In the final weeks of legislative session, the Indiana legislature debated and eventually passed HB1426, a bill which would promote long-acting reversible contraception (LARC) to postpartum people insured by Medicaid. The version of the bill which passed only required hospitals to tell postpartum patients with Medicaid about subdermal implants, after IUDs were removed from the bill due to anti-abortion opposition.
Far too many people in Indiana struggle to access the reproductive health care they need, and access to birth control is under attack nationwide. We know that our allies and policymakers are looking for a way to make a difference for women in Indiana. However, as an organization guided by reproductive justice values, All-Options opposes HB1426, not only in its current form, but as it was originally written to include IUDs.
Every person should be able to make the reproductive decisions that are right for them, without coercion or condition. That means all postpartum Hoosiers deserve to be told about all contraceptive options – from LARCs to diaphragms to pills, patches, and rings. While IUDs and implants are important contraceptive options that should be accessible to anyone who wants them, they should not be promoted above other methods. Bills that prioritize long-acting reversible contraception over other forms of birth control do not adequately consider individual needs and preferences. Each person should be able to weigh the factors that matter most to them and choose the method they prefer.
In addition, policies that focus solely on providing long-acting birth control to people with Medicaid reflect a long history of efforts to target low-income women, young people, immigrants, and communities of color with LARCs as a way to control their fertility and discourage childbearing. Research has demonstrated how advocates’ unchecked enthusiasm for promoting LARCs, even with the intention of improving access, can actually undermine reproductive autonomy. Almost exactly 10 years ago, a groundbreaking paper, “Women or LARC First? Reproductive Autonomy and the Promotion of Long-Acting Reversible Contraceptive Methods,” was published documenting these very issues.
Indiana can do better. In a state that bans abortion care, where 1 in 4 counties are considered maternity care deserts, and rates of infant mortality, child poverty, and maternal mortality are among the worst in the nation, there are so many policies that could truly make a difference. Let’s look for real solutions that will improve access for all Hoosiers, not only to all forms of contraceptives, but to prenatal care, birthing options, and the resources our children and families need to thrive.