Did the election of Donald Trump lead to a stampede of women getting IUDs?
Well, maybe not a stampede. But there was a measurable uptick in women getting long-acting contraceptives, namely intrauterine devices and hormonal implants, according to a new analysis published Monday in JAMA Internal Medicine.
Trump’s vow to “repeal and replace” the Affordable Care Act unnerved women who feared losing an important ACA benefit — access to all forms of birth control with no out-of-pocket costs. Days after the election, social media lit up with exhortations to get an IUD. That high-cost option works for five to 12 years, potentially enough to outlast Trump’s presidency.
For the new analysis, researchers from Harvard Medical School and Vanderbilt University used data from commercial health plans covering about 3.4 million women ages 17 to 45.
They compared IUD and implant insertions in the month before and after Trump’s election on Nov. 8, 2016. The daily rate of insertions rose from about to 13 to 16 per 100,000 women — about a 22 percent increase. To bolster the theory that it was a Trump effect, the researchers checked the same period a year earlier; it had no such surge.
Extrapolating the findings to the 33 million U.S. women of childbearing age would mean 700 more insertions per day, wrote the researchers, led by physician Lydia E. Pace.
The finding is in line with an analysis of AthenaResearch electronic health records that found IUD prescriptions and procedures increased 19 percent between October and December 2017.
Of course, Trump has not managed to get rid of Obamacare, although he hasn’t given up. But his administration has been hostile to family planning, to the dismay of experts in women’s health and health policy.
For example, the Department of Health and Human Services issued rules that would vastly expand the number of employers who could claim moral objections in order to opt out of providing no-cost contraception. (A federal judge in Pennsylvania issued an injunction on Jan. 14, the day the rules were to take effect.)
“The ACA’s contraceptive coverage mandate is an important strategy to reduce unintended pregnancies," Pace and her co-authors wrote. “The Trump administration has weakened this mandate.”
An opinion piece in last week’s New England Journal of Medicine by experts from the Penn State College of Medicine in Hershey went further, decrying the administration’s “attacks on reproductive rights.”
“Eroding the ACA’s contraceptive mandate is just one of several attacks the Trump administration is waging on family planning,” wrote Cynthia H. Chuang and Carol S. Weisman.
Another one, they said, is the administration’s new rules for the Title X family planning program. Besides denying money to family planning providers like Planned Parenthood that also offer abortion services, the rules would shift money to faith-based organizations that promote fertility awareness and abstinence as contraception.
The final rules are expected to be issued soon.