3 years after the Supreme Court limited access to abortion, contraception is also at risk
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On June 24, 2022, the decision of the United States Supreme Court Dobbs c. Jackson Women’s Health Organization Eliminated a constitutional right of almost 50 years to abortion and has made the authority to regulate abortion to the States.
THE Dobbs The decision, which overthrew Roe c. Wadehas largely reshaped the national abortion landscape. Three years later, many states have severely limited access to abortion care. But the decision also had a less well recognized result: it is increasingly compromising access to contraception.
We are scientific doctors and sociologists and researchers in health services who study women’s care and health policies, including access to contraception. We see a disturbing situation emerging.
Even if the growing limits of abortion in the United States strengthen the need for effective contraception, family planning providers are less available in many states, and health insurance coverage of some of the most effective types of contraception is at risk.
A growing demand for contraception
Abortion restrictions have proliferated throughout the country from the Dobbs decision. In June 2025, 12 states had almost total abortion and 10 states prohibited abortion before 23 or 24 weeks of gestation, that is to say when a fetus is generally deemed viable. Among the remaining states, 19 restrict abortion after viability and nine states and Washington has no gestational limits.
It is not surprising that women living in states that prohibit or seriously restrict abortion can be particularly motivated to avoid an unwanted pregnancy. Even planned pregnancies have become more risky, health care providers fearing legal repercussions to treat medical emergencies related to pregnancy such as false layers. Such concerns can partly explain emerging research that suggests the use of long -term contraception such as intrauterine or IUD devices, and permanent contraception – namely sterilization – are increasing.
A national survey carried out in 2024 asked women aged 18 to 49 if they had changed their contraception practices “following the overthrow of the Supreme Court Roe c. Wade. “He noted that almost 1 in 5 women started using contraception for the first time, passed to a more efficient contraceptive method, received a sterilization procedure or emergency contraception purchased to stay at hand.
A study in Ohio hospitals revealed an increase of almost 16% in women choosing long -lasting contraception methods Dobbs decision and a leap of 33% of men receiving vasectomies. Another study, which examined female and male sterilization in university medical centers across the country, also reported an increase in sterilization procedures for young adults aged 18 to 30 after the Dobbs decision, until 2023.
Loss of contraception suppliers
Ironically, the prohibition or severely restricting abortion across the state can also decrease the ability to provide contraception.
To date, there is no convincing evidence that OB-GYN doctors leave states with strict abortion laws in large numbers. A study revealed that states with severe abortion restrictions saw a reduction of 4.2% in these practitioners compared to the States without abortion restrictions.
However, the Association of American Medical Colleges reports that the drop in requests for residence training programs located in states that have abortion prohibitions – not only for OB -GYN training programs, but for residence training of all specialties. This drop suggests that doctors can be generally less likely to train in states that restrict medical practice. And since doctors often remain to be practiced in the United States where they are training, this may indicate a long-term drop in doctors in these states.
However, the largest decrease in contraceptive services is likely to closure of abortion clinics in states with the most restrictive abortion policies. Indeed, such clinics generally provide a wide range of reproductive services, including contraception. The 12 states with almost total abortion bans had 57 abortion clinics in 2020, which were all closed in March 2024. A study reported a 4.1% drop in oral contraceptives in these states.
Contraception under threat
THE Dobbs The decision also encouraged continuous efforts to wrongly redefine some of the most effective contraceptives as drugs that cause abortion. These efforts target emergency contraceptive pills, known as plan B on the counter and Ella by prescription, as well as certain IUDs. Emergency contraceptive pills are up to 98% effective to prevent pregnancy after unprotected sex, and IUDs are 99% effective.
None of the two methods put an end to a pregnancy which begins by definition when a fertilized egg implants in the uterus. Instead, emergency contraceptive pills prevent an egg from being released from the ovaries, while the IUDs, depending on the type, prevent sperm from fertilizing an egg or preventing an egg from implanting in the uterus.
The confusion of contraception and abortion distributes disinformation and causes confusion. People who believe that certain types of contraception cause abortions can be dissuaded from the use of these methods and count on less effective methods. In addition, this can affect health insurance coverage.
Medicaid, which provides health insurance for low -income children and adults, has been required to cover family planning services at no cost for patients since 1972. Since 2012, the affordable care law has forced private health insurers to cover certain preventive women’s health services at no cost for patients, including the full range of contraceptives approved by Food and Drug Administration.
According to our research, insurance coverage required by affordable care law has increased use of IUDs, which can be prohibitive when paid in his pocket. But if IUDs and emergency contraceptive pills were reclassified as interventions that induce abortion, they would probably not be covered by Medicaid or the affordable care law, because no type of health insurance requires coverage for abortion care. Thus, access to some of the most effective contraceptive methods could be compromised at a time when the right to terminate an involuntary or non -viable pregnancy has been canceled in a large part of the country.
Indeed, Project 2025, the agenda of the conservative policy that the Trump administration seems to follow, specifically calls for the abolition of Ella of the mandate of contraception of the law on affordable care because it is a “potential abortion”. And politicians in several states have expressed their support for the idea of ​​restricting these contraceptive methods, as well as contraception more broadly.
On the occasion of the third anniversary of Dobbs Decision, it is clear that its training effects include threats to contraception. Since the use of contraception is almost universal in women during their reproduction years, in our opinion, these threats should be taken seriously.
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