A recent article out of San Antonio highlights one of the biggest wins we’ve seen in Texas in quite some time.
I’m referring to a new state initiative in women’s health care that has the potential to make a real difference for the women of Texas. That initiative is designed to improve the availability and use of long-acting reversible contraception, or LARC, methods, such as contraceptive subdermal implants and intrauterine devices.
We have long known that one of the keys to a healthier population is helping patients to plan and space their pregnancies in a way that meets their families’ goals. But, for too long, Texas has been a leader in unplanned pregnancies, teen pregnancies and repeat teen pregnancies.
There are also recent reports that show alarming spikes in maternal mortality in Texas, with African-American women most at-risk.
One of the challenges facing Texas women has been an unreliable and fragmented system for providing effective contraception to the patients who desperately need access to reliable, effective family planning. There has also been a lack of emphasis on providing the most effective methods of birth control, contraceptive implants and IUDs.
These methods, once properly prescribed and provided to the patient, do not require any further action from the patient to provide reliable birth control. No pills to take, no trips to the pharmacy. These methods provide 10 to 50 times better protection against an unplanned pregnancy, and can last anywhere from 3 to 10 years.
Yet, they are still reversible, meaning that the patient can have them easily removed when she feels truly ready for her next child.
Well over 50 percent of all pregnancy care in Texas is funded through the Texas Medicaid program. In the past, once the pregnancy was delivered, after 60 days, the Medicaid coverage expired. This left the patient without coverage for prescription birth control pills or shots.
With the revamping of the Texas Women’s Health Programs, the vast majority of these patients will now automatically be enrolled in the new Healthy Texas Women program. This program will provide continued access to vital health services, including pelvic exams, contraceptive services, screening for high blood pressure, diabetes and cholesterol, immunizations and more.
And the program will provide access to LARC methods, including the contraceptive implants and IUDs.
The state has also provided a new program that will allow the doctor to place the device, in properly selected patients, while she is still in the hospital after having her baby. This means that a busy new mom that has a delay in getting back to her doctor for her postpartum check-up won’t be left without reliable contraception.
Over the last several years, we have dealt with the loss of adequate access and facilities to provide basic care and contraception services for women. By providing improved access to LARC methods, we have the opportunity to help patients with inter-conception care, to address health issues in a way that will make future pregnancies safer and healthier.
The American College of Obstetricians and Gynecologists recommends offering LARC methods as first-line contraceptive options, and supports immediate postpartum insertion of LARC devices as safe, effective and advantageous.
Over the last four years, the number of Texas women choosing one of these more reliable options has increased from 5-6 percent up to 10-13 percent. With these new changes, we hope to see that number go even higher.
Improved access to reliable contraception and inter-conception care means a healthier Texas, lower health care costs, and a brighter future. That’s an important win for Texas.
Dr. Carl (Tony) Dunn is an OB/Gyn in Waco. He is the incoming chair of the Texas District of the American College of Obstetricians and Gynecologists and co-vice chair of the Texas Women’s Healthcare Coalition.