From Health Affairs Today <[email protected]>
Subject Postpartum LARC Trends In South Carolina & Beyond
Date February 24, 2021 9:13 PM
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The Latest Research, Commentary, And News From Health Affairs

Wednesday, February 24, 2021

Dear John,

Welcome to today's newsletter. We'll be focusing on a South Carolina
Medicaid rule change that had significant implications for women's
postpartum health.

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Vital Directions for Health & Health Care: Priorities for 2021 virtual
briefing, hosted by the National Academy of Medicine and Health Affairs,
will discuss a set of issues with a particularly compelling need for
attention to help ensure improved health and health care for all
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top priorities for the new presidential administration and nation.

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Postpartum LARC Trends in South Carolina & Beyond

Pregnancies shortly after childbirth are common, but many of these
pregnancies are unintended. In fact, unintended pregnancies make up
close to half of all pregnancies in the US.

The availability and cost of contraception critically influences
pregnancy determinants.

When family planning, immediate postpartum placement of long-acting
reversible contraception (LARC) is an option for many new parents. But
this method is not cheap. While the Affordable Care Act contraceptive
coverage requirement

decreased out-of-pocket spending on contraception and increased use of
LARC for privately insured women, many women enrolled in Medicaid
struggle to afford LARC.

In 2012, South Carolina's Medicaid program began paying for LARC
separately from the global maternity payment with the goal of increasing
the availability of postpartum LARC.

In an article featured in the February edition of Health Affairs, Maria
W. Steenland and coauthors found that South Carolina's policy was
associated with a significant overall increase in the use of highly
effective contraceptive methods for postpartum adolescents
,
despite uneven availability among providers.

LARC utilization trends are important for providers, especially during
the COVID-19 pandemic. In a recent blog post
,
Steenland and coauthors examine the implications of the COVID-19
pandemic on postpartum LARC
.
"To maintain contraceptive choice during the pandemic, hospitals must
find solutions to ongoing implementation challenges, including provider
training, device supply management, and billing changes," they
argue.  

Today we also turn to the issue of diversity in genomic databases in our
Elevating Voices series for Black History Month. In a May 2018 article,
Latrice G. Landry
and
coauthors

examine the populations included in genomic studies whose data were
available in two public databases and find significantly fewer studies
of African, Latin American, and Asian ancestral populations in
comparison to European populations.

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