide, diaphragms, female condoms, dental dams, and Long Acting Reversible Condoms
(LARCs). Once this service has been established, the Hope Clinic for Women, Ltd. will advocate
within the community the importance of women’s reproductive health and begin offering clients
the expanded services. The Hope Walk (5K) and agency website announcements will serve as
opportunities to impart information concerning the newly offered services to women of the
community.
Expanded Services Program Timeline
Activity Time Frame
Hire Nurse Practitioner June 2015
Agency website announcement of expanded
services
June 2015
Expanded services flyer distribution June 30, 2016-2022 (Hope Walk events)
Coupon (reduced fee-for-service) distribution June 30, 2016-2022 (Hope Walk events)
Coupon (reduced fee-for-service) redemption July 1, 2016 (no expiration)
Condom Exchange:
Funding will also provide for a condom exchange program. The condom exchange program will
serve clients that have utilized the extended services or spoken with a Health Educator staff
member and have chosen to use male condoms as a form of contraception. The condom
exchange program entails the client bringing empty condom wrappers in exchange for new
condoms, however any request for free condoms will be honored. The condoms will be free of
charge throughout the length of the program (ending in 2022) and will later be funded with the
proceeds from the annual Hope Walk.
Goals Outcomes Evaluation
1: Increase awareness
of Hope Clinic and
services offered at the
clinic to women
living in the St. Louis
Metro East Area.
1.1: The Hope Clinic
will have 6,000 women
access the expanded
services at Hope Clinic
by year 2022
1.1: The Hope Clinic staff will tabulate the
number of women that visited the clinic to
utilize the expanded services during the time
period of June 30, 2015 through June 30,
2022.
1.2: Hope Clinic will
obtain a 50% increase
of visits on their
website by June 30,
2022.
1.2: The Program Director will observe the
number of hits received on the Hope Clinic’s
website previous to the start of the Hope for
Women project, track monthly hits
throughout the program’s implementation,
and at the end of the program. The final
9. results will be recorded in a report for any
staff and program stakeholders to view.
2: Reduce the rate of
unintended
pregnancies in the St.
Louis Metro East
Area.
2.1: The number of
abortions that are
performed at Hope
Clinic per year will
decrease by 2% by
June 30, 2018; 5% by
June 30, 2020; 10% by
June 30, 2022.
2.1: Annual tabulations will be conducted to
track how many abortion services were
performed and reported figures for the end of
three years (2018), five years (2020) and
seven years (2022).
2.2: By June 30, 2022,
1,500 women of
reproductive age, that
visit the Hope Clinic,
will obtain a Long-
Acting Reversible
Contraceptive (LARC).
2.2 & 2.3: To determine if we met Outcome
2.2, LARC sales will be tracked throughout
the program and a final tally reported on June
30, 2022. To assess the success of Outcome
2.3, the sales of all forms of contraception
will be tracked, tallied, and reported on June
30, 2022. Additionally, the measure the
success of the condom exchange program
based on the number of condoms distributed.
2.3: By June 30, 2022
3,000 women of
reproductive age, that
visit the Hope Clinic,
will obtain some form
of contraception other
than LARC.
11. Personnel Expenses
Executive director: The agency executive director will be responsible for overseeing the project
director, together they will provide overall agency fiscal reports as well as network within the
community to create or maintain relationships with individuals and agencies that have similar
interests regarding the project. They will work part time with a FTE of 0.5, making $2,500
monthly.
(12 months X $2,500 = $30,000 a year)
Project director: The project director will personally oversee the entire project. The project
director will be responsible for managing and overseeing professional staff, volunteers, and
others participating in the events (DJ and Booth rentals). The director will provide monthly and
yearly reports regarding the progress of the project. They will also be responsible for managing
the staff while planning, implementing, and evaluating the various aspects of the project. The
project director will work full-time with a FTE of 1.0, to ensure the success of the project. They
will make $3,645.83 monthly.
