Increasing Contraception Options Immediately After Birth: Did Immediate Postpartum Long-Acting Reversible Contraception (IPP LARC) Utilization Increase During the COVID-19 Pandemic? [ID: 1377847]

Abstract

INTRODUCTION: Preliminary research indicates prenatal and postpartum care decreased during the COVID-19 pandemic. Models also indicate increases in unintended pregnancies after 2020. The goal of this study was to assess whether immediate postpartum long-acting reversible contraception (IPP LARC) insertions and desire for IPP LARC increased during COVID-19 among patients insured under TennCare Medicaid (TennCare or CoverKids) with access to coverage for this type of contraception. METHODS: Deliveries in patients insured under TennCare Medicaid Programs (n=6,922) in one East Tennessee hospital were assessed before and during the COVID-19 pandemic (January 2019 to May 2020 and June 2020 to December 2021, respectively). Data from electronic health records were securely collected in Excel and analyzed using SPSS software. Comparisons were made using chi-square tests. RESULTS: During COVID, increased uptake of IPP LARC was statistically significant: 18.0% (CI 16.9–19.1%) before the COVID-19 pandemic and 22.0% (CI 20.6–23.3%) during (P<.001). In addition, desire for IPP LARC increased significantly among patients: 20.0% (CI 19.1–21.3%) before COVID-19 and 22.3% (CI 21.0–23.7%) during COVID-19 (P=.016). Significant increases in desire for IPP LARC during the pandemic occurred among adolescent patients (<20 years of age) (P=.003), those living HRSA-defined nonrural areas (P=.024), non-Hispanic women (P=.036), and White women (P=.027). CONCLUSION: IPP LARC is a highly effective, convenient contraception option for women, especially during times with possible increased limitations in accessing postpartum care. Perhaps because of shelter-at-home orders, limitations in “nonessential” health care being practiced, or personal preferences and desires during the pandemic, IPP LARC was more highly utilized and desired by those wishing to avoid unintended pregnancy after the pandemic began.