The Iowa Initiative to Reduce Unintended Pregnancies was a five-year project (2007-2012) with the aim of reducing the high rate of unintended pregnancies among Iowa women ages 18-30 through networking, research, and public outreach.

With nearly half of all pregnancies unintended nationwide and with similar rates in Iowa, the goal of the Iowa Initiative (and a sister project in Colorado) was to provide evidence-based research to support better access and use of family planning services to reduce the number of unintended pregnancies.

Preliminary results of the research, which focused on publicly funded clinics in Iowa, were very encouraging. During the five years of the Iowa Initiative project, the number of Iowa women utilizing the most effective reversible birth control methods (long-acting reversible contraceptives, or LARCs) increased, while the rate of unintended pregnancies and abortions decreased.

The Iowa Initiative project had two external evaluation teams collecting data and evaluating the results of the clinical access research portion of the project. Those evaluators were:

• The Bixby Center for Global Reproductive Health at the University of California at San Francisco – Claire Brindis, Director, Abigail Arons, and Antonia Biggs; and
• Philliber Research Associates – Susan Philliber, Founder and Senior Partner, Heather Hirsch, Ashley Philliber, Rita Turner, and Louis Mortillaro.

In addition, a research program was also conducted by the University of Northern Iowa’s Center for Social and Behavioral Research, led by Mary Losch, PhD, in conjunction with the University of Iowa and the University of Alabama-Birmingham. It included four studies designed to increase knowledge, persuade adult women to seek and access contraception if they wish to delay or prevent pregnancy, and improve contraceptive behaviors. Those studies were as follows:

1. Until You’re Ready, Avoid the Stork – Project leads: Shelly Campo, Natoshia Askelson, Erica Spies, and Mary Losch
2. “Speak UP!” Salon Project – Project lead: Susan Roberts-Dobie
3. Radio Serial Dramas – Project leads: Connie L. Kohler and Shelly Campo
4. Unintended Pregnancy Pharmacy Project – Project leads: Karen B. Farris and Mary Aquilino

The Iowa Initiative Staff, Board, and Partners

The project consisted of three main components: research conducted through family planning clinics in the state; intervention research that happened throughout the state; and the central office, which was primarily responsible for the public networking and outreach work.

The central office was first headed up by former Iowa First Lady Christie Vilsack, who served as executive director from the project’s inception in 2007 until February 2011. Former Iowa Lieutenant Governor Sally Pederson succeeded her, leading the Initiative from March 2011 until the project’s conclusion in December 2012. Deb Madison-Levi served as Director of Operations throughout the project. Mary Triick, Tonja Richards, and Laura Riordan Berardi were also on staff at different times.

As a 501(c)3 non-profit organization, the Iowa Initiative was governed by a Board of Directors. Many of the Board members were able to serve for the entire five years of the project. At the time of the Initiative’s end in 2012, the members of the Board were as follows: The Honorable Lee Clancey; Rev. Elizabeth Dilley; Susan Knapp; Dr. Andrea McGuire; Alba Perez; Louise Porter; Dr. Yogesh Shah; Mary Stier; Thomas Temple; The Honorable Maggie Tinsman; and Christie Vilsack.

Key partner organizations to the Iowa Initiative were as follows: the Iowa Department of Public Health, Bureau of Family Health, led by Denise Wheeler; the Family Planning Council of Iowa, led by Jodi Tomlonovic; and the Healthy Families Project of Planned Parenthood of the Heartland (formerly Planned Parenthood of Greater Iowa), led by Jill June; and the Center for Social and Behavioral Research at the University of Northern Iowa, where the Iowa Initiative Research Program was based.

In addition, the Iowa Initiative worked with family planning agencies throughout the state: Allen Women’s Health, Central Iowa Family Planning, Edgerton Women’s Health Center, Emma Goldman Clinic, Hillcrest Family Services, Myrtue Medical Center, New Opportunities, North Iowa Community Action, Northeast Iowa Community Action, Planned Parenthood of the Heartland (PPH), Planned Parenthood of East Central Iowa (now part of PPH), Planned Parenthood of Southeast Iowa (now part of PPH), Southern Iowa Family Planning, St. Luke’s Family Health Center, Trinity Muscatine Public Health, Venus Family Planning/VNS of Iowa, and Women’s Health Services.

The Iowa Initiative to Reduce Unintended Pregnancies was funded entirely through private, non-taxpayer funds.

Looking to the Future

Iowa’s experience can be a model for other states and for the nation, and provide policymakers and health care professionals with important data to guide decision-making. The four recommendations of the Iowa Initiative are as follows:

1. Enhancing investments in publicly funded family planning services so clinics can educate patients, through outreach and advertising, about the most effective birth control options and offer those options at little or no cost.
2. Educating obstetricians and gynecologists, family practice physicians, nurse practitioners, nurse midwives and physician assistants about the safety and efficacy of LARCs and provide training on their use.
3. Encouraging health care professionals, nonprofit human services organizations, civic organizations, foundations, advocates and public officials to work together to reduce unintended pregnancies and abortions through better access to the most effective contraception.
4. Instituting programs at community colleges, private colleges and universities to help students avoid unplanned pregnancies and thereby improve academic success.

The project officially concluded, and the Des Moines office closed, on December 31, 2012.

Those involved directly in the research have said they have enough numbers and data to analyze to keep them busy for quite sometime. While the preliminary results have been posted on the Iowa Initiative website, which will remain live until December 4, 2013, interested persons are encouraged to check the websites of the evaluators (Philliber Research Associates and the Bixby Center for Global Reproductive Health) and the research program (UNI Center for Social and Behavioral Research) for additional reports, publications, and findings based on this project published after the Iowa Initiative office closes.

The Iowa Initiative team would like to thank all of the people who worked tirelessly on this project, as well as all of the groups and individuals who invited us into their meetings, offices, and sometimes even their homes to talk about this important issue. We were able to meet many courageous, enthusiastic, and dedicated Iowans who have the same desire we do: To make our families healthier and our communities stronger. Thank you.