美国国家公共电台 NPR Long-Term, Reversible Contraception Gains Traction With Young Women（在线收听）

Long-Term, Reversible Contraception Gains Traction With Young Women

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And we're going to spend a few minutes now talking about birth control, specifically LARCs, L-A-R-Cs, which stands for long-acting reversible contraception. That includes intrauterine devices and arm implants. They're safe effective, which is why federal health leaders are encouraging state Medicaid programs to increase access to LARCs in hopes that planned pregnancies lead to healthier mothers and healthier babies. From member station WFAE in Charlotte, Michael Tomsic reports the Carolinas are ahead of the curve.

(SOUNDBITE OF KNOCKING)

UNIDENTIFIED WOMAN: Come on in.

KIM HAMM: You cool if we come in?

UNIDENTIFIED WOMAN: Yes.

MICHAEL TOMSIC, BYLINE: Nurse Practitioner Kim Hamm walks into a clinic in Gaston County, N.C. A teenager has talked through her options with a health care provider and chosen a contraceptive arm implant.

HAMM: This is the numbing medicine, OK? So you're going to feel me touch you here. Now a little stick - one, two, three, ouch - and then a little bit of burn, OK?

TOMSIC: Next is the actual implant, which works by slowly releasing hormones. It's about the size of a matchstick. Hamm uses a small device to insert it between the girl's biceps and triceps.

HAMM: Feel tons of pressure here. That's it.

TOMSIC: Research shows long-acting reversible contraception, or LARCs, are incredibly effective and safe forms of birth control. But they're not that well-known. They can be expensive, and there were problems with some older versions. So only about 10 percent of American women use them, says Megan Kavanaugh of the Guttmacher Institute.

MEGAN KAVANAUGH: Some of the other developed countries that we look at are in the high teens, maybe low 20s, in terms of percentage of use.

TOMSIC: Kavanaugh says better provider training and patient education should lead to higher usage in the United States. That's exactly what happened in Gaston County, N.C., where clinics have seen usage rates soar to nearly 30 percent among teens. It's also played out in Colorado, with higher usage and subsequent drops in teen pregnancy and abortion, says Jody Camp of Colorado's public health department.

JODY CAMP: While we are not claiming full responsibility for all the decreases in these public health indicators, we do believe that our LARC investment made a huge impact on those.

TOMSIC: Now federal health leaders are encouraging all states to make it more accessible through Medicaid, government insurance that covers many low-income women. And they highlighted the way South Carolina has been doing that. Women have the choice to get it right after they give birth. The state uses simulations to teach hospital staff.

UNIDENTIFIED MAN: The head is delivering.

RECORDED VOICE: (Screaming).

TOMSIC: The Palmetto Health-USC School of Medicine in Columbia uses a high-tech mannequin in what's basically an RV. They drive it around the state, and part of their training is about contraception, says Dr. Judy Burgis.

JUDY BURGIS: The IUD is inserted 10 minutes after delivery of the placenta - like the patient you just saw.

TOMSIC: The director of the South Carolina Birth Outcomes Initiative, BZ Giese, says about half of women on Medicaid weren't showing up to their postpartum visit, when a doctor would discuss contraception options.

B Z GIESE: And that's normally when contraception would be initiated. So we were missing a lot of moms that did not come back. And actually, the next time the doctor saw them, they came back pregnant with another child.

TOMSIC: In 2012, South Carolina Medicaid implemented a new way of paying hospitals so they'd take care of contraception before the mom left the first time. It's still completely up to her, and they talk through it in advance. Ana Walker chose an arm implant that'll last three years.

ANA WALKER: I mean, right when I heard about it, I went for it 'cause I was just like, that's probably going to work best for me.

TOMSIC: That's her daughter Bella in the background. Walker, who's 18, got the implant after giving birth to her. She likes that she won't have to remember to take a pill every day. Twenty-year-old Breanna Martin chose a five-year IUD after she had a baby recently. She says it puts her in control.

BREANNA MARTIN: That's the wonderful thing about it is if I want to wait five years, I'm protected for five years. And then if I want to have kids sooner, then I can get it taken out.

TOMSIC: And, South Carolina Researchers say, this initiative is saving the state money. The devices cost roughly a thousand dollars. That's a fraction of what childbirth costs.

For NPR News, I'm Michael Tomsic.

MARTIN: That story is part of a reporting partnership with NPR, WFAE and Kaiser Health News.