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Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion.
Obstet Gynecol 2017; 130(1):109-117OG

Abstract

OBJECTIVE

To evaluate whether contraceptive insurance coverage for women who present for an abortion is associated with obtaining long-acting reversible contraception or depot medroxyprogesterone acetate (DMPA) on the day the abortion is completed.

METHODS

We conducted a prospective cohort study of women presenting for medical or surgical abortion at a single health center in North Carolina. Eligible women were 18 years or older and fluent in English or Spanish. Data were from participant questionnaires, medical charts, and financial records. Our main exposure was whether the woman had insurance coverage for contraception at clinic intake. Our primary outcome was receiving DMPA, an intrauterine device, or a contraceptive subdermal implant on the same day of their surgical abortion or at the visit that determined their medication abortion was complete. We used univariable, bivariable, and multivariable analysis to report our findings.

RESULTS

Five hundred seventy-five women enrolled in our cohort between September 2015 and April 2016. One hundred twenty-eight (22%) had insurance coverage and 447 (78%) did not. In the group with insurance coverage for contraception, 38% (49/128) received a long-acting reversible contraception method or DMPA compared with 7% (33/447) in the group without insurance coverage for contraception. After adjusting for confounding, women with contraceptive coverage were more than five times as likely to receive immediate postabortion contraception with one of these methods compared with women without coverage (relative risk 5.6, 95% confidence interval 3.8-8.3).

CONCLUSION

Women with contraceptive insurance coverage on the day of their abortion were more likely to leave the abortion clinic with an intrauterine device or implant in place or receive DMPA injection compared with women without coverage.

Authors+Show Affiliations

Department of Obstetrics & Gynecology, University of North Carolina School of Medicine, Chapel Hill, Planned Parenthood South Atlantic, Raleigh, and RTI International, Research Triangle Park, North Carolina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28594755

Citation

Krashin, Jamie W., et al. "Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate On the Day of Abortion." Obstetrics and Gynecology, vol. 130, no. 1, 2017, pp. 109-117.
Krashin JW, Stuart GS, Garrett J, et al. Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion. Obstet Gynecol. 2017;130(1):109-117.
Krashin, J. W., Stuart, G. S., Garrett, J., Spector, H., Bryant, A. G., Charm, S., & Morse, J. E. (2017). Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion. Obstetrics and Gynecology, 130(1), pp. 109-117. doi:10.1097/AOG.0000000000002070.
Krashin JW, et al. Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate On the Day of Abortion. Obstet Gynecol. 2017;130(1):109-117. PubMed PMID: 28594755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contraception Insurance Coverage and Receipt of Long-Acting Reversible Contraception or Depot Medroxyprogesterone Acetate on the Day of Abortion. AU - Krashin,Jamie W, AU - Stuart,Gretchen S, AU - Garrett,Joanne, AU - Spector,Hannah, AU - Bryant,Amy G, AU - Charm,Samantha, AU - Morse,Jessica E, PY - 2017/6/9/pubmed PY - 2017/7/25/medline PY - 2017/6/9/entrez SP - 109 EP - 117 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 130 IS - 1 N2 - OBJECTIVE: To evaluate whether contraceptive insurance coverage for women who present for an abortion is associated with obtaining long-acting reversible contraception or depot medroxyprogesterone acetate (DMPA) on the day the abortion is completed. METHODS: We conducted a prospective cohort study of women presenting for medical or surgical abortion at a single health center in North Carolina. Eligible women were 18 years or older and fluent in English or Spanish. Data were from participant questionnaires, medical charts, and financial records. Our main exposure was whether the woman had insurance coverage for contraception at clinic intake. Our primary outcome was receiving DMPA, an intrauterine device, or a contraceptive subdermal implant on the same day of their surgical abortion or at the visit that determined their medication abortion was complete. We used univariable, bivariable, and multivariable analysis to report our findings. RESULTS: Five hundred seventy-five women enrolled in our cohort between September 2015 and April 2016. One hundred twenty-eight (22%) had insurance coverage and 447 (78%) did not. In the group with insurance coverage for contraception, 38% (49/128) received a long-acting reversible contraception method or DMPA compared with 7% (33/447) in the group without insurance coverage for contraception. After adjusting for confounding, women with contraceptive coverage were more than five times as likely to receive immediate postabortion contraception with one of these methods compared with women without coverage (relative risk 5.6, 95% confidence interval 3.8-8.3). CONCLUSION: Women with contraceptive insurance coverage on the day of their abortion were more likely to leave the abortion clinic with an intrauterine device or implant in place or receive DMPA injection compared with women without coverage. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/28594755/Contraception_Insurance_Coverage_and_Receipt_of_Long_Acting_Reversible_Contraception_or_Depot_Medroxyprogesterone_Acetate_on_the_Day_of_Abortion_ L2 - http://Insights.ovid.com/pubmed?pmid=28594755 DB - PRIME DP - Unbound Medicine ER -