Where U.S. Women Obtained Contraceptive and Related Care and How They Paid for It in 2022–2023: An Analysis of the National Survey of Family Growth

We aimed to examine receipt of contraceptive and other sexual and reproductive health (SRH) services among U.S. women of reproductive age in 2022–2023, sources of care, and payment methods, with attention to implications for the SRH safety net.

 

Using female respondent data from the 2022–2023 National Survey of Family Growth, we examined receipt of and source of care for 14 SRH services, including contraceptive, preventive gynecologic, sexually transmitted infection testing, and pregnancy-related services. We examined payment methods for contraceptive services by source of care, classified by provider type and funding status, and demographic characteristics.

 

In the prior year, most U.S. women aged 15–49 (64%) received at least one SRH service and more than one-third received contraceptive services. While most obtained SRH care from private providers, publicly supported clinics served a notable share of adolescent, low-income, publicly insured, and uninsured women (30–36%). Overall, private insurance was the most common way individuals paid for contraceptive services (65%), but this varied by income, type of insurance coverage, and source of care. More than 40% of women who received contraceptive services at publicly supported clinics reported paying with Medicaid, compared with 18% at private providers. Out-of-pocket payments were most common among uninsured women (60%) and least common among those with Medicaid (13%). Uninsured women reported receiving no-cost services more often than those with insurance.

 

Publicly supported clinics are essential sources of SRH care, particularly for under-resourced populations. Recent policy changes threaten this safety net. Protecting publicly funded SRH services and maintaining robust provider networks is critical to ensuring equitable access to essential care.