Now Is the Time to Protect and Expand Birth Control Access

House Speaker Nancy Pelosi (D-Calif.) on Capitol Hill on July 20, 2022, and other members of the Democratic caucus, discuss the Right to Contraception Act, a law that would codify the right to access and use FDA-approved contraceptives. It passed in the House and awaits a Senate vote. (Win McNamee / Getty Images)

We are at a unique moment for contraceptive access in the United States.

On the one hand, the Food and Drug Administration is considering the first-ever application for an over-the-counter oral contraceptive pill—an outcome of more than two decades of science and advocacy. Approval of this application, without an age restriction, would help expand access for people in every part of the country, particularly for those who already face barriers obtaining clinical care, such as adolescents, young adults, and people of color.

At the same time, contraceptive access is under attack at state and federal levels. This threat is evident in strategic efforts to falsely conflate birth control with abortion, as well as Justice Clarence Thomas’ explicit questioning of long-standing legal precedent for contraceptive rights in his concurring opinion to the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision in June, which rolled back federal protections for abortion rights. 

It is no surprise young adults are concerned about their ability to access birth control and other basic reproductive healthcare in the future. This sentiment was clearly expressed in a new survey commissioned by Power to Decide as part of an award-winning annual campaign, #ThxBirthControl, which celebrates the key role contraception plays in helping people live their lives on their own terms.

The survey found while nearly three-quarters (73 percent) of people between the ages of 18 and 29 think it is easy to access birth control in the U.S. currently, half (50 percent) think it will be very (17 percent) or somewhat hard (33 percent) to do so in the future.

Of the 17 percent who believe contraceptive access will be very hard, the survey found significantly higher proportions among groups who typically face greater barriers to access:

  • 31 percent for Black respondents and 20 percent for Hispanic respondents, compared to 12 percent for white respondents;
  • 20 percent for those with an annual household income under $50,000, compared to 13 percent for those with an annual household income of $50,000 or more; and
  • 22 percent for those living in the South, compared to 12 percent for those in the West.

When asked if “the Supreme Court’s decision in June [that] allows states to set their own abortion laws” changed their opinion about how easy or hard it will be for people to get birth control in the future, nearly six in 10 (57 percent) reported they think it will be harder to access birth control. 

Pervasive misconceptions conflating contraception with abortion may be partly driving concern about access to contraception in the context of increasing abortion bans. The survey found that 69 percent of respondents incorrectly think emergency contraception pills “can end a pregnancy in its early stages.”

Concern about future access to emergency contraception may have contributed to the 60 percent increase in views for the emergency contraceptive pages on Power to Decide’s online birth control support network during the three-month period after the draft Supreme Court decision was leaked. Concerns about access are understandable, given state legislators have strategically perpetuated misinformation as part of efforts targeting access to contraception.

In response, we must call on elected officials to support urgently-needed legislation, such as the Right to Contraception Act, which seeks to protect the right of individuals to use birth control and the right of physicians and other healthcare professionals to provide this basic, essential care. 

Concerns about access are understandable, given state legislators have strategically perpetuated misinformation as part of efforts targeting access to contraception.

We must not only protect access to the full range of birth control methods but also expand the ways people can use the method that works best for them based on existing evidence.

Approval of a progestin-only oral contraceptive pill available over the counter without age restrictions would mark an important step in that direction, and research has shown it can be done safely. One study found that less than 2 percent of reproductive-age women had contraindications, health conditions or other risk factors that might prevent them from taking a progestin-only pill safely.

Other research has shown women, including adolescents, can accurately self-identify contraindications for oral contraception. Given such evidence, the American College of Obstetricians and Gynecologists has recommended oral contraception be available over-the-counter.

Working together we can ensure young people and people of every age have control over their bodies and can decide if, when, and under what circumstances to get pregnant and have a child. By expanding access to contraception, we hope they can join us and millions of people across the country in saying, “Thanks, Birth Control!”

This op-ed is adapted from a commentary forthcoming in the journal Contraception.

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Riley Steiner, MPH, Ph.D., is the senior director of research and evaluation for Power to Decide.