Insurance loss more than 2 months after childbirth is associated with 26% lower odds of prescription contraception use, with Hispanic Spanish-language respondents experiencing higher rates of coverage loss. Pregnancy Risk Assessment Monitoring System (PRAMS) data from 223,430 respondents reveals that 78.9% maintained continuous insurance coverage postpartum.

"Medicaid expansion has been shown to be associated largely with improved perinatal health outcomes, including a 17% reduction in hospitalization during the first 60 days postpartum, decreased postpartum uninsurance and insurance, and decreased racial inequities in postpartum coverage. With regard to contraception, specifically, Medicaid expansion is associated with an increase in use of any postpartum contraception, especially more effective forms of contraception," wrote the authors of the study.

The study was led by Kimberly M. Schaefer, MD, MPP, Oregon Health & Science University in Portland, Oregon. It was published online in O&G Open.

The study excluded data from several major states including Arizona, California, Florida, Idaho, Indiana, Nevada, South Carolina, and Texas, which may limit generalizability. Additionally, researchers could not examine insurance discontinuity within the same insurance strata, potentially underestimating the discontinuity population. The analysis was also limited by incomplete income data, which may introduce sampling bias.

The authors did not report any potential conflicts of interest.