Contraceptive care is a vital part of general well being take care of many individuals, and most ladies use contraception sooner or later of their lifetime. As abortion entry has change into extra restricted post-Dobbs there was an elevated consideration on the necessity for and way forward for contraceptive entry.
This transient gives an in depth examination of girls’s experiences with contraception, insurance coverage protection, contraceptive preferences, and interactions with the well being care system. We additionally discover the affect and attain of contraceptive data on social media. The KFF Ladies’s Well being Survey, a nationally consultant survey of girls in the USA was fielded in Might and June 2024 and features a pattern of three,901 ladies of reproductive age (18-49). Ladies embody people who establish as such, in addition to these with different gender identities that most well-liked to finish the feminine set of sexual and reproductive well being questions within the survey. See the methodology part for detailed definitions, sampling design, and margins of sampling error.
Key Takeaways
Use of Contraceptives
Eight in ten (82%) ladies of reproductive age say they used some type of contraception prior to now 12 months.
Virtually half (48%) of contraceptive customers used a couple of contraceptive methodology prior to now 12 months, with male condoms and oral contraceptives representing probably the most generally used strategies.
Nearly all of ladies use contraception to stop being pregnant (85%), however one in seven (14%) use it solely for an additional cause, reminiscent of managing a medical situation or stopping a sexually transmitted an infection.
Practically seven in ten (69%) ladies of reproductive age say it is rather necessary for them to keep away from turning into pregnant within the subsequent month.
Contraception in Social Media
Practically 4 in ten (39%) of reproductive age ladies have heard one thing on social media about contraception prior to now 12 months, together with half (49%) of girls ages 18 to 25.
Virtually 4 in ten (38%) ladies of reproductive age who’ve heard one thing on social media about contraception (19% of all reproductive age ladies), have talked to somebody of their life about what they noticed or heard.
One in seven ladies ages 18 to 25 (14%) say they made a change or thought of making a change to their contraception methodology due to one thing they noticed or heard on social media.
Contraceptive Protection
Whereas insurance coverage paid the complete value of contraception for almost all (69%) of contraceptive customers with non-public insurance coverage, 1 / 4 (24%) report that they paid some or the entire prices out-of-pocket as a result of their plan didn’t cowl the complete value or didn’t cowl contraception in any respect.
Regardless of emergency contraceptive capsules being lined by insurance coverage without charge (with a prescription), few (17%) of those that have used emergency contraception prior to now 12 months say they bought it with a prescription.
The prices of contraceptives are nonetheless a barrier for some ladies; one in 5 (20%) uninsured ladies needed to cease utilizing a contraception methodology as a result of they couldn’t afford it.
Entry and High quality of Care
Three quarters (78%) of girls obtained their most up-to-date contraceptive care at a health care provider’s workplace, however clinics play an necessary position for girls with low incomes (21%) and girls with out insurance coverage (28%).
One in 5 (20%) reproductive age ladies say they might not know the place to get emergency contraception in the event that they needed or wanted it regardless of its availability as an over-the-counter methodology.
4 in ten (42%) contraceptive customers rated their contraceptive counseling as wonderful throughout all measures of care.
Practically 1 / 4 (23%) of contraceptive customers say if they may use any kind of contraception methodology obtainable, they might use a unique methodology than the one they’re presently utilizing. Of this group, practically one in 4 (23%) say they like their companion get a vasectomy.
Use of Contraceptives
Nearly all of reproductive age ladies use contraception. Eight in ten (82%) ladies ages 18 to 49 say they used some type of contraception prior to now 12 months (Determine 1). Strategies used embody a sterilization process that they or their companion have had, capsules, injectables, patch, ring, intrauterine machine, contraceptive implant, male condoms, emergency contraception, fertility awareness-based strategies, and withdrawal. Practically one in ten (9%) reproductive age ladies say they’re both pregnant or making an attempt to conceive, 4% say they’re unable to conceive, and 6% didn’t use contraception prior to now 12 months.
