Should Indiana hospitals offer IUDs to women after childbirth? It's a statehouse debate.

EVANSVILLE — A local legislator is caught in the midst of an argument over contraceptives at the Indiana Statehouse.

Rep. Cindy Ledbetter, R-Warrick County, is a sponsor to House Bill 1426. The bill would require hospitals with a maternity unit to stock and offer a long-acting, reversible subdermal contraceptive to women after they give birth.

The bill, authored by Rep. Rita Fleming, D-Jeffersonville, has been recommitted to the Senate Committee on Appropriations. It already has passed Indiana's House of Representatives.

Specification of the "subdermal" part has Indiana Democrats, and some physicians, worried about the bill's consequences. Two physicians from the Good Trouble Coalition spoke against the bill in committee last week. The group initially supported the bill, but no longer does.

The bill originally included intrauterine devices. But that language was removed after Right to Life joined the debate, according to legislators.

A spokesperson for Indiana Right to Life said they have not taken a position on this bill this year, nor testified on it.

Local Republican State Sen. Vaneta Becker, representing Warrick County and part of Vanderburgh County, is a member of the Health and Provider Services committee, where the bill was heard last week. Becker also has concerns with the removal of IUDs from the bill, but said her "yes" vote to move it forward was because she feels it is an improvement of current state law.

Many Republicans are in favor of the bill, including Ledbetter, who called the bill "good legislation for women" when testifying before the Health and Provider Services Committee last week.

"Fifty-two percent of our Indiana births are Medicaid," Ledbetter said. "That's 33,000 births at a cost of $20,000 per birth, at a total cost of $640 million annually."

Ledbetter said same-day access to LARCs, which are currently priced around $2,000, could save costs from unintended pregnancies.

"Access to contraception allows women to pursue further education, participate in the workforce at higher rates and increase their earnings," she said. "Publicly funded contraception reduces poverty rates allowing women to invest more heavily in their own human capital and enhance their economic security."

Right to Life impacting legislation

Echoing her comments from a local Meet Your Legislators event in Evansville on Feb. 17, Ledbetter said the argument around Right to Life was frustrating. Ledbetter is a regular attendee of the Right to Life of Southwest Indiana's annual banquet.

Ledbetter said Right to Life believes the IUD has an abortive effect.

"That might be considered a far-right argument," Ledbetter said. "And today I have to sit here and listen to this far-left argument, when this is about helping women improve their lives and moving forward so that they can do better."

Democrats are taking issue with the bill not including IUDs, believing it pushes incorrect information about how the contraceptive works.

Ledbetter said IUDs without a hormonal component, a copper IUD, allow a woman to conceive and then the embryo is not allowed to implant in the uterus, "thus aborting the fetus."

That is not how IUDs prevent pregnancy.

KFF, a non-profit organization focused on health care issues in the United States, has an article from October 2023 highlighting where contraceptives stand in the conversation following the Supreme Courts vote on abortion.

"Despite some common misconceptions, emergency contraceptive methods and regular use of the IUD do not terminate a pregnancy, stop the implantation of a fertilized egg, or affect a developing embryo," the organization states.

A Yale Medicine article about IUDs explains how they work.

  • Hormonal IUDs release progestin, a synthetic version of the hormone progesterone. This causes the cervical mucus to thicken, preventing the sperm from getting to the uterus and reaching an egg.

  • Copper IUDs do not contain hormones, but a small amount of copper, which causes an immune response in the uterus. This creates a toxic environment for sperm.

Sen. Shelli Yoder, D-Bloomington, blasted the claim that some IUDs are abortifacients. She shared her comments via Twitter, stating, "by removing funding for IUDs from this bill, this Legislature threatens access to birth control, and I could not support it. We cannot allow myths to dictate our legislative decisions."

During the committee hearing, Yoder said the concern is also that hospitals will not stock all the options. Since the bill mandates subdermal implants, that will be what is on hand.

"This is clawing back choices for women when it comes to birth control," Yoder said. "... My concern is we're going to use (House Bill) 1426 going forward to say Medicaid will not cover IUDs for Medicaid patients in the state of Indiana. We're already dipping our toe in that with 1426 as amended."

This article originally appeared on Evansville Courier & Press: Indiana Legislature weighs requiring hospitals to offer IUDs