Almost half of all live births in the United States are unintended. A pregnancy that is unintended may contribute to a delay in onset or absence of prenatal care, which could potentially put mom and/or baby at risk for unfavorable health outcomes, including low birthweight, shorter time breastfeeding, mental health issues, and abuse. Most unintended pregnancies occur because a person is either not using birth control or not using it correctly. Goals for Healthy People 2030 include increasing the proportion of women and girls who use effective birth control.
The American College of Obstetricians and Gynecologists (ACOG) Committee on Adolescent Health Care reports that adolescents who choose LARC are more satisfied and more likely to continue use. ACOG recognizes immediate postpartum LARC insertion as a best practice and acknowledges its benefits in avoiding unintended pregnancy and short interpregnancy intervals (less than 18 months).
As reported by the American Academy of Pediatrics, the safety and efficacy of LARC for the adolescent population are well established. LARC is not only the most effective contraception for preventing pregnancy, but it can also help to decrease heavy bleeding and painful cramping associated with menstrual periods. Lowering unintended pregnancy rates requires a multi-faceted approach. Pediatricians, OB/GYNs, family practice physicians, and health care providers can play a significant role in increasing the use of LARC by discussing sexual health at select well visits and providing contraception counseling.
Effective January 1, 2023, the Division of Medical Services director revised the Medicaid State Plan to update the rate methodology for long-acting reversible contraceptives. Claims with a date of service on and after January 1, 2023, will be based on Wholesale Acquisition Cost plus 6%.
Health care providers interested in training programs for LARC insertion may contact
References
America's Health Rankings Health of Women and Children (2022). Unintended Pregnancy. https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/unintended_pregnancy/state/U.S.
Healthy People 2030. https://health.gov/healthypeople/objectives-and-data/browse-objectives.
The American Academy of Pediatrics (AAP). (2020). Long-acting reversible contraception: specific issues for adolescents. Volume 146(2). https://publications.aap.org/pediatrics/article/146/2/e2020007252/36888/Long-Acting-Reversible-Contraception-Specific?autologincheck=redirected.
The American College of Obstetrics and Gynecologists (ACOG). (2018. Reaffirmed 2021). Adolescents and long-acting reversible contraception: implants and intrauterine devices. ACOG Committee Opinion No. 735. https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2018/05/adolescents-and-long-acting-reversible-contraception-implants-and-intrauterine-devices.pdf.
The American College of Obstetrics and Gynecologists (ACOG). (2023). Postpartum Contraceptive Access Initiative. https://pcainitiative.acog.org/postpartum-contraception/immediate-postpartum-larc/.
The American College of Obstetrics and Gynecologists (ACOG). (2017. Reaffirmed 2021). Long-acting reversible contraception: implants and intrauterine devices. Practice Bulletin No. 186. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devices.
Resources
Reviewed and Revised March 2024
