Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
J Womens Health (Larchmt). 2019 Apr;28(4):551-559. doi: 10.1089/jwh.2018.7129. Epub 2018 Nov 28.
To determine the effect of state Medicaid family planning (FP) programs transitioning from a Section 1115 waiver to a State Plan Amendment (SPA) on reproductive health outcomes.
Data were from the Pregnancy Risk Assessment Monitoring System on 75,082 women who had a live birth between 2007 and 2013 and were living in one of nine states. We performed a difference-in-differences analysis to quantify the effect of the transition on postpartum contraceptive (PPC) use and unintended births (UBs).
Over 80% of the sample reported using PPC; half reported an UB. The odds of PPC use among women who were living in a study state and gave birth after the transition were 1.14 times that of women who were living in a comparison state and/or gave birth before the transition (95% confidence interval: 1.04-1.24).
Findings suggest that women living in states that transitioned from a waiver to SPA experienced an increased likelihood of PPC compared with those living in comparison states.
确定州医疗补助计划生育（FP）计划从第 1115 项豁免过渡到州计划修正案（SPA）对生殖健康结果的影响。
数据来自 2007 年至 2013 年间生活在 9 个州之一的 75082 名活产妇女的妊娠风险评估监测系统。我们进行了差异分析，以量化过渡对产后避孕药具（PPC）使用和意外怀孕（UB）的影响。
超过 80%的样本报告使用了 PPC；一半报告了 UB。与生活在比较州且在过渡前分娩的妇女相比，生活在研究州且在过渡后分娩的妇女使用 PPC 的几率高 1.14 倍（95%置信区间：1.04-1.24）。
研究结果表明，与生活在比较州的妇女相比，从豁免过渡到 SPA 的州的妇女更有可能使用 PPC。