(12 months X $3,645.83 = $43,750 a year)
Professional Staff: The Hope Clinic will staff three health educators to help plan, implement, and
evaluate the expanded services at Hope Clinic. They will also be responsible for helping to plan
and successfully host the six 5K’s throughout the project. They will also be responsible for
advertising, updating the Hope Clinic website, and advocating, along with networking, within the
community. The three health educators will be working part-time with a FTE of 0.5 and resulting
in a monthly salary of $1,822.92 per person.
(12 months X $1,822.92 = $21,875 a year X 3 Health Educators = $65,625.12 total)
Nurse Practitioner: The Hope Clinic will hire a nurse practitioner who will be responsible for
conducting consultations with women concerning birth control options best suited for the client
as well as perform LARC insertions. Hiring a nurse practitioner instead of another physician will
assist in saving money on the project. The nurse practitioner will work part time with a FTE of
0.5, only being at the clinic only on Tuesdays, Thursdays, and Saturdays. She/he will make
$3,750 a month.
(12 months X $3,750 = $45,000 a year)
Volunteers: We will utilize health education students and community members to help us
prepare and operate our Hope Walk 5K events. The volunteers will work ten hours during the
week of the 5K, with a FTE of 0.25. We will need ten volunteers to help us facilitate the Hope
Walk, three volunteers to help advertise the walk by passing out flyers, along with three
additional volunteers to help pass out flyers the Clinic’s new services. Theoretically, the
volunteers would be paid $9 an hour (minimum wage). Each of the three volunteers that will be
12. passing out the flyers regarding the Hope Clinic’s expanded services will be working four hours
total, distributing one hundred flyers per hour (for a total of 1,428 flyers).
Each of the four volunteers passing out the Hope Walk flyers will work five hours total,
distributing five hundred flyers (for about a total of 2,000 fliers each year). The volunteers
passing out flyers will only be FTE of 0.125. Using these volunteers we will save the project a
total of $1,206 yearly and $7,398 total for the whole project.
5K Volunteers: $9 X 10 hours = 90 X 10 volunteers = $900
$900 X 6 years = $5,400 total
5K Flyer Volunteers: $9 X 4 hours = $36 X 4 volunteers = $144
$144 X 6 years = $864 total
Hope Clinic (Expanded Service) Flyer Volunteers: $9 X 6 hours = $54 X 3 volunteers = $162
$162 X 7 years = $1,134 total
DJ: For each of the six Hope Walk events, a DJ will be hired. This will be an agency in-kind
expense, as the DJ is local and will be volunteering their time for these events. We will be saving
a total of $600 yearly.
(6 years X $600 = $3,600 total)
Operating Expenses
Tent Rental: During the project the Hope Clinic will be renting four 10’ X 10’ tents from Grand
Rental Station for the six Hope Walk 5K events. The Hope Clinic representatives will utilize to
hand out clinic information, for late registration for the event, and to pass out the tote bags to
participants. This will account for a total of $280 yearly.
($70 X 4 tents = $280. $280 X 6 years = $1,680)
Table Rental: We will need to rent twenty 30” X 72” banquet tables from Grand Rental Station
for each of the six Hope Walk 5K’s that we will be hosting. Fifteen will be devoted to the booth
rentals, three will be needed for registration, one for the Hope Clinic to provide clinic
information, and the last for the tote bags. This will account for $140 yearly.
($7 X 20 tables = $140. $140 X 6 years = $840)
Chair Rental: Forty black plastic folding chairs from Grand Rental Station will be needed for
each of the six Hope Walk 5K’s to provide each table with two chairs. This will account for $54
yearly.
($1.35 X 40 chairs = $54. $54 X 6 years = $324)
T-shirts: We will create a T-shirt design for the 5K’s that advertises the Hope Clinic. We will
make 200 before the first event, and subsequent races T-shirts will be created using the revenue
from the first Hope Walk. The T-shirts will act as free advertisement because individuals will
13. wear them in the community. This will only require us to use $1,000 of grant money the first
year, sustainability funding the rest.
