In 2016, Texas became the 17th state to allow Medicaid to reimburse for immediate postpartum (IPP) insertion of long-acting reversible contraception (LARC). But years before the state rule change, a safety net public hospital in Houston began using county funds to implement its own program. We use data from a prospective cohort of postpartum women to evaluate the impact of this county policy change on provision of IPP LARC. We found that half of women were offered IPP LARC, with Spanish-speaking women the least likely to have been offered LARC. 73% of those who were offered IPP LARC received it. Satisfaction was high but dropped between three and six months postpartum, mainly due to negative side effects. Continuation was high 24 months postpartum with no differences between IUD and implant. These results demonstrate that motivated health systems can enact local policy changes that have a positive impact on their patients.
Presented in Session 10. Fertility, Family Planning, Sexual Behavior & Reproductive Health 2