Category Archives: Teen Pregnancy

Becky Wagner on Reducing Teen Pregnancy

Becky Wagner sent me an interesting message in response to an earlier post on teen pregnancy:

I thought I would follow up to your blog regarding long term contraception and the evidence of the benefits represented in the drop in teen pregnancies.

Advocates for Children and Youth is a non-partisan policy reform organization (Maryland’s Annie E. Casey Foundation KIDS COUNT organization) that tracks over 60 indicators of the well-being of children in Maryland. We know that unplanned pregnancies can create poor outcomes for children and families and for that reason supported legislation sponsored by Del. Heather Mizeur which established pre-conception health care for low income women.

Regarding your concern that Maryland was not listed as covering the long term contraceptive described in the article, I asked our Health Policy Director, Neha Trivedi, to look into the matter. Her feedback is as follows:

Individuals in Maryland who are enrolled in a Managed Care Organization (MCO), or those on Medicaid with a family planning program do get coverage for birth control, which includes long term contraceptives such as IUDs. However, depending on the type of plan they have with Medicaid, I found that only certain forms of birth control are covered. Therefore, some plans may or may not cover some types of birth control i.e. implants as described in the article. For those who are inquiring about new forms of birth control they need to speak directly to their Medicaid MCO, or the family planning program at Medicaid to see what type of birth control is covered by their providers.

So it would appear that, just as prescription drugs for various treatments are or are not covered under certain health plans, it is the same with contraception.

Advocates for Children and Youth focuses on the issue areas of health, education, child welfare and juvenile justice, all through the lens of racial equity and economic sufficiency. We are happy to provide information and data for Maryland’s children in these issues areas.

Reducing Teen Pregnancy

The Washington Post has a terrific story on success in Colorado and Missouri in reducing teen pregnancy via long-term reversible contraception, accelerating a national trend occurring for other reasons:

[The study] reported a 40 percent decline in births among teens 15 to 19 from 2009 to 2013. The stunning decline in teen birth rates is significant not just for its size, but for its explanation. State public health officials are crediting a sustained, focused effort to offer low-income women free or low-cost long acting reversible contraception, that is, intrauterine devices or implants.. . . . The state’s analysis suggests the initiative was responsible for three-quarters of the decline in the state’s teen birth rates. . . .

Colorado’s initiative built upon a somewhat similar effort in St. Louis, Mo., . . .  Seventy percent of women in the Missouri study chose an IUD or implant. The conclusion: those who chose short-term methods such as the pill or the patch were 20 times more likely to have an unintended pregnancy than those who used an IUD or an implant.

Why this matters. A lot:

Buried amid the headlines in Colorado is more welcome news. The state also saw a 50 percent drop in repeat pregnancies among teens. With a second child, the already-high odds are ratcheted up that a low-income mother will not finish high school, remain trapped at the low-paying end of the economic ladder and reliant upon public assistance. (You, taxpayer, may read this as ka-ching, ka-ching, ka-ching.)

The long-term contraception program appears especially effective when promoted right after a first teen pregnancy:

Several years ago, [the Colorado Adolescent Maternity Program] offered 396 of its pregnant adolescent mothers who wanted birth control a choice: They could have an implant inserted after they gave birth, but before they left the hospital. Or, they could wait the typical six weeks and then start any form of contraception they wished. . . .

Of the mothers who chose the immediate post-partum implant, only 2.6 percent became pregnant again within a year– and that’s because they had their implants removed.Among those who chose the delayed start, 20 percent got pregnant again within the first year.

The Post identifies five states–California, Colorado, New Mexico, New York and South Carolina–that allow Medicaid coverage of of immediate post-partum long-acting reversible contraception. Unfortunately, Maryland is not listed among them.

I don’t know if Maryland allows Medcaid to cover this form of contraception (or has a similar, yet different program) but it seems like a no-brainer way to improve lives and to save money. There are so many pressing social needs that it is great when a program that helps people makes the government money.