The reversal of Roe v. Wade marked the beginning of a slew of ongoing attacks on reproductive health — and experts predict the next round of assaults will focus on contraceptive access. A dangerous combination of clinic closures, staffing shortages, misinformation, and draconian legislation has already turned some such fears into reality.
“We certainly saw reports of more contraceptive refusals right after the [Dobbs] decision… it’s really concerning how quickly they could start chipping away at the right to contraception,” Mara Gandal-Powers, Senior Council at the National Women’s Law Center said.
States seeking to limit access to contraception may claim that contraception is an abortifacient, or a medication which induces an abortion. But contraception prevents a pregnancy from happening—it stops ovulation, fertilization, or the implantation of a fertilized egg into the uterine lining. In contrast, abortion ends existing pregnancies, and requires the removal of an embryo.
In equating contraception with abortion, states may have found a successful method of limiting access to contraception altogether. Wendy Parmet, professor of Public Policy and Urban Affairs at Northeastern University School of Law, said that without a Supreme Court ruling to protect access to contraception through an interpretation of the constitutional right to privacy, states could legally ban contraception and criminalize the health care professionals who provide them.
Before the Dobbs decision, states had worked to limit contraceptive access. Many Southern and Midwestern states routinely disallow pharmacists from providing birth control to patients. Eighteen states have banned public funding of entities that provide contraceptives or information about them, Sarah Redd, director of Research Translation at the Center for Reproductive Health Research in the Southeast, said.
Dobbs has further emboldened both public and private actors who want to limit contraception. Live Action, a conservative anti-abortion group with over half a million Instagram followers, has repeatedly spread allegations that contraception is harmful. Similar social media campaigns have been crafted by youth groups like Students for Life of America and Students for Life Action, who spread false claims that hormonal birth control is an abortifacient. These campaigns have 178,000 and 23,000 followers on Instagram, respectively.
“With the Dobbs decision, we are beginning to see a new level of extreme and unabashed restrictive rhetoric and political strategies enacted by politicians seeking to limit access to reproductive health services,” Redd explained.
Redd predicts a coordinated attack on contraception in the upcoming legislative session as well. “We have already seen some incredibly concerning comments coming out of political spaces about extending beyond abortion to restrict access to contraceptives,” she said.
Redd referred to comments from Senator Marsha Blackburn (R-TN), questioning the Supreme Court’s 1965 decision in Griswold v. Connecticut, a landmark ruling that allowed married couples to access and use contraceptives without government restriction. Supporters of contraceptive access are additionally worried by Supreme Court Justice Clarence Thomas’ suggestion that the Dobbs decision could serve as precedent for the weakening of other civil rights. Thomas specifically cited Griswold as an example of a case that warranted reconsideration. Democrats in Congress felt alarmed enough at the opinion to push for the Right to Contraception Act last summer, a bill seeking to establish the federal right for people to obtain and use contraceptives. The bill passed through the House on party lines, but failed in the Senate.
In states like Louisiana, Republican legislators have moved forward with bills that define personhood as beginning at fertilization. A trigger law in Arkansas, which would ban most abortions in the state, could have a similar effect on access to contraceptives. There is a move by anti-abortion advocates there to classify access to Plan B contraceptives as abortion drugs. The law also opens questions about the legality of crossing state lines to access abortion or mail-order prescriptions delivered from another state.
At least 12 states — including Florida and Colorado — allow health care providers such as doctors, hospitals, and pharmacists, to deny treatment for patients seeking contraceptive services, including Plan B.
States where contraceptives are readily available are now overwhelmed and struggling to meet demands. Megan Kavanaugh, research scientist at the Guttmacher Institute, explained that states where abortion is available are experiencing an influx of people traveling there to access abortion providers and contraceptive services.
In Illinois, for example, the Fairview Heights Planned Parenthood facility is located directly across the border from St. Louis, Missouri, a state that completely banned abortion after the Dobbs decision. Given its proximity to such a conservative state, the Fairview clinic has grown accustomed to serving out-of-state patients. But now it has become a national sanctuary and anticipates an additional 14,000 patients traveling from states across the South and Midwest every year.
The increase in patients seeking out-of-state treatment for abortion reflects the larger scramble to find reproductive services in a post-Dobbs world. There’s been a spike of people seeking to buy contraception since the decision, forcing pharmaceutical chains like CVS and Rite Aid to place quotas on how many contraceptives an individual can purchase.
“We will see those same states that have trigger bans begin to impose restrictions on contraception as well,” said Smith College professor Carrie Baker, who researches women’s legal history, gender, and public policy. “Many conservative states have seen [Dobbs] as an invitation that the court is open to reconsidering those precedents and allowing states to ban contraception.”
Moreover, fifteen states with abortion bans — including Texas and Florida — do not have exceptions for rape, meaning survivors, including children, could be denied emergency contraception.
“More [minors] will have to carry those pregnancies to term. They’re going to prevent any public hospital from doing emergency contraception,” Baker said. “The irony in all this is that if you ban contraception, you’re going to get more unwanted pregnancies and more abortions.”
In addition to legislative restrictions, Baker explained that extremist groups have mobilized and expanded since the reversal of Roe. Crisis pregnancy centers, organizations that deceptively dissuade pregnant people from getting abortions, have received increased public funding.
Republican lawmakers in Florida have proposed a fivefold increase in taxpayer funding for anti-abortion centers, from $4.5 million to $25 million. Florida is one of fourteen states which funds crisis pregnancy centers. This year, Kansas, Tennessee, and West Virginia are considering similar multi-million dollar funding expansions.
According to Baker, these centers constitute the front-line of the anti-abortion movement. “They’re part of national and international networks that collect information on people, spread disinformation, and actively interfere with people’s access to contraception,” she said.
Even if contraception is not explicitly restricted, new abortion laws can create an environment of fear around reproductive health services and exacerbate misinformation, discouraging both providers and patients from pursuing care and limiting access to health services. Right-wing advocacy groups have strategically worked to confuse people about the difference between contraception and medication abortion, said Kelly Cleland, executive director of the American Society for Emergency Contraception.
The misinformation surrounding abortion bans has already created barriers to access across the United States. After Missouri enacted an abortion ban, uncertainty about whether contraceptives were included caused major hospital systems to stop providing contraceptives. Idaho public universities put out guidance that said no staff members could talk about or provide contraception. After bans in Iowa, the share of patients at publicly funded family planning centers who had not recently received contraceptive care increased from 32% to 62%.
“They don’t care about using evidence based reasoning. And they just want to do whatever they need to to restrict access,” said Cleland. “When they start to attack contraception, they absolutely lose the ability to make an argument about human life. It is clearly about controlling the reproductive capacity of humans, and our ability to control our own futures.”