Emboldened and incensed by the U.S. Supreme Court's recent decision limiting certain contraceptive coverage in the private sector, New York health officials moved forward Thursday with a plan to provide contraceptive devices to low-income women who don't want to get pregnant soon after giving birth.
The state, which this spring became one of a few covering intrauterine devices and contraceptive implants through its Medicaid program, went public encouraging health providers to ensure women get the $350 to $700 devices immediately after delivery. And they're calling on private insurers to follow their lead.
"Birth control plays a vital role in helping women plan the best time to have a baby," acting state Health Commissioner Dr. Howard Zucker said at a news conference at Bellevue Hospital in Manhattan. "When a woman is able to plan her subsequent pregnancies, she is better able to safeguard her health and well-being, as well as that of any future children."
Officials said giving women access to the devices immediately after birth, instead of at a post-delivery appointment — usually about six weeks later — would guard against a recurrence of pregnancy in the interim or a growing reluctance to having a device inserted.
"A lot of women would jump at the opportunity if it was presented right away, because you're going through so much with giving birth and the delivery process," said Shanique Santana, the mother of a 17-month-old boy. "To go back a few weeks later and have something inserted, you're like, 'again?'"
In New York City, where about 195,000 babies are born each year, Health Commissioner Dr. Mary Bassett said 3 out of every 5 pregnancies are unplanned. She said the devices covered under the state's Medicaid program are 99 percent effective, last 3 to 10 years, can be removed anytime and do not affect the ability to get pregnant in the future.
Federal funding covers 80 to 90 percent of the cost of the devices for Medicaid recipients in New York, Zucker said. The state covers the rest, he said.
Dr. Laura MacIssac, of the American Congress of Obstetricians and Gynecologists, said contraceptive devices today don't carry the risk of major side effects associated with early, largely unregulated models. She said women tend to use IUDs longer than other birth control methods because, with no pills to take and prescriptions to fill, they are the least disruptive to their lifestyles.
The Catholic League for Religious and Civil Rights opposes the Medicaid contraceptive coverage, saying in an email Thursday that "anti-child crusaders" in the city and state health departments had declared "war on kids."
"The idea that the government is now in the business of arm-twisting women not to have more children, 'immediately after childbirth' is morally obnoxious and socially disturbing," Catholic League President Bill Donohue said in a statement. "Given our dangerously low fertility rate, we need a pro-breeders campaign, not one that puts a cap on kids."
The New York City Health and Hospitals Corporation, which operates the city's public hospitals and clinics, started providing free contraceptive devices for uninsured women in 2010, soon after they were deemed safe and effective.
The organization's president, Dr. Ram Raju, lauded New York for expanding access to care and patients' choices in the face of religious and political debate, highlighted most recently by the Supreme Court decision exempting Hobby Lobby and other privately held companies from providing certain contraceptives based on the owners' beliefs.
"We believe in letting people live their lives the way they want to live their lives," Raju said. "As we're moving forward, some parts of the country are moving backward."
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