Association of the Delaware Contraceptive Access Now Initiative with Postpartum LARC Use.
Long acting reversible contraceptives (LARCs)
Medicaid
Postpartum contraceptive use
Provider training
Journal
Maternal and child health journal
ISSN: 1573-6628
Titre abrégé: Matern Child Health J
Pays: United States
ID NLM: 9715672
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
accepted:
19
03
2022
pubmed:
1
5
2022
medline:
30
7
2022
entrez:
30
4
2022
Statut:
ppublish
Résumé
Although multi-component policy interventions can be important tools to increase access to contraception, we know little about how they may change contraceptive use among postpartum women. We estimate the association of the Delaware Contraceptive Access Now (DelCAN) initiative with use of postpartum Long-Acting Reversible Contraception (LARC). DelCAN included Medicaid payment reform for immediate postpartum LARC use, provider training and technical assistance in LARC provision, and a public awareness campaign. We used a difference-in-differences design and data from the 2012 to 2017 pregnancy risk assessment monitoring system to compare changes in postpartum LARC use in Delaware versus 15 comparison states, and differences in such changes by women's Medicaid enrollment. Relative to the comparison states, postpartum LARC use in Delaware increased by 5.26 percentage points (95% CI 2.90-7.61, P < 0.001) during the 2015-2017 DelCAN implementation period. This increase was the largest among Medicaid-covered women, and grew over the first three implementation years. By the third year of the DelCAN initiative (2017), the relative increase in postpartum LARC use for Medicaid women exceeded that for non-Medicaid women by 7.24 percentage points (95% CI 0.12-14.37, P = 0.046). The DelCAN initiative was associated with increased LARC use among postpartum women in Delaware. During the first 3 years of the initiative, LARC use increased progressively and to a greater extent among Medicaid-enrolled women. Comprehensive initiatives that combine Medicaid payment reforms, provider training, free contraceptive services, and public awareness efforts may reduce unmet demand for highly effective contraceptives in the postpartum months.
Identifiants
pubmed: 35488950
doi: 10.1007/s10995-022-03433-2
pii: 10.1007/s10995-022-03433-2
pmc: PMC9055365
doi:
Substances chimiques
Contraceptive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1657-1666Subventions
Organisme : NICHD NIH HHS
ID : P2C HD041041
Pays : United States
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : P2C-HD041041
Informations de copyright
© 2022. The Author(s).
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