The U.S. Supreme Court’s overturning of Roe v. Wade two years ago has affected women’s contraceptive use for the worse, new research suggests. The study found that prescriptions of birth control and emergency contraception have declined significantly more in the states that passed the most restrictive abortion laws following the Supreme Court decision. Sounds counterintuitive, but these findings make perfect sense when viewed through the lens of the ongoing war on women’s reproductive rights.
In June 2022, the U.S. Supreme Court’s ruling on the case of Dobbs v. Jackson Women’s Health stripped away the constitutional right to an abortion previously established by Roe 50 years earlier. The 6-3 decision relegated the regulation of abortion to the states, and many anti-abortion lawmakers seized on the opportunity, passing some of the most restrictive laws on abortion seen yet. These efforts were boosted by the passing of the Texas Heartbeat Act a year earlier—a law that banned abortions after a fetal heartbeat could be detected, typically around six weeks of gestation (between a quarter to nearly half of abortions are thought to happen at or before six weeks, depending on the state).
Research has long shown that restrictive abortion laws can negatively impact women’s health in various ways beyond just limiting access to abortion. A study earlier this May, for instance, found evidence that such laws had slightly boosted murder rates among girls and women, even prior to the overturning of Roe. Many experts have expected that these negative impacts would only worsen in the wake of Dobbs, and the data is now starting to affirm these fears.
This newest study was led by researchers at the University of Southern California. They wanted to examine if and how the removal of Roe affected rates of contraceptive use, particularly in the states that passed the harshest abortion laws afterward. The team analyzed data on filled-out prescriptions for oral birth control and emergency contraceptive pills from states before and after the Dobbs decision. These states were grouped based on their pre-existing level of abortion restrictions and whether they had passed further restrictions since.
The number of monthly prescriptions for birth control declined nationwide between March 2021 and October 2023, the researchers found. But leading up to the Dobbs decision, these trends were similar between the different groups of states. After Dobbs, however, the decline of birth control prescriptions became noticeably worse in the states that had passed the harshest laws, they found. Overall, these states saw a 24% decline in birth control prescriptions during the study period.
A more mixed picture was seen with emergency contraception. Prescription rates of emergency contraceptives actually increased in the first year nationally following Dobbs, but in the second year, they began to decline, especially for the states with the harshest laws post-Dobbs. These states saw an additional 65% decrease in fills for emergency contraceptives starting in the second year, relative to the states that had maintained moderate abortion restrictions.
The findings, published Wednesday in JAMA Network Open, may seem counterintuitive at first glance. But the authors note that many family planning clinics that provided abortions in these states have shut down in the wake of Dobbs, and since about 11% of women are thought to receive prescriptions for birth control from these sorts of clinics, the loss of Roe may have directly affected many women’s access to oral contraception. Misinformation about the exact effects of the Dobbs decision and subsequent abortion bans may have played a role as well. A February 2023 Kaiser Family Foundation poll found that about half of women living in states with these bans mistakenly believed or were unsure whether the bans applied to emergency contraception as well, for instance.
This research is only the latest this week to demonstrate the fallout from recent anti-abortion policies. A study published Monday in JAMA Pediatrics found evidence that Texas’ 2021 abortion ban has since led to an increase in infant deaths and birth defects. The authors of the current study say that more has to be done to safeguard the health and reproductive freedom of women, particularly those living in the states most hit hard by the loss of Roe.
“These findings suggest that efforts to protect and improve access to oral contraceptives are needed, especially for emergency contraceptives in states where abortion is most strongly restricted,” they wrote.
