Initial visit high-risk clients were more apt to use Depo Provera as their primary method of birth control than are women making annual visits with 15.8 percent and 12.0 percent reported respectively. This higher usage of Depo Provera at initial visit than annual visit is the case for all the categories that make up the high-risk group. Depo Provera is less client dependent than most other methods of contracepting which may make it more suitable for these clients.

Of all clients making an initial or annual visit to a family planning clinic, approximately 12 percent (2,213) had been pregnant in the twelve months preceding the visit. Of these pregnancies, 32 percent were intended and 55 percent were unintended with pregnancy intention unknown for the remaining pregnancies. Clients making an initial visit to a family planning clinic had a higher rate of unintended pregnancy than did clients making an annual visit. Nearly two-thirds of the clients with a pregnancy during the previous twelve months were making an initial visit to the clinic. Figure 1 presents a breakdown by type of visit and intentionality for those clients with a pregnancy within the past year. As Figure 1 indicates not only did those women making an initial visit have more pregnancies but also more of these pregnancies were unintended than were those of the women making an annual visit. Nevertheless, it is important to note that the majority of pregnancies were unintended even for those making an annual visit. Women making an initial visit to a family planning clinic had a much higher rate of pregnancy (200.0 per 1,000 females) than did women making an annual visit. This latter rate (73.1) was close to the overall state rate of 74.4 pregnancies per thousand females.

A measure of family planning impact is change in contraceptive practice. Accordingly, the contraceptive methods used by the client before and after the visit are compared in Table 2. Of all clients making an initial or annual visit nearly 2,000 were not using any method of contraception prior to the visit. Nearly 75 percent of these clients began using a prescription-based method and an additional 6 percent began using an over-the-counter method. Also, of those clients making an initial or annual visit with prior use of an over-the-counter method, over 75 percent changed to a prescription-based method. Clients who had been pregnant within the past year and had not been using a contraceptive were even more likely to adopt a prescription-based method (81.2 percent). Ninety percent of all clients chose one of the more-effective (prescription-based) methods as their contraceptive following the family planning visit.

It is estimated that "For every 1,000 women using reversible contraceptives and relying on a publicly funded provider, 260 unintended pregnancies are prevented, including 112 live births and 114 induced abortions with the remainder spontaneous abortions and stillbirths". Of the 18,464 females who utilized family planning clinics either for an initial or annual visit, 90.4 percent (16,689) were using a reversible contraceptive method after the visit. Applying this estimate to the 16,689 results in 4,339 averted pregnancies including 1,869 live births, 1,903 induced abortions and 567 spontaneous abortions and stillbirths

The chief measure of a program's effectiveness is whether it accomplishes stated goals. Despite the limited data available, it appears that the family planning program is meeting the goal of enabling women to better control their fertility through averting and/or delaying pregnancy. Decreases in abortions and in births occurring to women within 18 months of a previous birth suggest that some unintended pregnancies are being avoided. Most clients leave a family planning visit practicing some form of contraceptive and usually a more effective method than they were using prior to the visit.

An important part of the current effort in family planning is to provide services to those most in need of help in controlling their fertility. The overwhelming proportion of females utilizing public family planning services are the most at-risk for unintended pregnancy and therefore, the ones most in need of these services. The need for family planning services will not only not decrease in the immediate future but as the fertile range becomes more weighted toward the younger age groups may actually increase due to both their higher level of fertility and increased risk of unintended pregnancy.