Practically half (48%) of contraceptive customers report utilizing a couple of type of contraceptive methodology prior to now 12 months, and the strategies used shift as they age (Desk 1). Amongst all reproductive age ladies, three in ten (31%) depend on a everlasting methodology, reminiscent of feminine sterilization (21%) or a companion’s vasectomy (10%). The share of girls who report counting on everlasting strategies will increase to over half (52%) of girls ages 36 to 49. Virtually 1 / 4 (24%) of girls used a long-acting reversible methodology prior to now 12 months, reminiscent of an intrauterine machine (IUD) or contraceptive implant, with highest shares of girls ages 26 to 35 utilizing IUDs and bigger shares of girls ages 18 to 25 utilizing contraceptive implants. 4 in ten ladies used a shorter performing hormonal prescribed methodology prior to now 12 months, with oral contraceptive capsules accounting for the biggest share amongst all age teams.
Sizable shares of girls use contraceptive strategies that they will simply begin and cease on their very own with no prescription, with condoms and withdrawal representing two of probably the most broadly used strategies amongst ladies of all age teams. Virtually one in 4 (22%) youthful ladies ages 18 to 25 report utilizing fertility awareness-based strategies, which may replicate a rising curiosity in non-hormonal strategies, mentioned extensively on social media shops focusing on younger individuals. One in 4 (24%) youthful ladies additionally report utilizing emergency contraception prior to now 12 months in comparison with simply 4% of girls ages 36 to 49.
Ladies additionally use contraception for causes apart from stopping being pregnant. Two-thirds (65%) of girls say they use contraception solely to stop being pregnant (Determine 2), one in seven (14%) use contraception solely for a cause exterior of stopping being pregnant, reminiscent of to handle a medical situation or stop a sexually transmitted an infection within the case of condoms, and one in 5 (20%) use it to stop being pregnant and one more reason. Amongst ladies who establish as a disabled particular person or an individual with a incapacity, one in 4 (26%) use contraception solely for a cause exterior of stopping being pregnant, reminiscent of managing a medical situation, making entry to contraception significantly necessary for this inhabitants (information not proven in determine).
The kind of methodology chosen might rely on their cause to be used. For many who solely used an IUD prior to now 12 months, eight in ten (81%) report utilizing contraception for the only real cause of stopping being pregnant. A a lot bigger share of contraceptive capsule customers, in comparison with customers of different types of contraception, report utilizing contraception for under causes exterior of being pregnant prevention, as many hormonal strategies are used to handle menstrual irregularities, deal with pimples, alleviate menstrual migraines, and handle signs of circumstances like polycystic ovary syndrome (PCOS). Practically one in 5 condom solely customers use contraception to stop each stop being pregnant and another cause, more likely to stop STIs.
Practically seven in ten (69%) ladies of reproductive age say that avoiding being pregnant within the subsequent month is essential to them (Determine 3). Being pregnant prevention is essential to just about three in 4 (74%) ladies ages 18 to 25. Whereas smaller shares of contraceptive non-users say it is rather necessary for them to keep away from being pregnant in comparison with contraceptive customers (31% vs. 73%), 4 in ten (44%) nonetheless say it is vital for them to keep away from turning into pregnant within the subsequent month. There are usually not vital variations between ladies of sure demographics together with race/ethnicity, revenue, incapacity, and abortion standing in state of residence.
There are numerous explanation why somebody might select to not use contraception. Amongst sexually energetic ladies able to turning into pregnant who don’t use contraception, 4 in ten (40%) say they didn’t need to use contraception, one other practically 4 in ten (38%) say they didn’t actually thoughts in the event that they bought pregnant, and nearly one in 4 (22%) say they didn’t assume they may get pregnant (though they or their companion weren’t sterilized and many others.) (Desk 2). One in 5 (19%) don’t use contraception as a result of they had been nervous about or disliked the negative effects of contraception. One other 7% say they didn’t anticipate to have intercourse, 6% couldn’t discover a methodology they had been happy with, and 4% don’t use contraception for non secular causes.
Contraception in Social Media
Contraceptive data is pervasive on social media. Practically 4 in ten (39%) ladies of reproductive age say they’ve seen or heard one thing on social media about contraception prior to now 12 months (Determine 4). This contains half of girls ages 18 to 25 (49%) and 4 in 10 ladies ages 26 to 35 (41%) who report seeing or listening to details about contraception by way of social media. Publicity to social media that talks about contraception was greater amongst ladies who use contraception than those that don’t.
