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Medicaid Finds Opportune Time to Offer Birth Control: Right After Birth
COLUMBIA, S.C. — Last month, Akia Gayle gave birth to her third child. Sixteen hours later, while she was still in her hospital bed, a doctor implanted a matchstick-size plastic rod in her left arm because she did not want to have a fourth.
“To have it done right then and there — that’s good,” Ms. Gayle said. “I don’t want more kids.”
Ms. Gayle is one of thousands of women in South Carolina’s Medicaid program who have gotten long-acting contraception at an unusual moment — right after they give birth. The novel policy, which has since been adopted by at least 19 other states, covers long-acting contraception right after birth for women on Medicaid, the government health insurance for low-income Americans. It is intended to help answer one of the most vexing questions in public health: how to reduce unplanned pregnancy in the United States.
Nearly half of all pregnancies in the country are unplanned, and in a majority of those cases, the woman already has a child. Rates are at leasttwice as high for poor women. Yet contraceptive methods have never been better: Tiny implants and new, modern IUDs last for up to five years and are far more effective than condoms and the pill. The problem is that they are expensive and usually require several trips to the doctor, insurmountable hurdles for many low-income women.
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