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In 2012, South Carolina's Medicaid program became the first to provide separate global hospital reimbursement for maternity services as distinct from postpartum intrauterine devices (IUDs) and implants. To investigate the hypothesis that this discrete reimbursement for postpartum contraception might in turn reduce rates of rapid repeat birth (i.e., within 21 months of the first conception), researchers analyzed Medicaid claims data for all South Carolina delivery hospitalizations from 2010 through 2017.
Immediate postpartum placement of IUDs and implants was rare in 2010 (0.07% of Medicaid patients) but became more common by 2017 (5.6% of adults; 10.5% of adolescents). Although this trend had little effect on likelihood of rapid repeat birth…