College of Liberal Arts

Research Shows Unmet Demand for Long- Acting Contraception After Delivery in Texas

Wed, Jul 12, 2017
Research was based on interviews with 1,700 new mothers in eight Texas hospitals.
Research was based on interviews with 1,700 new mothers in eight Texas hospitals.

New research from the Texas Policy Evaluation Project (TxPEP) at The University of Texas at Austin identifies unmet demand for long-acting, reversible (LARC) and permanent contraception among recent mothers in Texas.

The study assessed the types of contraception publicly insured women would prefer to use after delivery, and found a much higher percentage of women prefer LARC and sterilization than the percentage of women who actually use these methods. The research, based on interviews with 1,700 women who delivered healthy babies at eight Texas hospitals, was published online in Obstetrics & Gynecology.

“These results show that preference for IUDs, implants and female sterilization is high among public patients in Texas, but that these low-income women often have trouble accessing their preferred method of contraception after delivery,” said lead author and UT Austin sociology professor Joseph Potter, principal investigator of TxPEP.

Of the eight hospitals that participated in the study, only one provided LARC methods immediately after delivery. Women at this hospital were much more likely to use implants and IUDs than women at the other hospitals in the study.

“This study suggests that one way to improve access to IUDs and implants, in particular, is by making these methods available to women who want them immediately after giving birth,” Potter said. Providing these methods in the hospital right after delivery is possible in Texas due to a Medicaid rule change that was instituted in January 2016, but the practice has not yet been widely adopted in the state, Potter explained.

The study also found that women who received prenatal care from a public clinic were more likely to use a LARC or a permanent method than those who obtained care from a provider in a private practice.

“Providing increased training and education about IUDs and implants to physicians and other clinicians in private practices, and finding ways to make sure that their patients have timely access to these methods could make a real difference,” said co-author Kate Coleman-Minahan, an assistant professor of nursing at the University of Colorado- Denver.

Another finding with policy implications for Texas and other states with large immigrant populations is the barriers foreign-born women face accessing LARC or permanent contraception, possibly due to undocumented immigrants’ lack of insurance coverage for contraception after delivery, researchers said.

The study’s authors suggested that using state funds to expand postpartum coverage to include contraceptive services could help generate a considerable increase in use of highly effective contraception, which would in turn reduce the incidence of unintended pregnancy and induced abortion.

The Texas Policy Evaluation Project is a comprehensive effort to document and analyze the impact of the measures affecting reproductive health passed by the Texas Legislature and includes researchers at UT Austin’s Population Research Center, the University of California San Francisco, Ibis Reproductive Health and the University of Alabama-Birmingham. The project is supported by grants from the Susan Thompson Buffett Foundation and the Society of Family Planning. 

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