Many women would like to have a contraceptive implant or intrauterine device immediately after giving birth but have not had the option, due to insurance reimbursement regulations. However, this service is now being offered in more and more states, as Medicaid expands coverage for it.
Insurers are increasingly covering IUD contraception straight after giving birth.
According to a University of Michigan analysis, published in the journal Contraception, in just 3 years, Medicaid reimbursement for an intrauterine device (IUD) or implant at the time of a birth has gone from not being available to being offered in 19 states, with eight more considering the option.
Not implementing contraception immediately after birth can lead to repeat pregnancy too soon after, which can be dangerous for mother and baby, with a higher likelihood of miscarriage, preterm labor and stillbirth. All of these will ultimately cost more for the insurers.
Among women from low-income backgrounds who would like to have a device fitted to prevent unwanted pregnancy, 40-60% do not obtain one, due to childcare, transportation and other reasons.
Telephone interviews with 40 Medicaid agencies have revealed that many insurers now support the option, due to perceived significant benefits for the health of mother and child. This in turn brings an overall financial saving, as it prevents complications related to conceiving again too soon after a birth.
Even agencies that do not yet provide payment for the service have expressed concern about health risks and uncertainty about financial implications.
Providing what women need, when they need it
Lead author Dr. Michelle Montiz, an assistant professor of obstetrics and gynecology, and researcher at the University of Michigan Medical School, says:
“Postpartum women have a high risk of unintended pregnancy, partly because less than 10% use the most effective forms of contraception. Many women’s first choice for birth control is an IUD or implant, which we know are the safest and most effective forms of reversible contraception.”
There have been misconceptions regarding immediate postpartum contraception, but the authors note that the risk of infection or injury when an IUD is inserted at this point is “exceedingly low.”
There is a slightly higher chance of the IUD falling out if implanted immediately, rather than 8-10 weeks later, but they are still cost-effective. Contraceptive implants have no risk of falling out, which makes them a very suitable option.
Medicaid reimbursements feature largely in the lives of women and families, with nearly 1.8 million births being covered by Medicaid in 2010.
Dr. Moniz says that the “landscape is changing,” with more insurance providers offering this service, and she is hopeful that this will benefit a large group of the most vulnerable women in the US by providing them with convenient birth control, when they need it.
In June this year, Medical News Today reported that the number of unwanted pregnancies in California has dramatically reduced due to improved counseling and provision of IUDs and contraceptive implants.
Written by Yvette Brazier
Copyright: Medical News Today
Read more breaking health news on our homepage