Decreasing Unintentional Pregnancies for Tennesseans

Abstract

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical visit. The purpose of this study was to document the process of nursing advocacy through a legislative initiative to change health policy to allow for over-the- counter contraception to decrease unintentional pregnancies and abortions in Tennessee. This case study used political process theory to describe the process of assembling a coalition and working with state legislators to implement a change in health policy that affects individuals, populations, and society. The case study findings were designed to inform nurses and other health professionals about advocacy and the health policy process, including the political realities of change in a conservative, antiabortion state.