A few days after the election of President Trump, some women saw in his victory a cause for concern: would he keep his election promise? repeal the Affordable Care Act? And if so, would it possibly become more difficult and more expensive to obtain birth control?
In November 2016, Sarah Christopherson, Director of Policy at the National Women's Health Network, said widely, branch of Vice Media, said that women should be "very, very worried" about birth control.
Have women rushed to get intrauterine devices and contraceptive implants?
A study published Monday in JAMA Internal Medicine supports what doctors had already observed: the rate of insertion of long – acting reversible contraceptives increased shortly after the 2016 presidential election.
"The peculiarity of IUDs and implants is that they last as long," said Dr. Lydia Pace, Assistant Professor of Medicine at Harvard Medical School and the main author of the study. Because of their longevity, women took advantage of the insurance coverage provided under the Affordable Care Act and obtained a sustainable birth control method based on potential changes in their policy.
The IUD, a small device placed in the uterus, has proven to be more than 99% effective in preventing pregnancy and can work up to 12 years, depending on the type. But without insurance coverage, IUDs can be expensive: personal expenses can range from $ 500 to $ 1,000. Implants are also effective at over 99% and last up to five years, but can cost up to $ 1,300 without insurance.
The study, which only included women registered in commercial health insurance, revealed a 21.6% increase in the rate of insertion of long-acting reversible contraceptive methods among women aged 18 to 45 in the 30 days following the election of President Trump.
When the researchers reviewed the 30 days before and after the elections and compared them at the same time in 2015, they found that 2.1 IUDs or additional implants inserted per 100,000 women per day were associated with the elections, although is not the case. possible to know for sure because they did not study the motivation of the women who received them. If one extrapolated these results to the 33 million American women aged 18 to 45 and enjoying employer-sponsored health insurance, this would mean that about 21,000 additional devices and implants were inserted in the month following the election. Pace said, an increase that she described as "impressive".
"Is there anything else that could explain this rise?" Dr. Pace asked. "Not that I know of."
The use of IUDs and implants has gradually increased in recent years, which Dr. Pace's study has taken into account. She also controlled such features as the location and age of the insured, as well as the type of health plan. The data did not provide any information on the race or ethnicity of women and did not include women who had public health insurance or no insurance.
The results of the study were not surprising. Dr. Aparna Sridhar, Associate Professor of Obstetrics and Gynecology at the David Geffen School of Medicine at the University of California at Los Angeles.
"My places would be reserved for women seeking an IUD," she said. "They specifically state that they are getting an IUD because of the political changes they are witnessing." The requests were made to insured patients privately or publicly, she said.
At U.C.L.A. Student Health Center, the changes were particularly pronounced. Dr. Sridhar and her colleagues looked at the data and found that the total number of long-acting reversible contraceptive insertions at the center had increased from 53 to 118 in the eight weeks following the 39, presidential election of 2016.
Family planning also experienced stronger demand. In the first week after the 2016 elections, there was "an unprecedented surge of questions about access to health care and birth control, both online and in our health centers, and a Ten-fold increase in the number of IUD appointments, "said Elizabeth Clark, director of health media at the Planned Parenthood Federation of America, said.
Affordable Care Act insurance companies required to cover 18 types of contraceptionincluding IUDs and implants, and has allowed millions of women to have access to birth control without the need for a copayment. The Trump administration initially canceled the birth control mandate in 2017, a movement that was quickly challenged in federal court.
Trump's new rules of administration published in November allow employers to obtain an exemption on the basis of their "sincere religious beliefs" or moral convictions. But a federal court issued a national injunction in January preventing the administration from interfering with women's access to free birth control.
Since the study only looked at the first 30 days before and after the elections, it may not have captured all people who were considering obtaining birth control long-acting. Getting an appointment with a private doctor can sometimes take months.
The data for 2017 was not available at the time of the study, making it impossible to know if the increase was lasting. Another analysis led by Athenahealth showed a decline in demand in the months following the elections. Dr. Pace and her colleagues plan to examine trends in the use of contraception in the years after 2016.
"Our findings suggest that many women with private insurance value contraceptive coverage provided by the Affordable Care Act," said Dr. Pace. "In light of recent events, women may have ongoing anxiety about their coverage, which may continue to influence their contraceptive choices and decision-making."