Immediate Postpartum Long-Acting Reversible Contraception Access and Child Maltreatment Rates

Policy changes that improve access to immediate postpartum long-acting reversible contraceptives (IPP LARC carveouts) were examined as a potential prevention measure against parent-perpetrated child maltreatment, neglect and physical abuse of children under five. Generalized differences-in-differences was applied to state-year outcome trends from the National Child Abuse and Neglect Data System child file. Findings suggest IPP LARC carveouts did not yield significant reductions in substantiated parent-perpetrated physical abuse (ATT = -22.9% or 49.97 fewer cases per 100,000 children under 5, p-value = 0.18) nor investigated parent-perpetrated physical abuse (ATT = -18.7% or 57.78 fewer cases per 100,000 children under 5, p-value = 0.26). However, among states whose proportions of births covered by Medicaid fall above the median, the policies were associated with significant reductions substantiated (ATT = -33.7% or 74 fewer cases per 100,000 children under 5, p-value = 0.05) and investigated (ATT = -38.7% or 120 fewer cases per 100,000 children under 5, p-value = 0.05) parent-perpetrated physical abuse cases per 100,000 children under 5. Collectively, findings suggest that enabling Medicaid to reimburse separately for IPP LARC may reduce parent-perpetrated physical abuse among young children.