Women living in states with low levels of access to abortion providers are more likely than women in states with greater provider access to use highly effective contraceptives rather than no method. Similarly, women in states characterized by a high level of abortion hostility are more likely than women in less or moderately hostile states to use highly effective methods rather than no method, according to "State Abortion Context and U.S. Women’s Contraceptive Choices, 1995–2010," by Josephine Jacobs of Western University in London, Ontario, and Maria Stanfors of Lund University, Sweden. Highly effective methods as defined in the study were surgical sterilization and the pill, injectable, implant, patch, ring and IUD.

In the past decade in particular, there have been substantial increases in the proportion of women of reproductive age living in states with highly restrictive abortion policies. Against that backdrop, the authors sought to understand how women’s contraceptive behavior is related to restrictions on abortion access in the state where they live. To do so, they analyzed data from 14,523 women aged 15–44 from the 1995 and 2010 cycles of the National Survey of Family Growth in conjunction with information on state-level abortion context.

The analysis suggests that women living in states with more restrictive abortion contexts tend to use highly effective contraceptives. However, increases in states’ restrictiveness during the study period did not appear to be associated with increased use of highly effective methods. The authors propose a likely explanation: that states introducing restrictive legislation already had significant restrictions in place, and women living in these states had previously adjusted their behaviors. Additionally, the authors note that contraceptive choice seems to be most strongly influenced by individual characteristics, irrespective of the larger abortion context.

The authors propose that the best way to prevent unintended pregnancies is to ensure access to highly effective contraceptive methods for all women, particularly in contexts where access to abortion is limited.

"State Abortion Context and U.S. Women’s Contraceptive Choices, 1995–2010," by Josephine Jacobs and Maria Stanfors, is currently available online in Perspectives on Sexual and Reproductive Health.