The Supreme Court’s landmark decision in Dobbs v. Jackson Women’s Health Organization in June 2022, which effectively overturned the federal right to an abortion, has dramatically reshaped reproductive healthcare across the United States. For many women, this change has also highlighted the pressing need for improved access to family planning services.
In Alabama, one of more than a dozen states that have banned nearly all abortions post-Dobbs, the West Alabama Women’s Center (WAWC Healthcare) had to pivot after the state law prohibited abortion services. Executive Director Robin Marty noted that many patients who previously sought abortion services at the clinic had initially faced challenges accessing contraception. “When you believe in bodily autonomy, you must support someone’s reproductive choices at every stage of their lives,” Marty explained.
This scenario is not unique to Alabama. Across the U.S., abortion bans have led to the closure or repurposing of 76 independent abortion clinics since 2022, leaving 14 states entirely without abortion services. For the majority of women served by these clinics, especially those uninsured or in low-income brackets, obtaining contraception has been just as difficult as accessing abortion care.
The Centers for Disease Control and Prevention (CDC) recently released a report underscoring significant inequities in access to family planning services, with disparities along racial and socioeconomic lines. According to survey data from 2022 and 2023:
- Nearly 40% of White women reported receiving family planning services in the previous year, compared to 35% of Black women and 32% of Hispanic women.
- Income and education levels also influenced access; higher-income, better-educated women were more likely to receive family planning services.
The survey also highlighted that contraception prescriptions were the most commonly accessed service, utilized by about 24% of women aged 15 to 49. Emergency contraception use was reported by nearly 4% of women, while 3% sought counseling for sterilization procedures.
Comparing family planning usage trends before and after the Dobbs decision is challenging due to changes in survey methodologies. However, studies suggest that women in states with restrictive abortion laws are now less likely to access prescription birth control, while emergency contraception and sterilization procedures appear to be on the rise.
Efforts to improve access to family planning services are ongoing. For example, the U.S. Food and Drug Administration approved Opill, the first nonprescription daily oral contraceptive, earlier this year. Consumer interest in Opill has steadily grown, reflecting a growing demand for accessible birth control options.
In October, the Biden administration proposed a rule requiring private insurance plans to cover over-the-counter contraception without a prescription at no cost. If implemented, this could address one of the significant barriers many women face in accessing birth control.
Despite these advancements, family planning services remain vulnerable to political and regulatory shifts. Title X, a federal program that funds family planning and preventative healthcare, has struggled to recover from restrictive regulations introduced during the Trump administration. A recent analysis by KFF revealed that the program served at least 1.1 million fewer people in 2023 compared to its pre-regulation numbers.
The potential for future political changes, particularly under a second Trump term, raises concerns about further limitations on Title X and other family planning initiatives.
The Dobbs decision has amplified the importance of ensuring comprehensive family planning access for all women, particularly in marginalized communities. While initiatives like Opill and proposed insurance coverage reforms are steps in the right direction, much work remains to address the deep-seated disparities and ensure that every woman has the resources she needs to make informed decisions about her reproductive health.
Empowering women with accessible and equitable family planning services is essential—not just as a response to restrictive abortion laws, but as a fundamental aspect of public health and human rights.