($5 per t-shirt X 200 t-shirts= $1,000. $1,000 X 1 year = $1,000)
Flyers: The Project Director will create two flyers, one will be advertising the new expanded
services offered at Hope, and the other will be advertising the Hope Walk 5K events we will be
hosting. (Dates on 5K flyer will be subject to change each year). We will require 10,000 flyers
advertising the Hope Clinic and their services and we will require 12,000 flyers advertising the
Hope Walk. We will also create a coupon for reduced services at the Clinic that runners will get
along with their T-shirts at the Hope Walk. We can print three coupons per page, requiring 1,000
pages in total (resulting in 3,000 total coupons). This will account for $953 yearly. Printing will
cost a total of $6,670 for the whole project duration. Agency in-kind expenses will help cover
$2,000 of the total printing costs.
($0.29 X 23,000 = $6,670 - $2,000 = $4,670)
Refreshments: A pallet of water bottles will be purchased for each Hope Walk. They are
customizable water bottles from Sam’s Club. The Hope Clinic logo, along with the clinic’s
contact information and new services offered will be on the label of each bottle. One pallet
contains 1,728 bottles. We will use the left over’s to give away to patrons of the Clinic. This will
account for $776 yearly.
(1 pallet of 1,728 water bottles X $776 per pallet = $776 X 6 years = $4,656)
Power: We will require power during the Hope Walk 5K’s to power the DJ. This will account for
$200 a year, per event.
(6 events X $200 = $1,200)
Condoms: Condoms will be purchases from Total Access Group to give to participants of the
Hope Walk events. Each participant will receive 5 condoms. A case contains 1,000 condoms, and
we will purchase 5 cases before the first 5K in June 2016 to last the duration of the six events we
will host over the next seven years. This will account for a total of $520. These will be important
towards our goal of lowering the number of unintended pregnancies, as men and women will
both be able to participate in the runs. Condoms will also be used to stock Hope Clinic so that
individuals can come either participate in the condom exchange program, or receive free
condoms upon request.
(5 cases of 1,000 condoms X $104 per case = $520)
LARCs: To expand the services at Hope Clinic, we will need to acquire Long Acting Reversible
Contraceptives (LARCs) for the clinic to have in stock. For individuals who have health
insurance, it will work depending on how their insurance company operates. Many health
insurance companies will require the individual to place the order directly with them, and they
14. will then send the device to the physician’s office. Since Hope Clinic may be working with a
majority of uninsured, or underinsured, women, it is necessary for the Clinic to have LARC’s on
hand. We will require 400 Intrauterine Devices (IUDs) for the first operating year. A typical fee
for an IUD and insertion is $800. The grant will provide the Clinic with 400 IUDs to offer at
lower costs. These costs will then help supplement future IUDs, along with other revenue
brought into the clinic.
400 IUDs X $800 = $320,000
Tote Bags: Tote bags with the Hope Clinic logo printed on them will be purchased from
Discountmugs.com. They will be given away at the Hope Walk events. They will contain a water
bottle, a Hope Clinic flyer, a coupon for reduced fee-for-service at Hope Clinic, and five
condoms. We will buy all 2,500 totes at the beginning of the program.
($0.61 X 2500 = $1,525 tote bags)
Revenue
Booth rentals: To generate some income, for project sustainability, fifteen booths will be
available for rent at each of the Hope Walk 5K’s. The Executive Director will establish contact
with organizations to solicit interest for filling the booth spaces. The Hope Clinic will contact
other organizations that have similar interests to preventing unintended pregnancies, as well as
agencies who would be happy to support the cause. Some of these include the Madison County
Health Department, St. Louis County Health Department, Planned Parenthood, Madison County
AIDS Program, Band Together, Equality Illinois, PRIDE St. Louis, PFLAG, St. Louis Effort for
AIDS, ThriVe @ St. Louis, Habitat for Humanity, Hospice of Southern Illinois, INC, Stray
Rescue St. Louis, and Madison County Humane Society, among many others. Having these
booths rented will provide an annual revenue of $1,500 for six years.
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