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P065Long acting reversible contraceptive (larc) insertions in 2019 in the states with most restrictive and trigger abortion policies

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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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