Access To Long Lasting Contraception Postpartum Is Unequal


Many women are choosing to acquire IUDs, or birth control implants immediately after childbirth. However, access to this option is unequal according to University of Michigan research.

About 96 percent of postpartum inpatient IUDs are placed at urban teaching hospitals. This suggests most women giving birth in rural and non-teaching hospitals do not have this option available.

“Getting an IUD right after childbirth may be more convenient and less painful than insertion at a later office visit,” said lead study author Michelle Moniz, M.D. M.Sc., an assistant professor at the University of Michigan Medical School.

“Maternity clinicians and policymakers should strive to ensure that women have access to the full range of contraceptive options after childbirth and that they are able to make an informed, voluntary, personal choice about whether and when to have another child,” adds Moniz.

Access to inpatient reversible contraception, and insurance coverage, can prevent unintended pregnancies too soon following a birth—which carries increased risk for miscarriage, stillbirth, and preterm labor. Women who use IUDs, implants, or tubal sterilization are four times more likely achieve a safe, adequate space between births. Yet, owed to lack of access, few women in the U.S. utilize these contraceptive methods by three months postpartum.

There is a slight risk that IUDs inserted after childbirth will fall out, but IUDs are cost-effective and the chance of infection, and injury is low. Contraceptive implants are an especially good option for post-delivery insertion since they cannot fall out.

Earlier research indicated that many women who want an IUD or implant do not return for follow-up appointments to receive the preferred option, usually because of transportation and childcare issues, or other barriers.

“We know that many women's first choice for birth control is an IUD or implant, which are also the safest and most effective forms of reversible contraception,” says Moniz. “We need to remove the barriers that prevent women from getting their preferred method of contraception in a way that's most convenient for them. Expanding access to reversible contraception after childbirth will have a far-reaching impact.”

Source: Institute For Healthcare Policy & Innovation / University of Michigan
Photo credit: george ruiz


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