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Harvard researchers see significant increase in long-term birth control use after Trump election

The number of privately insured women seeking long-acting reversible contraceptives significantly increased in the 30 days following President Donald Trump’s election in 2016, according to a study published Monday.

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Harvard University researchers said a higher-than-expected number of American women ages 18 to 45 sought intrauterine devices and implants immediately after the election.

The researchers, whose study was published in the Journal of the American Medical Association, looked at women enrolled in commercial insurance during the 30 business days before and after Nov. 8 in 2015 and 2016 and used billing codes to calculate the number of such procedures.

The researchers said that if they projected their findings to the 33 million insured women in the age group, the number would rise from an expected 4,716 insertions per day to 5,416, or 700 more per day.

“Our findings could reflect a response to fears of losing contraceptive coverage because of President Trump’s opposition to the ACA or an association of the 2016 election with reproductive intentions or LARC awareness,” study lead author Dr. Lydia Pace said, referring to long-acting reversible contraceptives.

Long-term birth control is attractive for a few reasons.

IUDs and implants can remain in place for years, meaning some can last longer than Trump’s presidency. They’re also more effective: IUDs are 99 percent effective compared with 91 percent for the pill, according to Planned Parenthood.

Although more costly out of pocket — IUDs range from $500 to $1,000 and the implant Nexplanon can cost $1,300 — some women have 100 percent of costs covered by insurance. Pace noted that the study has limitations because the researchers lacked information on race and ethnicity and studied only women with commercial insurance.

Lower out-of-pocket costs for birth control can be attributed to the Affordable Care Act, which mandates that insurers cover birth control. But one of Trump’s campaign promises was to repeal and replace Obamacare, and that led many women to fear they’ll have to pay for birth control in its entirety.

Pace said the findings suggest that women value their birth control coverage, and fear of losing that coverage may prompt a change in contraceptive methods.

“The ACA’s contraceptive coverage mandate is an important strategy to reduce unintended pregnancies,” according to the study. “The Trump Administration has weakened this mandate.”

Doctors and women’s health organizations agree.

“At Planned Parenthood, there was a nearly tenfold increase in appointments for IUDs in the first week after the election,” a spokeswoman for the women’s health nonprofit said in an email. “We also saw an unprecedented surge in questions about access to health care and birth control, both online and in our health centers. People were concerned that they might lose their coverage under a new Administration.”

Mara Gandal-Powers, senior counsel of reproductive rights and health at the National Women’s Law Center, which runs a birth control hotline, said her organization also noticed an uptick in questions about birth control.

Just after the election and the January 2017 inauguration, the hotline noticed a “significant” increase in questions about long-term contraceptive methods. Some of the increase is because more health providers are recommending the method. But Gandal-Powers said to see that kind of increase in just 30 days strongly suggests women were seeking out IUDs and implants as quickly as possible.

“Before the ACA, there weren’t cost sharing protections on birth control and we saw it harming people,” Gandal-Powers said. “That is something that we are concerned about … people not getting their care.”