Earlier this week, the American College of Obstetrics & Gynecology (ACOG) published a recommendation that hospitals should begin offering all women access to long acting reversible contraceptive (LARC) options immediately after giving birth. Currently, many physicians wait to discuss birth control options with new mothers until they return for their postpartum follow-up visit. Unfortunately, this approach can present a number of issues.
To begin with, the ACOG estimates that up to 40 percent of women miss their postpartum follow-up appointments. In other cases, women may lose insurance between the time they give birth and the time of their follow-up appointment.
By counseling women on birth control options before they’re discharged after giving birth, these barriers could be eliminated, at least in part.
The ACOG advises that long term birth control options such as implants and IUDs are the most effective ways to prevent short-interval pregnancies (pregnancies that occur within 1 year of delivery). Short-interval pregnancies are associated with a higher risk of preterm birth and neonatal complications. Furthermore, the ACOG estimates that at least 70 percent of short-interval pregnancies are unintended.
Although IUD expulsion rates are higher in cases of immediate postpartum insertion, the authors of the ACOG’s recommendation write that “the advantages of immediate placement outweigh the disadvantages.” The authors also encourage obstetricians to “advocate for appropriate reimbursement for immediate postpartum LARC insertion,” so that it doesn’t place an undue financial burden on new mothers.
In the past, many insurance companies failed to cover the cost of providing contraception during hospital stays following labor and delivery. Recently, however, that’s begun to change. Today Medicaid, which pays for approximately half of all births in the U.S., covers long acting contraceptives after delivery in at least 20 states.