The Guttmacher Institute, in partnership with Dr. Anu Manchukanti Gómez of the University of California–Berkeley, has developed an innovative new metric to measure contraceptive need in the United States. Estimating contraceptive need at the population level is a key public health indicator that the Institute has measured since the 1970s.
Grounded in a person-centered approach to sexual and reproductive health research, Guttmacher experts worked with Dr. Gómez and the Coalition to Expand Contraceptive Access to elicit input on contraceptive needs and services from diverse stakeholders, including current and potential contraceptive users. These perspectives inform our updated approach to calculating this metric to more closely align with individuals’ contraceptive desires and preferences. The new metric estimates the number of individuals who have a self-defined need for contraception based on their current or recent contraceptive method or service use or their expressed desires to use contraception. This is a departure from the Institute’s previous metric which measured contraceptive need based on a woman’s sexual experience and assumed risk of pregnancy.
“Guttmacher’s research is grounded in the belief that every person deserves access to high-quality, affordable sexual and reproductive health care that aligns with their needs and preferences. This new metric reflects Guttmacher’s commitment to that principle,” says Megan L. Kavanaugh, Guttmacher principal research scientist. “We believe that with this newly adapted methodology, we are calculating more accurate estimates of contraceptive need that can better identify gaps in care, expand access to contraceptive services and support individuals in achieving their reproductive health goals.”
In an accompanying report, Guttmacher experts use the new metric to produce contraceptive need estimates for 2023 in the United States. Key data include:
- 51.9 million women of reproductive age (15–49) were estimated to have a self-defined need for contraceptive services.
- 21.5 million US women were likely in need of public support to meet their self-defined need for contraceptive services, 41% of those needing care overall.
- Nearly 16.6 million women who likely needed public support for contraception were adults, aged 20–49, living below 250% of the Federal Poverty Line (FPL).
- Young women aged 15–19 accounted for 23% (4.9 million) of those who likely needed public support for contraception.
- Of all women who likely needed public support for contraception, 10.1 million were non-Hispanic White, 4.0 million were non-Hispanic Black, 5.4 million were Hispanic, and 1.9 million were members of other or multiple racial and ethnic groups.
- The proportion of all women estimated to have a self-defined need for contraceptive care in 2023 varied little across states, from 65% (in New Mexico and Hawaii) to 72% (in New Hampshire).
- The proportion of those with self-defined need who likely needed public support for care exhibited larger variation across states, varying from 29% (in the District of Columbia) to 57% (in Mississippi).
Additional data and information on women with a likely need for publicly supported contraceptive services are available in Guttmacher’s updated Publicly Supported Family Planning Services fact sheet.