REPRODUCTIVE HEALTH IN NEBRASKA WOMEN: THE EFFECT OF INSURANCE STATUS ON PREGNANCY INTENDEDNESS AND INTERPREGNANCY INTERVALS Pubblico

Abstract

Publicly-subsidized reproductive health services, including contraception, prenatal care, delivery and postpartum care are important for assisting low-income women in adequately spacing their pregnancies, reducing unintended pregnancies and delivering healthier babies.

The goal of this study was to better understand the current status of women's access to reproductive health services in Nebraska and to determine how additional subsidized services might impact access and state costs. Binary and multiple logistic regression on weighted data from the Nebraska Pregnancy Risk Assessment Monitoring System (PRAMS), 2005-2008, indicated that women with unintended pregnancies were more likely to have no insurance (crude OR=2.3; 95% CI: 1.93, 2.75) and that short interpregnancy intervals were associated with unintended pregnancy (adjusted OR=2.14; 95% CI: 1.76, 2.60). Interpregnancy interval was not associated with insurance status among women with unintended pregnancy. A review of trends in Nebraska Title X clinic usage based on administrative data from Nebraska Family Planning Annual Reports (FPARs), 1995-2007, indicated an expanding population of clinic users with incomes less than 101% of poverty and greater reliance on Medicaid for payment for services revenue. Estimated costs/savings of implementing an income-based Medicaid family planning waiver in Nebraska range from millions to tens of millions of dollars in savings.

To reduce public costs and improve the health of Nebraska women and their babies, Nebraska should consider an income-based Medicaid family planning waiver or state plan amendment to expand Medicaid eligibility for family planning services.

Table of Contents

TABLE OF CONTENTS

Chapter 1: Introduction Chapter II: Review of the Literature Chapter III: Methodology Chapter IV: Results Chapter V: Conclusions, Implications, and Recommendations References

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	Title X unintended pregnancy Nebraska Medicaid interpregnancy interval insurance
Committee Chair / Thesis Advisor	Hogue, Carol J, Emory University
Committee Members	Barnes-Josiah, Debora, Nebraska Department of Health and Human Services
Partnering Agencies	Does not apply (no collaborating organization)

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