Bixby launches new contraceptive reimbursement guide

The UCSF Bixby Center has released a new guide to help health providers offer women the full range of contraceptive options. The guide, Intrauterine Devices and Implants: A Guide to Reimbursement, provides information to navigate patient coverage, stocking and reimbursement of these highly effective contraceptive methods. The guide is a joint project of the Bixby Center and the:

  • American College of Obstetricians and Gynecologists
  • National Family Planning & Reproductive Health Association
  • National Health Law Program
  • National Women’s Law Center

Intrauterine devices (IUDs) and implants are safe and highly effective forms of contraception, but their high cost often creates obstacles for providers to offer these methods to women. This new guide aims to decrease the cost barriers for providers and patients alike.


New agreement will save mothers’ lives worldwide

The UCSF Bixby Center and partners have reached new agreement to reduce the cost of a tool that helps save women’s lives during childbirth. The agreement reduces the cost per use of the non-pneumatic anti-shock garment known as Lifewrap™, which has been shown to safely and effectively reduce deaths due to postpartum hemorrhage. Under the agreement, the cost per use of Lifewrap™ will be reduced from $1.30 to below $0.30 for public sector purchasers in 51 countries.

The agreement represents a partnership between the Bixby Center’s Safe Motherhood Program and the

  • UN Commission on Life-Saving Commodities for Women and Children
  • Clinton Health Access Initiative, Inc.
  • Blue Fuzion Group, which supplies the product

Postpartum hemorrhage is the leading cause of maternal death worldwide. The Lifewrap™ can be applied by anyone after a short, simple training and has been used to help over 9,000 women in 20 countries to date.


Abortion does not cause risky alcohol use

Some previous research has found higher levels of alcohol use among women who have received abortions, and these findings are often used to discourage women from accessing abortion care. However, new research from the UCSF Bixby Center challenges the notion that abortion is related to increased alcohol use. Using data from the Turnaway Study, researchers found that women who had a child from an unwanted pregnancy reduced alcohol consumption over a two-year period, while women who had abortions resumed their typical pre-pregnancy alcohol consumption. This new study shows that the difference in alcohol consumption for these two groups is due primarily to reductions among women continuing pregnancies rather than increases among women having abortions.

There was no evidence that having an abortion lead to risky or problematic drinking over time, or that it caused women to start binge drinking. These new findings join others showing that abortion care is medically safe and does not have negative consequences for women.


Louisiana law would drastically limit abortion access

In 2014, Louisiana passed a law requiring abortion providers to have hospital admitting privileges. The law is temporarily on hold while a court case challenging it continues. According to new research from the UCSF Bixby Center, this law would close all of the state’s abortion facilities, forcing three-quarters of Louisiana women to travel 150 miles or more each way for services.

Using data from three of the five Louisiana abortion care facilities in the year before the law was scheduled to take effect, Bixby Center researchers aimed to describe who would be affected if the law went into effect. They found that:

  • Louisiana women in the study had traveled, on average, 58 miles each way to have an abortion. 
  • If Louisiana’s abortion facilities closed, the average distance would more than triple to 208 miles each way, about the distance from New York to Boston. 
  • Most women who had abortions at the three Louisiana facilities had no education beyond high school. They were also more likely to live in areas where average incomes were below the state mean.

The study may actually underestimate the distance women would have to travel, since three of Louisiana­’s neighboring states—Texas, Mississippi and Alabama—have also passed admitting privilege laws and other restrictions that could close their abortion care facilities. Forcing women to travel further would likely contribute to delays in care and put an additional financial burden on women. The researchers concluded that Louisiana’s law would put a considerable burden on many Louisiana women, particularly those who are already financially vulnerable.


Over-the-counter birth control would reduce intended pregnancies, save money

About half of pregnancies in the U.S. are accidental, with inconsistent use and non-use of birth control being the leading causes. For some women, going to a healthcare provider to obtain a prescription stands in the way of using birth control. Making oral contraceptives available without a prescription has the potential to increase the number of women using this method and reduce gaps in use.

New research from the UCSF Bixby Center examines how non-prescription oral contraceptives might impact women's access, use and pregnancies, as well as public health costs. Using national and state data, the researchers found that if women were able to obtain oral contraceptives without a prescription as a covered health insurance benefit, there would be an 11 to 21 percent increase in the number of women using the Pill. As a result, the rate of accidental pregnancies in the U.S. would decrease by 7 to 25 percent.

The researchers also considered the public sector costs of providing oral contraceptives without a prescription and of providing medical care for unintended pregnancy. They found that the combined costs would be reduced for public health plans that chose to cover oral contraceptives without a prescription. Despite these cost savings, it is relatively uncommon for public health insurance to cover non-prescription methods of birth control.

“In the era of no-co-pay contraception, there is still a need for over-the-counter birth control to fill the gap when women run out of pills while traveling, for example, or for those who find it inconvenient to get to a clinic," study co-author Dan Grossman said. "But to reach the largest number of women most in need, it's critical that a future [non-prescription] pill be covered by insurance.