A recent report released by Family Health International, the Guttmacher Institute and the University of New Mexico shows that the United States has seen in a rise in the number of women who use an intrauterine device (IUD) as a method of birth control in the past few years. Among other factors, the report credits an increase of this form of birth control with “top tier of contraceptive effectiveness” because of “contraceptive equity laws that require insurance plans to cover contraceptive methods, including intrauterine contraception.”

The report found that the use of IUD’s in the US is at its highest level since the early 1980’s. The 2006–08 National Survey of Family Growth (NSFG) found that approximately 2.1 million American women use an IUD as a form of birth control in the United States.

The report makes the case that IUDs provide an effective and safe way of battling the high rates of “unintended pregnancy in the United States”–an epidemic the report describes as a “stubborn problem.” According to the report, “intrauterine contraception is in the top tier of contraceptive effectiveness and provides better protection from unintended pregnancy than many alternatives.”

The report says many changes in the past few years have contributed to this increase, including:

  • “In-migration from Mexico, where use and acceptability of the IUD is high, has created additional demand.”
  • “A greater number of clinicians are trained and competent in insertion and removal.”
  • “Evidence and expert opinion [suggesting] that increased voluntary uptake of intrauterine contraception, which is highly efficacious and requires minimal user involvement, may help alleviate the national problem of unintended pregnancy and high rates of abortion.”
  • “U.S.-based organizations (e.g., the Association of Reproductive Health Professionals and the Society of Family Planning) have assisted in the dissemination of evidence-based information on the safety and efficacy of IUDs.”
  • “U.S. providers [becoming] more aware of the higher level of IUD use in other countries”

The report also explained that “contraceptive equity laws” have played a major role in the rise of IUD use in the states.

“Many states have passed contraceptive equity laws that require insurance plans to cover contraceptive methods, including intrauterine contraception. Equity laws are particularly relevant for IUDs because the products have high initial costs. Many states have Medicaid family planning expansion programs (“waivers”) that increase the income cutoff below which women can receive benefits, including access to all FDA-approved contraceptives.”

In Florida, however, Medicaid overhaul approved by the Legislature would allow providers to opt-out of providing family planning services, such as IUDs, on “moral or religious grounds.”

Last week, State Sen. Nan Rich, D-Sunrise, sought to include an amendment that would uphold these equity standards by adding language that would “ensure the availability of federally-required benefits if it is not covered by the plan.” The amendment failed and the Medicaid reform bill passed with original opt-out provisions.

The report concludes that “universal access to the full range of options and a true choice of family planning methods, including intrauterine contraception, is critical to reducing unintended pregnancy and improving reproductive health in the U.S.”

Here is the full report:

j.contraception.2010.09.004

 

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