In the 16 months since the Supreme Court’s Dobbs ruling, fewer prescriptions for birth control pills and emergency contraception were filled in states with the strongest abortion restrictions, according to a study published Wednesday in the journal JAMA Network Open.
The researchers discovered a 5.6% decline in birth control pill prescriptions in states with the tightest abortion regulations, compared to states that continued to allow abortion. Although fills for emergency contraception increased momentarily after Dobbs in all states, states with the most restrictive regulations had a 65% decrease in those prescriptions between July and October 2023, compared to states where abortion is universally legal.
According to the study, one of the key reasons for the trend is that abortion prohibitions established following the Dobbs ruling in June 2022 caused abortion and family planning clinics in those states to cease, resulting in the loss of many women’s access to birth control. According to the study, the new legislation also raised questions about whether emergency contraception, such as Plan B, remained allowed in places with abortion prohibitions. (They remain legal in all 50 states.)
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“It’s important to show that restrictive environments around reproductive health, and in this case Dobbs, impact access to contraception and threaten a woman’s right to reproductive choice,” said Dima Qato, the study’s senior author and director of the University of Southern California pharmacy school’s Program on Medicines and Public Health.
The study examined monthly prescription data from March 2021 to October 2023. The researchers divided states into seven categories based on their abortion legislation, which included gestational period limits and constitutional safeguards. Prescriptions in the most stringent states were then compared to those in states with more moderate abortion laws.
The researchers studied two forms of emergency contraceptive pills: Ella and Plan B. The former requires a prescription, whereas Plan B is available over the counter. However, Plan B is provided by insurance in some states with a prescription, therefore Qato stated that the study data is “limited to Plan B fills that were processed and dispensed at a pharmacy, not purchased over the counter.”
According to Julia Strasser, director of the Jacobs Institute of Women’s Health at George Washington University, who was not involved in the new study, this disparity makes understanding general trends in emergency contraceptive use challenging.
“You’re only looking at a part of what’s happening,” she said, adding that her study revealed a short boost in oral contraceptive use in the month following Dobbs, followed by an overall reduction through December 2022.
The study also concluded before Opill, the United States’ first over-the-counter birth control pill, became available.
Birth control pills are the most commonly used hormonal contraceptive in the United States, with one out of every four women aged 15 to 44 using them, according to a study published in February. According to a 2019 analysis by NBCNEWS, a healthcare research and policy organization, approximately 28% of women in that age range who had sex with men had used emergency contraception at least once in their lives.
CVS and Walgreens declined to comment on whether they have seen changes in contraceptive prescription fill rates at their stores.