Long-acting birth control offered free to Columbus women

December 7, 2015

The Columbus Dispatch highlights new program to improve access to birth control and reproductive health planning to South Side women.

By Misti Crane

The Columbus Dispatch

Sunday, December 6, 2015

After the birth of her first son two years ago, Maria Guzman Rodriguez decided she wanted an IUD to prevent another pregnancy until she was ready.

But when she learned the appointments and device combined could cost her as much as $1,000, she abandoned that plan.

This time, after giving birth to another son in September, someone at the hospital told the 23-year-old Northwest Side woman about care she could get at little or no cost at Columbus Public Health.

Last week, Rodriguez received her IUD and paid nothing out of pocket, save for a donation she made to express her gratitude to the Women’s Health Clinic.

More Columbus women, including those with no insurance or co-pays they can’t afford, are receiving various forms of long-acting birth control thanks to efforts to increase accessibility and pick up the tab when necessary.

Medicaid also covers the Nexplanon arm implant and IUDs, which can last for years and are highly reliable and reversible when women decide they want to have a child.

Long-acting, reversible birth control, often referred to as LARC, also is key to helping women and teens have babies only when they intend to have them, which is proved to reduce problems during pregnancy and to lower rates of prematurity.

And when that happens, fewer families lose babies in the first year of life, and this community’s high infant-mortality rate decreases, said Dr. Jeffrey Marable of PrimaryOne Health, which operates neighborhood health centers in and around Columbus.

“(LARC) is easy to use. It’s a one-time insertion. There’s nothing you have to remember to take, and there are few and minimal side effects,” he said. “And it’s starting to make a difference in terms of unwanted pregnancy and teenage pregnancies.”

As fewer women and teens find themselves faced with a bill that averages about $700, the ability of the birth-control methods to make a difference will be better appreciated, Marable said.

About half of the 6.6 million pregnancies in the United States each year are unintended. Studies have shown that unplanned pregnancies are more common among unmarried women, black women and those with lower education and income levels, according to the Centers for Disease Control and Prevention.

PrimaryOne, Columbus Public Health and Nationwide Children’s Hospital have been working together to improve access to long-acting, reversible birth control.

The first two agencies are starting a project aimed at providing free birth control to uninsured and underinsured women in two ZIP codes on the South Side, 43206 and 43207. The effort is supported by $19,000 in state grant money.

(Most of the teens seen at the Nationwide Children’s Hospital’s birth-control clinic have insurance, and those who don’t already receive LARC if they want it free of charge.)

The South Side effort is part of concentrated work there to lower infant death rates. Columbus is working with eight other Ohio communities and the state to find ways to improve the health and well-being of moms and babies and to reduce racial disparities. Ohio has the worst black infant death rate of any state.

Beyond providing birth control, the South Side project is designed to educate women and teens and provide them with resources, including help developing a reproductive life plan that prompts them to think about when they’d like to have children, said Nancie Bechtel, assistant health commissioner for the city.

The partners, including Children’s, will collect and analyze data to determine how well their efforts work.

“If it’s successful, maybe it’s something we want to replicate in other areas of the city, especially in areas with high rates of infant mortality,” Bechtel said.

Safe spacing between pregnancies — the CDC recommends two years — is known to improve the chances that a baby will be born healthy and survive infancy, said Johanna Taylor, nurse practitioner for the city’s Women’s Health Clinic.

“Two of the most preventable causes of infant mortality are unplanned pregnancy and unsafe birth spacing,” she said.

Beyond better access in Columbus, the health centers and the city’s clinic have made sure that women can get same-day access to the long-acting birth control so they don’t have to schedule a second appointment, Taylor said.

While the South Side effort is new and focused on those ZIP codes, the city makes sure that women everywhere who want an IUD or implant get them.

The number of women getting long-acting birth control at the city clinic each month has more than doubled from the beginning of the year through September, when 24 women sought an IUD or implant.

Dr. Elise Berlan, an adolescent-medicine specialist who directs the BC4Teens clinic at Children’s , said the Nexplanon implant has been particularly popular among her young patients.

“It’s a very quick office procedure and is effective for three years. And it’s 99.95 percent effective,” said Berlan, who has been training more practitioners to offer LARC.

For Rodriguez, the IUD made good sense and will allow her to decide whether she wants to try for a daughter one day, she said.

In the meantime, she and her husband, Saul Pici, can focus on raising the boys — Saul Abraham and Juventino — and working and planning for the future they want.

“We don’t want them to have to struggle,” she said. “The ultimate goal in our future is to have our kids go to college. We didn’t have that.”