Demand for Long-Acting Contraception Increased in Wake of Concerns About Birth Control Access

In the 30 days after President Donald Trump was elected in 2016, demand for long-acting reversible contraception (LARC) was on the rise, according to new research published in JAMA Internal Medicine.

In the month after the election, rates of insertion for intrauterine devices and implants were up 21.6% compared with the same time the previous year.

“Our study tells us something important about women’s health preferences in a changing political climate,” author Lydia Pace, MD, MPH, of Harvard Medical School and Brigham and Women’s Hospital, said in a statement. “Women responded to this political event by seeking out this method of contraception, perhaps because the threat of losing access expedited a decision or encouraged them to seek out a method they hadn’t previously considered.”

The authors used the IBM/Truven MarketScan Analytics Commercial Claims and Encounters Database to study women between the ages of 39 and 45 who were enrolled in commercial insurance in the month before and the month after November 8 in both 2015 and 2016.

A total of 3,449,445 women in 2015 and 3,253,703 women in 2016 were included who had similar demographic and health plan characteristics. In 2015, the mean adjusted daily LARC insertion rate was 12.9 per 100,000 women on and before November 8 and 13.7 after. In 2016, the change was more apparent: the LARC insertion rate before the 2016 election was 13.4 per 100,000 compared with 16.3 per 100,000 women after.

“If our findings were projected to the approximately 33 million women in the US in this age range with employer-sponsored health insurance, this would correspond to 700 additional insertions per day in association with the 2016 election,” said Pace. “The changes in rate that we report here could reflect women’s concerns about losing contraceptive coverage under the Trump administration.”

In April 2018, experts at the annual meeting of American College of Obstetricians and Gynecologists highlighted barriers to access of LARC, including geography, payer coverage, and health institutions. The results of a survey of residents across the country found that training is an issue, with 8% of chief residents saying they had never inserted a contraceptive implant. In addition, religious affiliation of the institution was a barrier in the Midwest.