Virtually 4 in ten (38%) reproductive age ladies who’ve seen or heard one thing on social media about contraception report they’ve talked to a minimum of one particular person of their lives in regards to the content material (Determine 5). Amongst those that have seen or heard something on social media about contraception (39% of girls ages 18 to 49), 1 / 4 (25%) say they talked to their household or associates about the contraception content material. One in 5 (19%) say they talked to their companion or partner, and one in ten (10%) say they talked to their physician or healthcare supplier. Most ladies who’ve seen or heard something on social media about contraception didn’t speak to anybody in regards to the content material (62%).
Whereas social media generally is a software to unfold dependable and reliable health-related data, it may be and has been used to unfold mis- and dis-information. A rising variety of social media influencers have tapped into their social networks to share their destructive experiences with sure contraception strategies reminiscent of oral contraceptive capsules or intrauterine units (IUDs), typically making false claims in regards to the security and efficacy of hormonal contraception. Whereas earlier KFF analysis discovered that solely a small share of girls use social media as their principal supply of details about contraception negative effects, there have been anecdotal reviews about ladies stopping contraception use after consuming deceptive or factually incorrect social media.
Few ladies say they made a change or thought of making a change to their methodology of contraception due to one thing they noticed on social media, however youthful ladies appear to be extra receptive to alter primarily based on social media messaging (Determine 6). In comparison with older reproductive age ladies (ages 36 to 49; 3%), bigger shares of girls ages 18 to 25 (14%) and 26 to 35 (8%) made a change or thought of making a change to their contraception methodology primarily based on one thing they noticed or heard on social media. Throughout all age teams, most reproductive age ladies say they didn’t change their contraception methodology due to one thing they noticed or heard on social media.
Contraceptive Protection
The ACA requires that plans cowl out-of-pocket contraception prices for most people with non-public insurance coverage, but a large share of girls are nonetheless paying among the value. 1 / 4 (24%) of contraceptive customers with non-public insurance coverage say they paid out-of-pocket some or the entire prices of their contraception as a result of their plan didn’t cowl the complete value or didn’t cowl contraception in any respect (Determine 7).
The share of people paying out-of-pocket for contraception dropped dramatically shortly after the ACA’s contraceptive protection necessities had been adopted, nevertheless, there have been a number of reviews about individuals persevering with to pay out-of-pocket. Causes might be enrollment in a grandfathered well being plan that doesn’t have to stick to the contraceptive protection necessities, working for an employer that has non secular or ethical objections to overlaying contraception, or going to an out-of-network supplier. Some face out-of-pocket prices for utilizing a model title methodology that has a generic different. A better share of privately insured ladies who obtained their contraceptive care at a location apart from a health care provider’s workplace say they paid out-of-pocket for his or her care (40% vs. 20%) (Determine 8).
This might embody people utilizing telecontraception apps, which don’t at all times settle for insurance coverage or cost a membership or subscriber price. It may additionally embody people buying emergency contraception with no prescription, which well being plans haven’t been required to cowl. New proposed laws issued by the Biden administration, if finalized would require well being plans to cowl all OTC strategies, together with Opill, spermicide, and male condoms when obtained via an in-network pharmacy. Whereas a sort of emergency contraceptive capsules (Plan B and its generic options) is out there over-the-counter, most insurers require a prescription earlier than they’ll cowl the prices. Amongst those that used EC capsules prior to now 12 months (12% of reproductive age ladies), lower than one in 5 (17%) bought it with a prescription. The bulk (83%) of reproductive age ladies who used EC capsules prior to now years obtained over-the-counter emergency contraception with no prescription and almost definitely pay the complete value, which may be as much as $50.
General, 5% of reproductive age ladies and 20% of those that are uninsured, say they’ve needed to cease utilizing a contraceptive methodology as a result of they may not afford it (Determine 9). Discontinuation of a way resulting from prices was reported by practically one in ten (9%) ladies with low incomes and one in 5 (20%) ladies who’re uninsured. Title X clinics and federally certified well being facilities are designed to offer free or low-cost contraception to individuals with low incomes and people with out insurance coverage. Nevertheless, individuals might not be conscious of those free or low-cost companies, or they could reside in a group that doesn’t have a clinic web site close by.
