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Literature Review 3 planning is a potential path out of cycles of poverty, cycles that facilitate high rates of unintended pregnancy. There is a clear association between women of particular demographic subgroups, increased rates of unintended pregnancy, and cycles of poverty. Through an understanding of the causal mechanisms between those with low incomes and/or a low level of education and the outcome of an unintended pregnancy, solutions to this public health problem be crafted. However, contraceptive access and use appear to be a key component of the solution. BIRTH CONTROL PILLS: ADVANTAGES AND DISADVANTAGES On May 9, 1960, the Food and Drug Administration approved oral contraceptive pills, giving many women more reproductive freedom (“FDA Approves,” n.d.). There are many different pill options, each with different levels of hormones. Birth control pills prevent pregnancies by “interfering with ovulation and possible fertilization of the egg” (Birth Control, n.d.). There are many advantages when it comes to the pill (Anderson, 2013). These include: · Less than a 1% failure rate with perfect use; · Reduced heavy bleeding, menstrual cramps, and mood changes during periods; · Reduces risk of pelvic inflammatory diseases and cancer of the uterus and ovaries; · Extended cycle pills allow women to have fewer periods, and continuous cycle pills allow women to have no periods; · Improved acne and premenstrual dysphoric disorder; and · Lessens the severity of endometriosis and fibroid tumors. · Gives women the freedom to limit how many children she wants based on her needs (Shah et al., 2001). However, there are also many disadvantages of taking the pill. They include: · Higher risk for blood clots, heart attack, and stroke. These risks are increased in smokers; · Side effects, including weight gain, nausea, stomach pain, mood changes, blurred vision, headache, swelling or pain in legs, breast pain, vaginal dryness, and spotting or breakthrough bleeding; · Some women face a monthly cost or copay, which may not be affordable; · Must be taken at the same time every day to be effective; · Drug interactions may reduce effectiveness; and · It may be difficult to start ovulating again for several months after stopping the pill. It is important to note that birth control pills are most effective when used correctly and consistently. Under typical use, birth control pills are far less effective than long-acting reversible contraceptives; annually, 9 out of 100 women who use the pill typically get pregnant. However, the risk of pregnancy is far lower for women who use the pill at the same time every day (Birth Control Pill Fact Sheet, n.d.). Women who take birth control pills are three to four times more likely to develop a blood clot. It is estimated that one in three thousand women on birth control pills will develop a blood clot (James, n.d.).