July 17, 2014 – The New York City Health Department, New York City Health and Hospitals Corporation (HHC), New York State Department of Health and the New York State District of the American Congress of Obstetricians and Gynecologists (ACOG) announced today that health care providers will now be reimbursed for providing intrauterine devices (IUDs) and contraceptive implants immediately after childbirth for women who choose one of these methods. IUDs and contraceptive implants are safe, 99% effective at preventing pregnancy and can be removed at any time. Health Commissioner Dr. Mary Bassett and HHC President and CEO Dr. Ram Raju made this announcement at Bellevue Hospital Center, where they were joined by Acting State Health Commissioner Dr. Howard Zucker, Dr. Machelle Allen, Deputy Chief Medical Officer for Healthcare Improvement at HHC and Dr. Laura MacIsaac of ACOG District II. This initiative will result in increased contraceptive options for women in the postpartum period.
The New York State Department of Health issued a Medicaid policy change which allows health care providers to be reimbursed for providing these safe, highly effective birth control methods. Prior to this change, a woman who was insured by Medicaid and who wanted an IUD or contraceptive implant could not access these methods at the time of childbirth; typically the IUD or implant were too costly for providers to offer when they were not reimbursed. Unlike birth control pills, which could be readily prescribed before a woman left the hospital, the IUD and implant required a separate return visit. New York State is one of the first states to provide Medicaid reimbursement for immediate post-partum placement of these methods.
“Every woman should have the information and the resources she needs to make personal decisions about her own life, including when or if she wants to be pregnant,” said Health Commissioner Bassett. “Our goal is to ensure that women, regardless of life circumstances or ability to pay, can make informed choices about their reproductive health based on accurate information and have access to the full range of contraceptive options, including IUDs and contraceptive implants. I applaud the New York State Department of Health for making this important change to protect all women’s ability to choose the birth control method that is right for them.”
“Reproductive rights are a freedom many have fought for, and in New York we are expanding those rights,” said Dr. Ram Raju, President and CEO of the New York City Health and Hospitals Corporation (HHC). “HHC offers birth control options to all women in New York City, regardless of their ability to pay or insurance status. The decision by the State Department of Health to provide reimbursement for the use of IUDs postpartum creates fewer barriers to this service and will support our commitment to expand timely access to safe and effective birth control to even more women. Modern IUDs in particular have been proven a very successful method of contraception, and should be considered a robust family planning option.”
“Birth control plays a vital role in helping women plan the best time to have a baby,” said Acting New York State Health Commissioner Dr. Howard Zucker. “When a woman is able to plan her subsequent pregnancies, she is better able to safeguard her health and well-being, as well as that of her new baby and any future children. The additional birth control methods now covered under Medicaid empowers new mothers and lets them take control of their family planning.”
This new change is key to supporting women’s decisions about when and if they want to be pregnant by assuring that all women have access to their contraceptive method of choice. Providing accurate information at prenatal visits and providing the selected method of contraception immediately after childbirth makes family planning easier for new mothers, and eliminates the need to return for a separate appointment. Additionally, having access to IUDs and contraceptive implants immediately postpartum helps women receive safe, highly effective methods of birth control, avoid health risks associated with rapid repeat pregnancies (pregnancies that are less than 18 months apart), and achieve a family size that is right for their particular needs and circumstances.
An intrauterine device (IUD) is a small, T-shaped contraceptive made of plastic. There are two types of IUDs – one contains copper, and one releases a small dose of hormones, like the birth control pill, to prevent pregnancy. A health care provider inserts an IUD into a woman’s uterus. IUDs are safe, 99% effective at preventing pregnancy, and last up to three to 10 years. An IUD can be removed at any time and will not affect a woman’s ability to get pregnant after it is removed.
A contraceptive implant is a flexible plastic rod the size of a matchstick that is placed under the skin of a woman’s arm. Implants release a hormone, like the birth control pill, and can be used for up to three years. The implant is 99% effective at preventing pregnancy, and can be removed at any time. Neither the IUD nor contraceptive implant protects women from sexually transmitted infections including HIV. It is important to always use a condom when having sex to prevent sexually transmitted infections.
“As one of New York’s strongest public advocates for women, ACOG District II encourages the use of the most effective contraceptive methods for women who want them,” said Dr. Laura MacIsaac, Chair of ACOG District II’s Committee on Long-Acting Reversible Contraception (LARC) and Director of the Family Planning Division of Mount Sinai Beth Israel in New York City. “Offering women the birth control method of their choice right after giving birth is extremely safe and a best clinical practice. All health insurance plans should follow Medicaid’s lead to reduce economic barriers to high impart preventive health interventions.”
“As one of New York City’s leading providers of reproductive health services, Planned Parenthood of New York City understands that birth control is an essential part of women’s basic preventive health care. Long-acting birth control methods like the IUD have become a popular option for many women, but the high upfront cost often creates a serious barrier to widespread use,” said Joan Malin, president and CEO of Planned Parenthood of New York City. “We applaud the New York State Health Department’s revised reimbursement policy. This will go a long way to helping women gain access to a highly effective birth control method that works for them and their lives, and not one based solely on what they can afford.”
“Having access to highly effective contraception on site is not just a medical or health issue but has become the difference between living in poverty or attaining one’s potential for the teenagers in my practice,” said Dr. Tosan Oruwariye, E.V.P & Chief Medical Officer, Morris Heights Health Center. “Access to contraceptive care should be guaranteed as a right for all who need it.”
“Birth control for new mothers has been out of reach,” said Dr. Carolyn Westhoff, Professor, Obstetrics and Gynecology, and Director, Division of Family Planning and Preventive Services, Columbia University. “New moms don't have time for extra clinic visits. New York’s initiative will have a huge impact on helping women and thus on the health of the whole family.”
The NYC Health Department and HHC encourage health care providers to increase women’s access to contraception. In addition, the Health Department supports men and women through community-based efforts including Nurse-Family Partnership, Newborn Home Visiting Program and Bronx Teens Connection, partners with healthcare providers to improve the quality of and increase access to reproductive health services, disseminates information on clinical best practices, advocates for policy change to assure adequate insurance reimbursement for all contraceptive methods and conducts surveillance on pregnancy in NYC. Health care providers can access provider and patient educational materials by searching “Sexual and Reproductive Health” at nyc.gov. Women can call 311 to find out where to get free or low-cost contraceptives in NYC. Teens can also search for where contraceptive methods are available through the Teens in NYC Preferred Referral Guide available on the NYC Teen website or by downloading the Teens in NYC Protection+ mobile app for Apple and Android devices.
The American Congress of Obstetricians and Gynecologists, District II (ACOG) represents 4,200 board certified obstetrician-gynecologists in the state who deliver health care to New York’s women. ACOG’s Albany office offers the New York State Legislature its resources as a non-profit scientific and educational organization dedicated to quality health care for women. ACOG’s Long-Acting Reversible Contraception (LARC) Program provides information and guidance on LARC methods, specifically the contraceptive implant and IUDs, to reduce unintended pregnancy and increase women’s access to the full range of contraceptive methods.