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The following is a summary of “Decomposition analysis of racial and ethnic differences in receipt of immediate postpartum, long-acting, reversible, and permanent contraception,” published in the August 2024 issue of Obstetrics and Gynecology by Rodriguez et al.

Researchers conducted a retrospective study to determine the factors contributing to racial and ethnic disparities in the use of immediate postpartum long-acting reversible contraception (IPP LARC) and permanent contraception among Medicaid recipients.

They conducted a cross-sectional study using 3 years of national Medicaid claims data (2016-2018) to examine the rates of IPP LARC use alone and a composite measure of postpartum permanent contraception and IPP LARC within 7 days of delivery by race and ethnicity. A Blinder–Oaxaca model analyzed how medical complexity, age, rurality, delivery mode, and year influenced outcome differences between minority groups and non-Hispanic White women across 1,729,663 deliveries from 2016 to 2018.

The results showed that IPP LARC use rates were highest among Blacks (2.2%), followed by American Indian and Alaska Native at 2.1%, Hawaiian/Pacific Islander beneficiaries at 1.9%, Hispanic (all races) at 1.2%, and Asian at 1.0%. The IPP LARC was lowest among White beneficiaries (0.8%). Medical complexity, age, rurality, year, and mode of delivery explained only 12.3% of the difference in IPP LARC rates between Black and White beneficiaries. Postpartum permanent contraception was highest among White (7.6%), Hispanic (7.2%), and American Indian and Alaska Native (6.8%), followed by Black (6.3%), Hawaiian/Pacific Islander (5.1%) and lowest among Asian women (4.1%). When examining the use of IPP LARC or postpartum permanent contraception together, the same factors explained 94.4% of the differences between Black and White beneficiaries.

Investigators concluded that despite racial and ethnic disparities in the use of IPP LARC, inpatient highly effective contraception use was generally consistent across groups.

Source: sciencedirect.com/science/article/abs/pii/S0010782424001926