Birth control right after having a baby: Why it’s important, why it should be covered

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The American Congress of Obstetricians and Gynecologists (ACOG) lately put out a brand new Committee Opinion, “Rapid Postpartum Lengthy-Performing Reversible Contraception.” I counsel all my pregnant sufferers in regards to the choice of speedy postpartum contraception within the type of IUDs and implants, each of that are long-acting, reversible contraceptives (LARC). The contraceptive implant goes in your arm, and IUD is positioned inside your uterus. Rapid postpartum contraception refers to placement of LARC within the interval between supply of a child and the time a brand new mom leaves the hospital.

Many ladies are conscious that IUDs and implants are extremely efficient, protected, and forgettable strategies of contraception, together with for adolescents. What’s much less well-known is that also they are a handy and efficient choice for speedy postpartum contraception. Putting them proper after the start of a child within the hospital streamlines ladies’s entry to contraception, reduces the hassles of appointments within the weeks and months following start, and lowers the chance of unintended being pregnant and pregnancies that happen before deliberate. ACOG has lengthy supported efforts to advertise schooling round, entry to, and precise use of LARC. Nonetheless, that is ACOG’s first scientific opinion particularly devoted to speedy postpartum LARC.

Sadly, in Massachusetts, the place I apply, hospitals take a monetary loss at any time when we offer speedy postpartum LARC, as a result of insurance coverage funds for the start of a child are bundled, which suggests we get one price no matter what number of companies are offered. The machine and process are coated by most insurers, private and non-private, in an outpatient clinic, however should not reimbursed along with the worldwide price for supply of a child, if offered whereas the mother is within the hospital for supply. We have to prepared the ground with cost reform for speedy postpartum contraception to vary this.

Whereas many ladies might plan to begin utilizing contraception at their six-week postpartum checkup, as much as 40% of ladies don’t attend a follow-up appointment, and so by no means receive a dependable contraception methodology. However even for ladies who do go to the routine six-week postpartum follow-up go to, ovulation can happen as early as three weeks after start and can lead to being pregnant. The early days with a brand new child are a busy, exhausting, and sometimes aggravating time. Having LARC inserted earlier than leaving the hospital takes one factor off the checklist. There is no such thing as a fear about scheduling an appointment or attending to the physician’s workplace. The one draw back is that IUDs positioned proper after start are barely extra more likely to be expelled in comparison with these positioned on the six-week go to. But many ladies nonetheless discover that the benefits of insertion earlier than leaving the hospital outweigh the disadvantages.

Entry to and efficient use of contraception is the essential basis for empowering ladies, bettering well being outcomes, and saving cash. Advocating for enlargement of speedy postpartum contraception is important to cut back unintended being pregnant and fast, repeat being pregnant charges. A number of states have modified their insurance coverage reimbursement insurance policies, however Massachusetts just isn’t one in all them. Massachusetts is the state that led the way in which in well being care reform, and we have to be part of different states which can be already taking the lead in additional bettering reproductive well being care by including insurance coverage protection for speedy postpartum contraception.

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