It’s Time to Close Contraceptive Access Gaps

Access to birth control helps people not only plan if and when to get pregnant, but plan their education, grow in their career, prioritize their health, and more. But many are living in contraceptive access gaps and continue to face barriers to contraceptive care. 

One way to fight these barriers is by naming them. That's what Thanks, Birth Control Day is all about. On Thursday, November 12, Power to Decide celebrates its 14th year of inviting people everywhere to share how birth control has shaped their lives, using #ThxBirthControl.

Millions of People Live in a Contraceptive Access Gap

This fall, Power to Decide and the Guttmacher Institute launched new Contraceptive Access Maps. They show, county by county, whether the availability of publicly funded health centers aligns with people's own need for low- or no-cost contraception. Where it doesn't, the county has a contraceptive access gap. Data show that 21.4 million women* of reproductive age who need low- or no-cost contraception live in a county with an access gap. 

And the maps can only capture part of the picture. Distance, transportation, cost, language, and clinic hours all shape whether care is truly within reach. 

Access Is Under Attack, and It's Not by Accident

Those gaps exist in a landscape where access to birth control is being attacked from many directions. These attacks aren't isolated incidents. They're part of a coordinated, sustained effort to roll back reproductive freedom, and each one shows up in people's lives.

• When the Supreme Court overturned Roe v. Wade in 2022, Justice Clarence Thomas wrote that the Court should reconsider Griswold v. Connecticut, the decision that established the right (for married people) to use contraception. A right many people have taken for granted for decades is now openly up for debate.
• Title X is the only federal program dedicated to family planning, and it helps people with low incomes or no insurance get birth control and related care. This year, HHS released new Title X funding guidelines that shift the program's focus away from expanding access to the full range of contraception and towards prioritizing natural family planning methods. That could limit which birth control options patients are offered. Family planning providers, Planned Parenthood, and 23 states have challenged the guidelines in court.
• Seven states, including Texas, Missouri, and South Carolina, block Planned Parenthood from participating in Medicaid. That means patients can't use their coverage to get birth control at the clinics they know and trust. Nationally, nearly 1 in 5 women enrolled in Medicaid got their contraceptive care at a Planned Parenthood health center.
• The Affordable Care Act requires most private plans to cover birth control at no cost. Yet according to KFF, one in four privately insured women who use birth control still pay at least part of the cost out of pocket. A surprise bill at the pharmacy counter can be the difference between staying on a method that works and going without.
  The result is a system where whether people can get birth control too often depends on their zip code, coverage, or the latest political decision, not on what they need.

Young People Want Trusted Information, and Too Many Aren't Getting It

Access isn't just about having a clinic nearby. It's also about people knowing their options and having someone to talk them through with. New data from Power to Decide’s Youth Reproductive Health Access (YouR HeAlth) Survey suggests many young people aren’t getting the birth control information they need, and what they see online may influence how they think about birth control: 

• Over one-third of young people didn’t get any information at all about birth control in the last year.
• One in five young people have considered starting, stopping, or changing their method because of something they saw on social media, and one in ten reported actually making a change. 
• Nearly three in four young people somewhat trust what they see about birth control on social media.
   

Put simply, young people want accurate information from sources they trust. Many are left to answer these questions on their own, often by scrolling. Honest stories, paired with trusted resources like Bedsider.org, help close the information gap one conversation at a time.

This Thanks, Birth Control Day post with #ThxBirthControl, and support Power to Decide’s efforts to increase contraceptive access and reproductive well-being for all.

* While we use the term "women" to align with our data sources, which do not always collect information about sex or gender consistently, we recognize that contraception is used by people with diverse gender identities.