Abstract
Disparities continue to exist in the timely provision of postpartum contraception. This study aimed to identify prevalence and factors associated with postpartum contraception provision among women enrolled in Medicaid. A retrospective cohort study was conducted using the 2014 National Medicaid data, linked to county-level social vulnerability index (SVI) data. Women aged 15–44 with a live birth in 2014 were included. Multivariable logistic regression was used to predict 3-day provision of long-acting reversible contraception (LARC) and 60-day provision of most effective or moderately effective contraceptives (MMEC). Overall, 3-day LARC provision was 0.2% while 60-day MMEC was 36.3%. Significantly lower odds of receiving MMEC was found among women aged 15–20 (adjusted odds ratio [aOR] = 0.87; 95% CI:0.86–0.89) compared to women 20–44 years as well as among Asian women (aOR = 0.69; 95% CI:0.66–0.72) and Hispanic women (aOR = 0.73; 95% CI:0.72–0.75) compared to White women. The provision of postpartum contraception remains low, generally, and needs attention in communities experiencing poor maternal outcomes.
Highlights
The United States (US) is one of the few developed countries with an increase in maternal mortality rate (MMR) since 1990, with MMR increasing from 8.0 deaths per100,000 in 1990 to 20.1 deaths per 100,000 live births in 2019 [1,2]
Postpartum contraception use can play a critical role in increasing the interpregnancy interval (IPI), which is essential for avoiding adverse maternal outcomes
The study protocol was approved by the Institutional Review Board (IRB) at the University of Mississippi, and the use of Medicaid data were covered under a data use agreement with the Centers for Medicare and Medicaid Services (DUA# RSCH-2017-51606)
Summary
The United States (US) is one of the few developed countries with an increase in maternal mortality rate (MMR) since 1990, with MMR increasing from 8.0 deaths per100,000 in 1990 to 20.1 deaths per 100,000 live births in 2019 [1,2]. The United States (US) is one of the few developed countries with an increase in maternal mortality rate (MMR) since 1990, with MMR increasing from 8.0 deaths per. Severe maternal morbidity has a variety of negative outcomes, from increased rates of receiving a blood transfusion, hysterectomy, or ventilation to increased lengths of hospital stays and higher use of health services [8,9]. Within this context, postpartum contraception use can play a critical role in increasing the interpregnancy interval (IPI), which is essential for avoiding adverse maternal outcomes.
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