The latest peer-reviewed articles from Guttmacher scientists explore patient knowledge of abortion via telehealth, contraceptive use among US women, the body of evidence showing that contraception does not impact long-term fertility, and the importance of using a person-centered metric to measure contraceptive use.
Do Patients Know They Can Order Abortion Pills Online?
Abortion via telehealth is an increasingly important way for people living in restrictive states to access care, but emerging evidence shows that many people may not be aware of this option. Published in Contraception, Guttmacher researchers analyzed pilot data from 356 people accessing care at six brick-and-mortar clinics between April and September 2025 to see how many knew they could order abortion pills online.
Key findings include:
- One-third of respondents (32%) knew that abortion medications could be mailed to any address in the United States.
- Knowledge of medication abortion via mail was highest among respondents under the age of 20 (47%) and decreased with age.
- Among patients who knew about the availability of abortion via telehealth, the majority (53%) went to a brick-and-mortar clinic because they wanted in-person care.
- Nearly a quarter (23%) of out-of-state patients who knew about the availability of abortion via telehealth indicated they had concerns about getting in trouble with the law.
“Prior Guttmacher research has shown the increased reliance on medication abortion via telehealth for people living in states with abortion bans, demonstrating how important this modality of care can be for people living in restrictive environments. However, findings from our latest study show that many people are unaware of this option,” says Dr. Rachel Jones, Guttmacher principal research scientist and study author. “This demonstrates a clear need for continued campaigns about the availability, safety and legality of abortion pills accessed online so that people can make informed decisions about the type of care that is right for them.”
Are US Women Using Their Preferred Method of Contraception?
Published in F&S Reports, this article provides updated national-level estimates of both method-specific contraceptive use and contraceptive preferences. These findings were calculated using a metric that includes use of up to four birth control methods to capture a broader picture of people’s contraceptive behaviors, a notable change from many past analyses of contraceptive use, which focused on use of the single, most effective contraceptive method. The importance of the new methodology and findings is highlighted by an accompanying editorial.
Key findings include:
- In 2022‒2023, 57% of US women aged 15–49, or 42.8 million, were using a contraceptive method.
- The most commonly used contraceptive methods include oral contraceptive pills (23%), condoms (21%), female permanent methods (20%), withdrawal (19%), and intrauterine devices or IUDs (16%).
- 13% of contraceptive users in 2022‒2023 (excluding those using only female permanent methods) reported preferring to use another method, and 31% of non-users preferred to start a contraceptive method, if cost were not an issue.
“This research underscores the importance of person-centered, evidence-based care that ensures people have access to the full range of birth control methods,” says Mia Zolna, Guttmacher senior research associate and article co-author. “In an increasingly fragmented contraceptive access landscape, comprehensive research and analysis remain essential for shaping protective policies that support people in getting the sexual and reproductive health care that best matches their needs and preferences.”
How Can Providers Alleviate Patient Concerns Around Contraception and Fertility?
Researchers from Guttmacher and the Population Council co-authored a commentary in Studies in Family Planning laying out the scientific evidence that disproves the widespread perception that contraceptives have a permanent negative impact on future fertility. The authors argue that providers have been too dismissive of patient concerns about fertility, which has allowed conservative movements to weaponize these fears and spread misinformation.
Key findings include:
- Reversible contraception does not cause permanent infertility: Systematic reviews of scientific studies and literature show that one-year pregnancy rates after stopping contraception, regardless of how long it was used, are similar to pregnancy rates among those who never used contraception at all.
- There can be short-term delays in return to fertility: While fertility returns promptly for users of most methods after stopping use, some users of hormonal birth control experience a temporary delay in return to ovulation, which can contribute to understandable but inaccurate fears of permanent infertility.
- Counseling frameworks are incomplete and inconsistent. Widely used counseling frameworks do not include content on return to fertility after contraceptive discontinuation. Systematically integrating this information could help individuals anticipate expected short-term delays in return to fertility and reduce opportunities for misinformation to fill the gap.
"Worries that contraception will harm future fertility are widespread, and they're often amplified by social media influencers and rooted in longstanding distrust of the health care system,” says Dr. Chelsea Polis, Guttmacher principal research scientist and co-author. "However, while the scientific evidence is clear—reversible contraception does not have adverse permanent effects on future fertility—providers still must take seriously patient concerns and offer clear, nuanced and accurate information about what to expect after stopping a contraceptive method.”
Why is Using a Person-Centered Lens Important for Measuring Contraceptive Use?
In a collaborative commentary published in BMJ Sexual & Reproductive Health, researchers from Guttmacher, the University of Wisconsin’s Reproductive Action Lab, and the Urban Institute argue that contraceptive effectiveness should not be the most important metric used to measure contraceptive use. Instead, the authors posit that incorporating user preferences and priorities will produce the most accurate estimates of contraceptive prevalence and will better reflect users' needs and lived experiences.
Key findings include:
- Highly clinical and technical survey language can contribute to conflicting responses from respondents who often understand and define contraception differently than researchers.
- Contraceptive use surveys often pay insufficient attention to the non-pregnancy prevention reasons individuals may use contraception and may not accurately capture those who use contraception for other reasons, like managing health conditions.
- Dual or multi-method use is not adequately captured in many contraceptive use surveys. Some surveys will prioritize the most effective method used, which can obscure users' preferences and priorities.
“For too long, contraceptive measurement in the United States has not adequately reflected the needs, preferences and lived realities of users. Accordingly, analyzing and refining how we measure contraception is not just a methodological exercise, but a critical process that can inform how reproductive autonomy and equity are understood by researchers, policymakers, advocates and public health officials,” says Dr. Megan L. Kavanaugh, Guttmacher principal research scientist and co-author. “The findings from this analysis have helped to inform updates to Guttmacher’s own contraception metrics, moving the Institute towards more person-centered measurement of contraceptive need, use and preferences.”