A new study shows that increased insurance coverage in more states is making contraception, particularly in the form of an intrauterine device (IUD), more available among women at the hospital right after delivery.
Some women decide to get an IUD or implant for long-term contraception at the hospital right after delivery, given the link between pregnancy shortly after giving birth and a higher risk of complications for both mother and infant.
Published in the journal Contraception on Oct. 6, the study showed that specific Medicaid reimbursement for an IUD or contraceptive implant immediately after giving birth has skyrocketed from zero to 19 states within three years. Eight other states are considering offering the enhanced reimbursement.
Lead author Michelle Moniz, obstetrics and gynecology assistant professor at the University of Michigan Medical School, warned that postpartum women retain “a high risk of unintended pregnancy” partly due to less than 10 percent use of effective contraception.
Compared to the tying of fallopian tubes, insurance coverage for long-acting reversible contraceptives (LARCs) is quite new, although LARCs are considered the safest and most effective birth control forms.
However, according to data, 40 to 60 percent of low-income women who express interest to get an IUD or implant do not make it to a follow-up appointment to obtain their preferred birth control technique due to childcare, transportation and other barriers.
The researchers surveyed representatives of 40 Medicaid agencies, who typically provided coverage due to perceived cost savings and “significant benefits for maternal and child health outcomes.” On the other hand, agencies that do not currently offer payment were concerned about high upfront costs and potential health risks.
Almost 1.8 million deliveries are covered by Medicaid in 2010, and the authors hope that private insurers follow the Medicaid example through enhanced immediate post-delivery contraception coverage.
“Reimbursement policies have been one barrier to providing a large group of high risk women with the safest and most effective forms of reversible birth control in a way that’s most convenient for them,” Moniz said.
Evidence shows that the interest in LARCs is on the rise, although American women are not as quick to embrace forms of it compared to other women worldwide.
Based on early 2015 data from the U.S. Centers for Disease Control and Prevention (CDC), IUD use increased 83 percent from 2006-2010 to 2011-2013. Implants also tripled in use during the same period.
Photo: Liz Henry | Flickr