Increasing Long-Acting Reversible Contraception [LARC; intrauterine devices (IUD)/implants] uptake has been reported. On 06/24/2022 the Supreme Court overturned Roe v Wade in the Dobbs Decision, returning abortion regulation to states, and prematurely leaked on 05/02/2022. This study examines patient-level characteristics and time trends of LARC procedures.

Methods

A retrospective cohort of 313,074 persons aged 15-54 with claims for LARC insertion procedures between 01/19-09/23 was identified from the Vizient^® Clinical Data Base (CDB) amongst 788 continuously reporting hospitals (IUD n=237,660; implant n=75,414).

Results

Patients were 31±9 years, white (64%) or Black (15%), 24% Hispanic, private payer (50%) and Medicaid (34%). Implant insertions were younger (26±8 years) and more likely Hispanic (39%), compared to IUD (33±9 years; 19% Hispanic) (p<0.05).

Compared to pre-2020 (to reflect pre-COVID), IUD insertions/day increased 10% post-2020, 21% in the leak period, and 27% post-Dobbs; implant rates decreased from pre-2020, followed by an 2% increase post-Dobbs.

Among states with pre-Roe bans/trigger laws, increasing trends were exacerbated in pre-Roe ban states where IUD insertion rates were 40% higher post-Dobbs. In trigger law states, a 22% increase in IUD uptake was noted after the leak and a 24% increase post-Dobbs, above pre-2020 rates. Similar trends were noted among implant insertions.

Conclusions

LARC uptake increased beyond pre-2020 rates within CDB hospitals, with sizable increases following the leak/Dobbs. Patterns among states with differing abortion protections reflects access to care and desire for long-term contraception. This study reinforces crucial access to LARC to limit worsened health disparities coinciding with restrictive policies.