Expanding Medicaid coverage will offer more women the choice to get an intrauterine device (IUD) or contraceptive implant immediately after giving birth, according to a study published September 28 online ahead of print in Contraception.

Between 40% and 60% of low-income women who want to get an IUD or implant never attend a follow-up appointment after having their child due to constraints such as transportation and childcare.

By offering reimbursement for an IUD or implant at the same time as delivery, Medicaid will give these women the opportunity to get the birth control they want. This can help reduce unintended pregnancies too close to the birth of the first child, which can carry risks for both the mother and fetus.

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Researchers interviewed 40 Medicaid agencies via telephone. Agencies that did provide post-delivery contraception reimbursement often cited health benefits and cost-savings as key reasons for their decision. Among agencies that did not provide this service, concerns about potential health risks and financial uncertainty were often referenced.

In 3 years, the number of states that offer Medicaid reimbursement for an IUD or contraceptive implant has increased from zero to 19. Medicaid agencies in an additional 8 states are considering offering this reimbursement.

The study authors hope that Medicaid agencies in more states, as well as private insurance companies, will begin to cover postpartum contraception.