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Objectives
As of May 2022, 26 states have been identified as certain or almost certain to ban
abortion should the 1973 Roe decision recognizing women's constitutional right to
choose to terminate be overturned. The purpose of this analysis was to describe the
rate of insertions of long-acting reversible contraceptives (LARCs), the most effective
forms of contraception, in those 26 states.
Methods
Data was from a HealthVerity Marketplace claims data source representing 130 million
patients, representing 58% of the US census population. Women aged 15–44 were included
in the analysis. For each healthcare encounter, the following data were gathered:
three-digit zip code, age, implant insertion (y/n), intrauterine device (IUD) insertion
(y/n), provider specialty, and payer type (Medicaid or commercial). LARC insertion
rates by three-digit zip code geographic areas in the 26 states with pending abortion
bans were described.
Results
In four states with pending abortion bans, LARC insertion rates were consistently
low: <2.6% in either all or nearly all three-digit zip code areas. Four states had
consistently top quartile LARC insertion rates (>4.1%). The remaining states had wide
variation in LARC insertion rates; some three-digit zip code areas fell in the lowest
quartile of insertions (<2.6%) and other areas showing highest percentiles of LARC
insertions (>4.1%)
Conclusions
Use of LARCs vary among the geographic areas within the states with certain or near-certain
abortion trigger bans. These variations in LARC insertion rates may indicate significant
additional reproductive health burdens for women who may already be facing significant
restrictions on their reproductive health choices.
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Copyright
© 2022 Published by Elsevier Inc.
