Objectives. To analyze births and birth intendedness after long-acting reversible contraception (LARC) removal among Medicaid-insured women. Methods. We linked all Delaware women with a Medicaid-covered LARC removal in 2012 to 2020 (n = 8047) to birth records and to Pregnancy Risk Assessment Monitoring System (PRAMS) pregnancy intendedness survey responses (n = 241). Results. Births within 3 years of a Medicaid-covered LARC removal were much more likely to be to women in their 20s compared with all Medicaid births (63.5% vs 53.4%; P < .001). The intended proportion for births within 3 years of Medicaid-covered LARC removal (65.2%) was higher than for all Medicaid-covered births (58.8%; P = .08) and was consistently above 60% across all age groups younger than 30 years. Conclusions. A state Medicaid-insured population's use of highly effective reversible contraception was associated with births being concentrated among women in their 20s and with consistently high fractions of intended births across younger ages at birth. Public Health Implications. Programs and policies may consider LARC access for its potential to increase low-income women's reproductive autonomy by enhancing their ability to achieve births at the age of their choosing. (Am J Public Health. Published online ahead of print October 10, 2024:e1-e8. https://doi.org/10.2105/AJPH.2024.307844).

中文翻译：

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长效可逆避孕法 （LARC） 和早儿再审视：州医疗补助人群去除 LARC 后的出生和出生意向（2012-2020 年）。


目标。分析医疗补助保险妇女去除长效可逆避孕 （LARC） 后的分娩和生育意向。方法。我们将 2012 年至 2020 年所有 Medicaid 覆盖的 LARC 移除的特拉华州妇女 （n = 8047） 与出生记录和妊娠风险评估监测系统 （PRAMS） 怀孕意向调查回复 （n = 241） 联系起来。结果。与所有 Medicaid 出生相比，20 多岁女性在 20 多岁女性在 3 年内出生的可能性要大得多（63.5% 对 53.4%;P < .001）.取消 Medicaid 承保的 LARC 后 3 年内的预期出生比例 （65.2%） 高于所有 Medicaid 承保的出生 （58.8%;P = .08），并且在 30 岁以下的所有年龄组中始终高于 30%。结论。一个由州医疗补助保险的人群使用高效可逆避孕措施与出生集中在 20 多岁的女性有关，并且在出生时年龄较小的预期生育比例一直很高。公共卫生影响。计划和政策可以考虑 LARC 访问，因为它可以通过提高低收入妇女在自己选择的年龄生育的能力来增加她们的生育自主权。（美国公共卫生杂志。2024 年 10 月 10 日提前在线发布：e1-e8。https://doi.org/10.2105/AJPH.2024.307844）。