Insurance loss more than 2 months after childbirth is associated with 26% lower odds of prescription contraception use, with Hispanic Spanish-language respondents experiencing higher rates of coverage loss.
Pregnancy Risk Assessment Monitoring System data from 223,430 respondents reveals that 78.9% maintained continuous insurance coverage postpartum.Researchers conducted a retrospective cohort study analyzing PRAMS survey data from 2012 to 2020 across 42 states, including 223,430 respondents who completed surveys between 2 months and 1 year postpartum.
Analysis categorized insurance status as continuous insurance, insurance loss, discontinuous Medicaid-to-private, discontinuous private-to-Medicaid, continuous uninsurance, and gain of insurance. Investigators used logistic regression to estimate odds ratios with 95% CIs for insurance status and prescription contraception use, adjusting for age, race, ethnicity, language, marital status, federal poverty level, education, and birth year.Among all respondents, 10.2% lost insurance coverage postpartum. Compared with continuous insurance, the adjusted OR for prescription postpartum contraception was 0.74 .
Discontinuous private-to-Medicaid insurance showed decreased odds of prescription contraception compared with continuous insurance. In states without Medicaid expansion, 14.0% of respondents experienced insurance loss compared to 6.8% in expansion states.“Medicaid expansion has been shown to be associated largely with improved perinatal health outcomes, including a 17% reduction in hospitalization during the first 60 days postpartum, decreased postpartum uninsurance and insurance, and decreased racial inequities in postpartum coverage.
Birth Control Contraceptive Management Management Of Contraception Insurance Practice Management Revenue Pregnancy Pregnant Postpartum Postpartum Period Postnatal Puerperium Medicaid Spain Spanish Oregon Social Determinants Of Health SDOH Social Determinants Of Health (SDOH)
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