Increasing women’s access to postpartum birth control has the potential to increase the health and well-being of women and their families, and immediate postpartum birth control can lead to a decrease in unplanned pregnancies, increased intervals between pregnancies, and a reduction in neonatal abstinence syndrome births (from drug exposure in the womb). Tennessee and California have developed unique Medicaid quality improvement and payment strategies to increase access to immediate postpartum long-acting reversible contraception (LARC).