Repeat fertility and contraceptive implant use among Medicaid recipients in Colorado

Late in 1991, Colorado's Medicaid program approved coverage for the hormonal contraceptive implant among Medicaid recipients. Subsequently, the Colorado Department of Public Health and Environment undertook an analysis of data supplied by the state's Medicaid program of the probability of repeat births among Medicaid recipients. According to life-table analysis of two cohorts of women in the database who had their first Medicaid-eligible birth in 1991 and 1992, the rate of repeat delivery within 24 months of the preceding birth fell from 14.1% among 11,554 women who first delivered in 1991 to 10.6% among 13,624 women who first delivered in 1992. The 25% decline in the rate of repeat births between the two cohorts was statistically significant. These rates were higher among Medicaid-eligible mothers who first gave birth as teenagers-22.3% in the 1991 cohort and 15.9% in the 1992 cohort. Among the 2,739 Medicaid-eligible women who delivered in 1992 and chose to use the implant within six months of delivery, the repeat delivery rate was just 2.5% within 24 months; this proportion was virtually the same among implant users in the 1992 cohort who first gave birth as teenagers (2.3%).