Women in rural areas who use illicit drugs have low rates of contraceptive use and high rates of unintended pregnancies compared to women in rural areas who do not use these drugs, according to the results of a survey conducted in eight rural areas of the United States.
The findings, published in the Journal of General Internal Medicinecome as access to reproductive health care – including abortion – is increasingly restricted in large swaths of the country, following the June 24 US Supreme Court ruling to undo the constitutional protections in place since Roe vs. Wade became a precedent in 1973.
The cross-sectional study was carried out by researchers from Oregon Health & Science University and co-authors across the country.
The results could be particularly remarkable given the recent Supreme Court ruling.
“This is going to have consequences in terms of increased maternal injuries and deaths, as well as exposure of newborns to harmful substances during pregnancy,” the lead author said. Ximena A. Levander, MD, MCRAssistant Professor (General Internal Medicine and Geriatrics) in the OHSU School of Medicine.
The researchers looked at data from the Rural Opioids Initiative, a survey conducted in eight rural areas of the United States from January 2018 to March 2020. They focused on women aged 18 to 49 who reported having used drugs illegal over the previous 30 days – a total of 855 people.
Only about 37% reported using contraceptives.
By comparison, survey data from the National Survey of Family Growth indicates that 66% of the total female population in rural areas used contraceptives. The researchers said the new findings underscore the need to expand access to reproductive health care and drug treatment in rural areas.
“There are long-term economic consequences for women who have children when they don’t intend to,” Levander said. “We know that women who use illicit drugs have higher rates of unintended pregnancy, which raises concerns for their health and that of the infant.”
The survey reached women in rural areas of Oregon, Illinois, Kentucky, North Carolina, Massachusetts, Vermont, New Hampshire, Ohio, Wisconsin and Virginia -Western.
The research is based on data collected and/or methods developed through the Rural Opioid Initiative (ROI), a multisite study with a common protocol that was developed collaboratively by researchers from eight research institutes and the National Institute of Drug Abuse (NIDA), Appalachian Regional Commission (ARC), Centers for Disease Control and Prevention (CDC), and Substance Abuse and Mental Health Services Administration (SAMHSA).
The research presented in this manuscript is the result of secondary data harmonization and analysis and was supported by NIDA grant U24DA048538. Primary data collection was supported by grants UG3DA044829/UH3DA044829, UG3DA044798/UH3DA044798, UG3DA044830/UH3DA044830, UG3DA044823/UH3DA044823, UH3DA044822/UH3DA044822, UG3DA044831/UH3DA044831, UG3DA044825, UG3DA044826/ UH3DA044826, and U24DA044801 co-funded by NIDA, ARC, CDC, and SAMHSA. XAL and RRC were supported by AHRQ K12 HS026370. ESA was supported by NIDA 0099148/00070029, NIDA UG1 DA050066-01, AHRQ 1R18HS027088-01 and NIDA 1U2CDA050098-01. KEL was supported by NIDA K01DA048174.