|
 On the other hand, low-income women who were ineligible for free
long-acting reversible contraception (LARC), such as an intrauterine
device (IUD) or arm implant, were much more likely to use less
effective contraception.
“As a result, these women were more likely to become pregnant again
within the year and seek an abortion again,” said study author
Vinita Goyal of the University of Texas at Austin. The study was
conducted at Planned Parenthood of Greater Texas in Austin.
In Texas, a waiver program of Medicaid, the federally-funded
insurance for the poor that is administered by states, uses a
combination of federal and local funds to offer free LARC to
low-income uninsured women from Travis County, which includes
Austin.
“In the absence of state family planning funded programs, or in
programs that restrict access and leave certain women out,
specialized funding can fill in that gap and play an important role
for low-income women,” she told Reuters Health.
Texas legislative policies have cut funding for other abortion
clinics in the state, meaning that residents of other counties often
seek abortions in Travis County, but if they don’t live in the
county, they are not eligible for the Medicaid 1115 program’s free
LARC.
Goyal and colleagues recruited more than 500 abortion patients
between October 2014 and March 2016 who fell into three groups -
low-income uninsured Travis County residents who were eligible for
the specialized funding, low-income uninsured non-residents of the
county who were ineligible for the funding and high-income insured
women who were ineligible for the funding.
The women answered questionnaires about their interest in using
long-acting contraception after the abortion, and researchers
followed the women for the next year to see what kind of
contraception they used and whether they had another unwanted
pregnancy.
The study team found that pre-abortion preference for LARC was high
among women in all three groups: 64 percent of eligible low-income
women, 44 percent of ineligible low-income women and 55 percent of
ineligible high-income women.
After abortion, 65 percent of the eligible low-income women received
long-term birth control, compared with 5 percent of ineligible
low-income women and 24 percent of ineligible high-income women.
Among those who received LARC, 90 percent of low-income women still
used it a year later.
Ineligible low-income women were also more than three times as
likely as eligible women to have another unwanted pregnancy, the
researchers report in Obstetrics and Gynecology.
[to top of second column] |
“This highlights what we’ve been learning the past five years about
women’s preference for contraception, and access for long-term
methods isn’t where it needs to be yet,” said Dr. Colleen McNicholas
of Washington University School of Medicine in St. Louis, who wasn’t
involved with the study.
“The (Affordable Care Act) contraceptive mandate was a good step
forward, but the implementation by the health insurance companies
isn’t there,” she told Reuters Health. “Contraceptives are one of
the most important preventive measures for women, and access
shouldn’t depend on ZIP code or how much you earn.”
If all U.S. women had full access to LARC, the country could see a
64 percent drop in unintended pregnancies, 63 percent drop in
unintended births and 67 percent drop in abortions, according to a
February analysis from the nonprofit research organization Child
Trends. It was based on a simulation model created by Child Trends
and the Brookings Institution think tank using data from a 2015
University of California, San Francisco (UCSF) randomized trial.
“It is certainly possible that the contraceptive mandate may end
with the current government’s plan to repeal and replace the ACA,”
said Corinne Rocca, a researcher on the UCSF trial who was not
involved in the current study.
“This week, we are also learning that the ACA replacement plan will
likely cut funding to Planned Parenthood because it provides
abortion care,” she told Reuters Health by email. “It is really
important that people understand the effects that cuts to funding
are likely to have on women’s ability to use birth control they want
and prevent unwanted pregnancy.”
SOURCE: http://bit.ly/2m7ulg0 Obstetrics and Gynecology, April 2017.
[© 2017 Thomson Reuters. All rights
reserved.] Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
