State Abortion Restrictions and Women’s Contraceptive Choices

Over the past two decades, the U.S. abortion policy environment has become increasingly restrictive. In light of the 2018 appointment to the Supreme Court, it seems likely that this trend will continue, at both the national and the state levels. We know that restricting abortion does not eliminate the need for it. We also know that using contraceptives can be an effective way to reduce the need for abortion. But does women’s contraceptive behavior change in response to abortion policies? This was the question explored by Josephine Jacobs and Maria Stanfors in a 2015 Perspectives article.

Using data from the 1995 and 2006–2010 cycles of the NSFG and data on state-level abortion policies, the researchers found some associations between contraceptive use and abortion availability. For instance, women living in states in which 50% of women resided in counties with no abortion provider were more likely than others to use highly effective contraceptives rather than no method; similarly, women living in states with four or more abortion restrictions in place were more likely to use a highly effective method than were those living in states with fewer restrictions.

Contrary to their expectations, Jacobs and Stanfors found no associations between an increase in state-level restrictions and contraceptive behavior; they accounted for this by noting that the states that increased abortion restrictions were restrictive to begin with, and that women may have adjusted their behavior before the most recent restrictions. They noted, however, that “not all women are equally able to adapt to restrictive abortion contexts” and concluded that ensuring access to highly effective contraceptive methods is crucial when abortion access is limited. Today, this message seems more salient than ever.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine