New study shows effect antiabortion bans have had on contraceptive care
Bixby Center for Global Reproductive Health publishes research that shows how fear of legal consequences limits birth control providers
Antiabortion restrictions have been known to have had a chilling effect on abortion care, but a new study indicates that trepidation extends to contraceptives as well.
The Bixby Center for Global Reproductive Health published a study called “I am putting my fear on them subconsciously”: a qualitative study of contraceptive care in the context of abortion bans in the U.S. They conducted interviews with healthcare providers around the country, and research found that requests for long-acting or permanent contraception have shot up. Panic about restrictions brought up the potential for coercing patients into using methods that might not be the best option for them. Yasaman Zia, one of the co-authors, spoke with me over the phone.
“We are highlighting the kind of spillover effects of abortion restrictions into contraception,” Zia said. “And we found that it has changed some of the practices of providers, but has also deeply affected providers themselves and caused a lot of moral injury to them.”
This research also adds to reports about the increasing pressure on reproductive health care providers, with Dobbs sowing confusion, fear, and moral injury. That includes providers engaging in excessive risk avoidance, potentially impacting people’s ability to get certain birth control methods. Providers are preparing themselves for the possibility that abortion restrictions—and the financial, logistical, health, and mental burdens they carry—could be a blueprint for upcoming attacks on contraception.
There is a sense of shared decision-making between patient and provider within contraceptive care. Much of that has to do with the history of contraceptive research. Several years ago, I wrote an essay on how the Pill had a questionable legacy with its testing methodology on Puerto Rican women in the 1950s as part of Gregory Pincus’ research financed by Planned Parenthood.
Even with that history, the current climate pushes doctors into uncomfortable terrain. Because there's a sort of increased pressure and urgency, both coming from patients being in their adolescence or coming in for longer-acting contraceptives, there's pressure on providers to prevent unwanted pregnancy.
“That creates this sort of vacuum where there can be the potential for more coercive or directive counseling when it comes to contraception,” Zia said.
Providers can’t counsel on the full range of birth control methods either for fear of violating antiabortion laws. Some think that inserting an IUD could be seen as causing an abortion.
“Institutions need to protect their providers and give them the information they need and the legal support they need to navigate these really hostile landscapes,” Zia said.