PROVIDENCE, RI [Brown University] – A new study finds that long-term contraceptive techniques, such as intrauterine devices and contraceptive implants, may allow people who have recently given birth to stop having birth. prevented them from falling unnoticed in the following months.
The study – which analyzed the effects of the 2012 Medicaid policy implemented in South Carolina – found that extended access to certain types of birth control was particularly helpful in preventing unexpected pregnancies among teenagers who had just given birth, giving them more control over their own futures.
“The ability to control your pregnancy and when you are pregnant is a fundamental human right, as pregnancy and childbirth have a significant impact on social and economic life indicators,” said Maria Steenland, assistant professor of population studies. (research) at Brown University affiliated to the Center for Population Research and Training.
Steenland conducted the study, published on Friday, Feb. 5, in Health Issues, along with three colleagues at Harvard University’s medical and public health schools.
Steenland said, in 2012, the Medicaid program in South Carolina became the first in the United States to reimburse hospitals for providing long-term postpartum reversible contraception (LARC) ). LARCs, which prevent pregnancy for long periods of time without any effort on the part of the patient, include intrauterine devices, arm implants and hormonal injections.
Before the state implemented the policy, she said, patients who had just given birth and wanted immediate postpartum contraception had few options; LARCs were only available if they were willing to return to the hospital for a separate patient procedure, and birth control pills are not considered medically safe for use early in the postpartum period. As a result, 59% chose not to use a very high or moderately effective method of contraception; 22% chose a short-acting method, such as spermicide; and 13% opted for sterilization, which is irreversible.
To examine the impact of the new policy, the study analyzed data on more than 150,000 South Carolina Medicaid-insured women between the ages of 12 and 50 born from 2010 to 2014. These were found in the medical facilities which began offering LARC after the policy change, a highly effective contraceptive practice among postpartum abortion patients among adolescents, who are particularly at risk of becoming pregnant with a higher-risk child. Among Medicaid patients ages 12 to 19, the rate of immediate postpartum LARC use increased by more than 6 percentage points between March 2012 and November 2014. Across all age groups, the overall percentage of Medicaid patients who opted for Postpartum LARCs are almost rectangular in two and a half years. In some facilities, medical staff administered LARCs to up to 20% of all postpartum patients.
“Contraceptive choice is based on many factors, such as side effects, reversibility and efficacy,” Steenland said. “Our study shows that it will be easier for patients to find a way to meet their needs and preferences, and ultimately it can give them more involvement in co-operating. close whether they should get pregnant again.
Less confident, Steenland said, the researchers found that less than half of South Carolina facilities had started offering immediate postpartum LARCs to patients, despite the policy change.
“We found that many hospitals did not start offering postpartum LARCs immediately after the policy change, indicating that Medicaid reimbursement is only the first step in providing these options. , “she said.
Steenland and her coauthors recommended that the state’s Medicaid facilities and program take additional policy steps to make long-term contraception more widespread – especially since many studies, including one of their own, showing when LARCs are available and free, more patients choose to use them and unexpected pregnancy rates decrease.
###
The work was funded in part by a grant from the population dynamics branch of the National Institute for Child Health and Human Development (R03HD099428). Steenland received support from the National Institutes of Health (training grant # T32 HD007338) and other NIH support (grant # P2C HD041020). The Eric M. Mindich Research Fund for Fundamentals of Human Behavior funded the data used in this study.
Disclaimer: AAAS and EurekAlert! they are not responsible for the accuracy of press releases posted to EurekAlert! by sending institutions or for using any information through the EurekAlert system.