It may seem a little premature to place an intrauterine device (IUD) or implant a long-acting contraceptive device immediately after delivery. But a growing number of states in the United States are offering this option through their Medicaid programs, according to a new study published in the latest issue of the journal Contraception. This is an important initiative, experts say, because postpartum women are at high risk for unintended pregnancy and many low-income mothers do not have the financial means to secure a reliable contraceptive option after childbirth. Researchers at the University of Michigan Health System found that a Medicaid grant specifically for the immediate placement of an IUD or skin implant for postpartum women became widely available in 19 U.S. states in just 3 years, and eight other states are considering strengthening the grant. The authors note that previous studies have shown that 40 to 60 percent of low-income women who wish to use an IUD or skin implant for contraception do so at a prohibitive cost, typically $800 to $1,000, not including expenses for communication appointments, child care, and transportation to and from clinics. ”Many women use postpartum placement of an IUD or skin implant as their preferred method of birth control, knowing that this method is the safest and most effective.” Michele K. Moniz, research assistant professor of obstetrics and gynecology at the University of Michigan Medical School. Moniz noted in a research report. “The problem is that there is no way to get them to return to a health care facility to have an IUD placed after delivery, and our findings suggest that more and more health care facilities are recognizing the obvious benefits of providing contraceptive services to mothers before they leave the hospital.” Another unplanned pregnancy after delivery can have negative effects on the health of both mother and baby, including an increased risk of miscarriage, preterm birth, and stillbirth. At the same time, “postpartum parents are fatigued coping with parenting and postpartum recovery on the one hand.” Linda of the Institute of Obstetrics, Gynecology and Women’s Health? Dr. Bradley told CBS News. “On the other hand there are financial issues, and taking maternity leave again can reduce income by leaving work.” The study identified Ohio as a pilot state to offer Medicaid for IUD placement immediately after delivery, but Bradley said, “In the clinic, most users still don’t know much about this method of contraception.” “Typically in the U.S., there’s not a lot of knowledge about IUDs among those who visit,” she says. “This is a gap that physicians can fill, and they can inform the attendee that this is a very safe, and very effective, method of contraception.” “Communication about postpartum contraception should begin at the first prenatal visit.” The researchers noted that while many insurance companies (both private and government-funded) support the maternal choice of permanent contraceptive methods, such as a tubal ligation, before a woman has been discharged from the hospital after giving birth, they usually do not include IUDs and skin implants. In this study, researchers conducted telephone interviews with 40 health care providers. They found that the most common factors influencing the decision included primarily the welfare of the mother and child, as well as overall cost savings. No providers yet expressed concern about the budgeting of costs and potential health risks associated with another unplanned pregnancy after delivery. Experts note that in studies on health issues, it is seen that while the chance of IUD dislodgement is slightly higher with immediate postpartum placement than with placement 8 to 10 weeks after delivery, the risk of complications, infection and injury is very low with both timing of IUD placement. Bradley said, “In short, the other risks are very low compared to the benefits of IUD placement.” The researchers explained, “In terms of IUD dislodgement, there is no harm to women, which attracts women to choose to have an IUD placed immediately after delivery.” The researchers said, “We hope that more states will provide policy support for this contraceptive and that private insurers will offer this option. ” “Reimbursement policies have been a barrier to providing safe and effective contraception for women in high-risk situations after childbirth.” Moniz said. “We’re finding that this state of affairs is changing rapidly. More providers, are finding ways to make it easier for women to get the contraceptive methods they want in the immediate postpartum period. But still more than half of the states do not yet offer this particular health insurance, and we recommend that they correct misconceptions about cost budgets and provide more help for women to have access to immediate postpartum contraceptive protection.”