Guttmacher’s latest US-focused research explores pressing topics including confusion around emergency contraception, the reasons people choose not to use birth control and the impact of state policies on contraceptive access and preferences.
What Misconceptions Do People Hold About Emergency Contraception?
Published in SSM Qualitative Research in Health, this qualitative study examines people’s beliefs and misconceptions around emergency contraception, sometimes known as the “morning-after pill.” The study authors interviewed 64 cisgender women, ages 18‒49, with the aim of understanding what reproductive experiences participants considered to be an abortion.
Key findings:
- Of the 64 participants, around half said that using emergency contraception was not an abortion, one-third said that using emergency contraception was maybe an abortion and 11 participants said that emergency contraception was an abortion.
- Participants were often confused about emergency contraception’s mechanism of action (such as incorrectly believing that emergency contraception can end a pregnancy) and when pregnancy begins.
- For some participants, the reason for taking emergency contraception influenced whether or not they considered it to be an abortion or not.
"Confusion around reproductive health care, especially emergency contraception, can be easily exploited by anti-abortion policymakers to further restrict access to all types of reproductive health care,” says Jennifer Mueller, Guttmacher senior research associate and lead study author. “When we better understand how people interpret the care they receive, we can more effectively advocate for policies that safeguard access to emergency contraception and all other forms of sexual and reproductive health care.”
Why do Some Patients Choose Not to Use Contraception?
In a new study published in Contraception, partners from the University of Wisconsin-Madison Reproductive Equity Action Lab and Collaborative for Reproductive Equity along with Guttmacher principal researcher, Megan Kavanaugh, sought to understand contraceptive nonusers’ reasons for not using contraception, as well as reasons for specifically not using long-acting reversible contraception (LARC). The authors analyzed data from the Arizona, Iowa, New Jersey and Wisconsin Surveys of Women collected in 2019‒2020, which are representative of women ages 18‒44 in each state.
Key findings:
- Personal needs and preferences are the primary reasons reported for not using contraception, including infrequent or no sex, openness to pregnancy and beliefs about low fecundity and side effects.
- Although personal needs and preferences are also the most common reasons for never having used a LARC method, access and systems issues were also cited by about half of LARC nonusers.
“With personal choices playing such a huge role in contraceptive behavior, the need for preference-aligned contraceptive care continues to be crucial,” says Megan L. Kavanaugh, Guttmacher principal research scientist. “Contraceptive care should not only respect patients’ decisions not to use birth control, but also work to address expressed concerns, including side effects and insertion and removal procedures.”
How Do State Policy Contexts Impact Contraceptive Use and Preferences?
For decades, Medicaid, Title V and Title X have provided individual and system-level funding for contraceptive care and other essential sexual and reproductive health services for people with limited resources. Originally published in Population Research and Policy Review, this study investigates how federal and state policies and public funding for sexual and reproductive health care shape contraceptive use and preferences among people with a likely need for public support for these services at the state level.
Key findings:
- Among this sample, those living in states with broader Medicaid eligibility were more likely to use contraception and have their contraceptive preferences met than those living in states with stricter eligibility requirements.
- Those living in states with more funding for Title X and Title V were more likely to use contraception—especially provider-involved methods—than those in states with less funding.
- State policies with broader and more equitable access to SRH care are associated with not only an increase in contraceptive use, but with using preferred methods of contraception among people with a likely need for publicly funded family planning care.
“Policies aimed at reducing inequities due to ability to pay—whether through Medicaid expansion or investments in Title X—are strongly linked to greater contraceptive use and fulfillment in contraceptive preferences,” says Hannah Olson, Guttmacher senior research scientist. “But these policies are increasingly at risk. As continuing attacks on publicly funded family planning care threaten to widen existing gaps in access to care, protective policy action is urgently needed to ensure that people—regardless of their zip code—can access the contraceptive care they want and need.”