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Birth control prescriptions are down in states with abortion bans


Research out today finds that states with highly restrictive abortion bans have also seen sharp declines in prescriptions for birth control and emergency contraception. NPR's Elissa Nadworny covers reproductive rights and joins us now. Hi, Elissa.


CHANG: OK, so tell us more about this study. Like, what did the researchers find exactly?

NADWORNY: Well, they looked at prescriptions in states that implemented strict bans after the Supreme Court overturned the right to an abortion in 2022, and they compared them with states that had more moderate bans or where the laws didn't change at all, and they did this over about a 15-month period.

They found that in states like Texas and Alabama, places with strict bans - they had these big declines. So in Texas, for example, prescription fills for birth control pills declined by nearly a third. Pills for emergency contraceptives, including things like Plan B, dropped by nearly half.


NADWORNY: Dima Qato, a professor at the University of Southern California, was the lead researcher on the study, which published today in the journal JAMA Network Open.

DIMA QATO: A lot of the focus has been on abortion and how Dobbs has impacted abortion. But we can't forget that, you know, preventing pregnancy and contraception is still key.

CHANG: But why such big declines? Like, what's going on here, you think?

NADWORNY: So Qato says the decline is likely because many family planning clinics with abortion services - they closed after the bans. But those were the same clinics that offered family planning and reproductive health. That's where people got these prescriptions.

The other reason for the decline in prescriptions may be just confusion over what is legal. A study last year by the Kaiser Family Foundation found more than half of the women surveyed believed that Plan B was illegal because of their state's abortion ban. And that's despite the fact that the FDA came out and said, emergency contraception, including Plan B - it prevents pregnancy. It does not terminate it. The thing is, Ailsa, there's so much misinformation, it can be hard for people to keep track.

CHANG: Yeah. Well, I know that this spring, we saw for the first time that oral birth control was being made available over the counter. Does that impact all of this, you think?

NADWORNY: So it wasn't included in the study, but Qato says it's unlikely to have made a big difference considering that those options are still really expensive and out of reach for low-income people. Take Opill, which is the FDA's approved birth control pill that you can get over the counter. There's no need for a prescription. It runs about $20 a month, but if you have insurance, even Medicaid, you can get prescription birth control covered for free, so it's not likely to have a big impact.

CHANG: OK. So, Elissa, can you just put these findings into context for us when it comes to reproductive rights overall? Like, why do these findings matter?

NADWORNY: So they show that there are big implications to Dobbs that go beyond abortion. So birth control or emergency contraception is the main way people prevent an unplanned or unwanted pregnancy. Lauren Ralph - she's a professor at the University of California San Francisco not affiliated with the study.

LAUREN RALPH: Especially in a landscape where access to abortion has become increasingly difficult, we should be really trying to improve access to contraception to help support people in having pregnancies when they want to.

NADWORNY: So there's no evidence yet about this, but both Ralph and Qato say they're going to be watching to see if these drops in prescriptions are going to affect pregnancy and live birth rates.

CHANG: That is NPR's Elissa Nadworny. Thank you so much, Elissa.

NADWORNY: You bet. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Elissa Nadworny reports on all things college for NPR, following big stories like unprecedented enrollment declines, college affordability, the student debt crisis and workforce training. During the 2020-2021 academic year, she traveled to dozens of campuses to document what it was like to reopen during the coronavirus pandemic. Her work has won several awards including a 2020 Gracie Award for a story about student parents in college, a 2018 James Beard Award for a story about the Chinese-American population in the Mississippi Delta and a 2017 Edward R. Murrow Award for excellence in innovation.