{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:35:27Z","timestamp":1777944927106,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["K12HD103083"],"award-info":[{"award-number":["K12HD103083"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"national institutes of health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The federal 30-day waiting period for Medicaid-covered female permanent contraception (PC) is a known barrier to timely fulfillment. In July 2020, West Virginia became the first state to bypass this waiting period by using state funds to support procedures that do not meet the waiting period for federal funding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To assess changes in postpartum fulfillment of PC requests following West Virginia\u2019s 2020 Medicaid policy change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort analysis of patients who delivered at \u2a7e20\u2009weeks of gestation at West Virginia University Hospital in 2019 and 2021, excluding 2020 due to the COVID-19 pandemic and implementation of the policy change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used multivariable logistic regression to assess the association between insurance type and inpatient postpartum PC fulfillment, with interaction terms between year and insurance type to examine policy impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 423 patients desiring postpartum PC, 61.5% had PC fulfillment before hospital discharge. In 2019, fulfillment was significantly lower for Medicaid patients than those with other insurance (55.0% vs. 73.3%; RD: \u22120.19; 95% CI [\u22120.32, \u22120.06]). By 2021, this difference was no longer significant (54.9% vs. 68.3%; RD: \u22120.13; [\u22120.27, 0.003]). In adjusted stratified models for 2019 and 2021, there were no significant differences in odds of fulfillment between patients with Medicaid and other insurance (2019 aOR: 0.55; [0.23, 1.28]; 2021 aOR: 0.92; [0.38, 2.21]; likelihood ratio test\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.36).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>West Virginia\u2019s policy change may have partially reduced one barrier to desired inpatient postpartum PC access; Medicaid fulfillment rates remained stable from 2019 to 2021, whereas fulfillment rates decreased for patients with non-Medicaid insurance. However, non-policy-level obstacles to inpatient postpartum PC remain prevalent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251385373","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T11:01:33Z","timestamp":1761130893000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Medicaid policy change and the association between insurance and postpartum permanent contraception fulfillment in West Virginia"],"prefix":"10.1177","volume":"21","author":[{"given":"Sarah","family":"Dotson","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology &amp; Reproductive Sciences, West Virginia University, Morgantown, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-5682","authenticated-orcid":false,"given":"Elizabeth","family":"Pleasants","sequence":"additional","affiliation":[{"name":"Center for Women\u2019s Health Research, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3341-087X","authenticated-orcid":false,"given":"Brooke W.","family":"Bullington","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arzice","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas J.","family":"Swartz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Duke University Medical Center; Core Faculty, Margolis Institute for Health Policy, Duke University, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9070-5343","authenticated-orcid":false,"given":"Suzanna","family":"Larkin","sequence":"additional","affiliation":[{"name":"Center for Women\u2019s Health Research, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavita Shah","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000110"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304369"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-genom-090314-024930"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000121"},{"key":"e_1_3_3_6_2","first-page":"50","article-title":"Forced sterilization and the racial politics of \u201cChoice\u201d","author":"Claire S.","year":"2016","unstructured":"Claire S. 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West Virginia Department of Health and Human Resources: Bureau for Medical Services (2020, accessed 19 March 2025).","journal-title":"West Virginia Department of Health and Human Resources: Bureau for Medical Services"},{"key":"e_1_3_3_20_2","unstructured":"Takubo and Stollings. Senate Bill 716. Charleston WV: West Virginia Legislature https:\/\/www.wvlegislature.gov\/bill_status\/bills_text.cfm?billdoc=SB716%20INTR.htm&yr=2020&sesstype=RS&i=716#:~:text=NOTE%3A%20The%20purpose%20of%20this at%20the%20time%20of%20delivery. (2020 accessed 12 January 2025)."},{"key":"e_1_3_3_21_2","unstructured":"Medicaid coverage of births: West Virginia 2018-2023. March of Dimes https:\/\/www.marchofdimes.org\/peristats\/data?reg=99&top=11&stop=154&lev=1&slev=4&obj=1&sreg=54 (2024 accessed 12 January 2025)."},{"key":"e_1_3_3_22_2","unstructured":"Centers for Medicare and Medicaid Services. 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