Birth control became a lot more common over the past couple of decades, but the number of women worldwide who lack access to modern methods of contraception, like the pill or intrauterine devices (IUDs), still tops 200 million.
That's according to a new study appearing in the Lancet, which found that in 2010, more than 63 percent of the world's married women of reproductive age (ages 15-49) reported using modern forms of contraception. That was up from about 55 percent in 1990.
Researchers also found that the percentage of women who had trouble accessing birth control decreased during that same 20-year window – from about 15 percent to about 12 percent.
Still, about 146 million women are estimated to have an "unmet need" for birth control, and that number jumps to 221 million if women who use "traditional methods" – periodic abstinence or pulling out, for example – are included.
By 2015, the study's authors believe that number will be as high as 233 million:
Our findings support calls to increase investments in family planning, especially in regions where contraceptive prevalence is still low, unmet need is high, and the growth in the number of women of reproductive age is rapid.
Less than 10 percent of women living in the African nations of Chad, Mali, Sierra Leone and South Sudan had access to birth control, while the same was true for more than 80 percent of their counterparts in China, Costa Rica, Malta, Norway and the United Kingdom.
In the U.S., around 4.3 million women lack access to modern contraceptive methods; that number is expected to experience a slight uptick in 2015.
The situation on the southside
South Los Angeles is no stranger to that unmet need – the area's got some of the county's highest rates of chlamydia and teen birth. Serena Josel, Planned Parenthood Los Angeles' director of public affairs, says the reason may be largely financial.
"There is a lot of awareness about birth control, but folks aren't necessarily aware that birth control can be accessed affordably or what the best method of birth control is for them," she said.
Josel pointed to California's Family PACT program as an example, noting that many of Planned Parenthood's patients are enrolled and receive free birth control and family planning education as a result.
Nationwide, there's the Affordable Care Act. One provision of the law requires most health insurance providers to cover federally-approved contraception; another, set to take effect next year, will expand health care coverage, either through statewide health insurance marketplaces or the Medi-Cal expansion. So, in theory, "access to birth control across the board should improve," said Josel.
"I think the question of whether it will in reality depends on a number of factors, the biggest of which is access to providers," she said. "There's just a real issue of provider shortages."
But "things will only get better" for people who already have insurance or who will become uninsured next year, said Josel.
"The rub is that we know that there are still going to be a decent amount of people who remain uncovered after the Affordable Care Act's full implementation," she said, including people who are undocumented and new immigrants who have been in the U.S. less than five years.
In the meantime, health providers and professionals in South L.A. and the rest of the county will continue to strategize about how to contend with a potential swell in demand for health care services while continuing to provide care to those who remain uninsured.
"It'll probably take a little while and it's probably going to be a work in progress," said Josel.
Serena Josel also listed nine important things to know about birth control.