Online Program

Initial Evaluation of the First State Medicaid Policy for Immediate Postpartum Insertions of Long Acting Reversible Contraceptives in Hospital Settings

Monday, November 2, 2015

Amy Mattison-Faye, MPH, Arnold School of Public Health, University of South Carolina, Columbia, SC
Emily Mann, PhD, Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
Heather Brandt, PhD, CHES, Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
Deborah Billings, PhD, South Carolina Contraceptive Access Campaign, Advocates for Youth, Columbia, SC
Jennifer Duffy, Ph.D., South Carolina Campaign to Prevent Teen Pregnancy, Columbia, SC
Jihong Liu, ScD, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
In the United States, unintended pregnancy remains a significant public health issue.  Policies that support linking women in need to highly reliable contraceptives is crucial for prevention of unintended pregnancy. In 2012, South Carolina became the first state to enact a new Medicaid policy that covers the cost of immediate postpartum insertions of long-acting reversible contraceptives (LARCs) in hospital settings paid for by Medicaid.  The overall goal of this new policy was to increase access to reliable contraceptives for women wanting to delay a repeat pregnancy. This policy was informed by the experience of practitioners and supporting data that found new mothers commonly missed their postpartum appointments, lacked access to contraception, and had repeat pregnancies sooner than intended.  To date, South Carolina is the only state with a Medicaid policy that facilitates women’s and adolescents’ immediate access to highly reliable contraceptives postpartum for those who decided to delay having a repeat birth. This study examined the implementation process of the policy on LARC use.  Medicaid data from before implementation of the policy and after were examined for trends in postpartum LARC insertion in the 43 labor and delivery hospitals in the state.  In addition, survey methods and in-depth interviews were used to gather information on implementation with implementers, including health care providers and administrators.  Preliminary results show great variability across hospitals and challenges to implementation of the policy.  If the policy is to be successful in achieving the goal of reduced unintended repeat pregnancies, the quality of implementation is critical.

Learning Areas:

Clinical medicine applied in public health
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify the key components of policy implementation in South Carolina’s labor and delivery hospitals.

Keyword(s): Contraception, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a public health research and evaluation specialist, I have worked on several federally funded and private grants related to assessing teen pregnancy prevention efforts. I also have evaluated a national risk-communication policy used to alert health care providers, hospitals and the public when a pharmaceutical, biological, or device has been recalled. In addition, I have assessed the implementation and utility of a farmers market associated with a federally qualified health center.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3217.0: Contraception