Entry to and High quality of Contraceptive Care
There was an elevated consideration to the significance of contraceptive entry, particularly post-Dobbs the place entry to abortion is now banned or severely restricted in lots of states. Nationally, practically one in 5 ladies of reproductive age say it’s “tough” to entry contraceptive care of their state and this rises to just about one in 4 (23%) amongst those that are uninsured ladies (Determine 10). Bigger shares of youthful ladies and girls with decrease incomes additionally describe contraceptive care as tough to entry in comparison with those that are older or with greater incomes.
The avenues via which individuals can entry contraception has been increasing, however most (77%) ladies nonetheless acquire their contraceptive care via a health care provider’s workplace (Determine 11). Clinics additionally play an necessary position for a lot of, with greater shares of Black (16%) and Hispanic (19%) ladies in comparison with White ladies (10%) receiving their contraceptive care at a clinic-based setting, reminiscent of a group well being heart, Deliberate Parenthood or different household planning clinic, or a school-based or walk-in clinic. Amongst contraceptive customers, one in 5 (21%) ladies with low incomes and those that have Medicaid protection (20%) acquire their contraceptive care at a clinic and this rises to twenty-eight% of girls who’re uninsured. Practically one in ten (9%) ladies utilizing contraception entry their contraception care exterior of a clinic setting, reminiscent of on-line via an internet site or app or via a pharmacy, drug retailer, or another place.
Over-the-counter (OTC) choices from pharmacies, drug shops, and on-line web sites may be interesting avenue for contraceptive entry particularly for individuals with no clinician’s prescription for hormonal strategies. Till lately, over-the-counter choices for contraceptives supposed for normal use had been restricted to non-hormonal strategies reminiscent of condoms and spermicides. After FDA-approval in 2023, the primary ever each day oral contraceptive capsule turned stocked in shops and on-line in early 2024, making Opill the simplest type of contraception obtainable over-the-counter. Nevertheless, consciousness of the brand new Opill is mostly low, with 1 / 4 (26%) of girls 18 to 49 saying they’ve heard of the brand new each day oral contraceptive capsule. Amongst those that have heard of it, simply 4% have bought it and an excellent smaller share (3%) have used or taken Opill because it turned stocked in shops and on-line earlier in 2024.
Emergency contraceptive capsules have been obtainable OTC since 2006, in addition to via many medical doctors’ places of work and clinics, nevertheless, one in 5 (19%) reproductive age ladies wouldn’t know the place to get emergency contraception capsules in the event that they needed or wanted them within the close to future (Determine 12). Increased shares of girls with decrease incomes in comparison with greater incomes (25% vs. 16%) and girls dwelling in rural areas in comparison with these dwelling in city or suburban areas (30% vs. 17%) say they might not know the place to get emergency contraception capsules in the event that they needed or wanted them in close to future. A better share of girls dwelling in states the place abortion is banned say they might not know the place they may go to get emergency contraception in comparison with ladies dwelling in states the place abortion is mostly obtainable (23% vs. 17%).
An necessary a part of a contraceptive care go to is contraceptive counseling that’s centered on a affected person’s personal wants, values, and preferences with regard to their contraceptive decision-making., known as person-centered contraceptive counseling. The standard of this counseling may be measured utilizing a four-item survey that makes use of a 5-point scale and asks sufferers to charge the extent to which their supplier revered them as an individual, allow them to say what mattered to them about their contraception methodology, took their preferences about their contraception significantly, and gave them sufficient data to make one of the best determination about their contraception methodology. Utilizing this measure, 4 in ten (42%) contraceptive customers report receiving wonderful person-centered contraceptive counseling throughout all dimensions (Determine 13). Smaller shares of girls with low incomes in comparison with ladies with greater incomes charge their contraceptive counseling as wonderful throughout all 4 objects (39% vs. 49%). Solely a 3rd (33%) of girls with out insurance coverage charge their contraceptive counseling as wonderful in comparison with 45% of girls with non-public insurance coverage. Smaller shares of girls receiving their contraceptive care at a clinic charge their contraceptive counseling as wonderful in comparison with these getting care in a health care provider’s workplace (38% vs. 49%) which disproportionately displays the experiences of girls who’re low revenue or uninsured. Simply over 10% of contraceptive customers rated their supplier as truthful or poor on a minimum of one of many 4 objects of patient-centered contraceptive counseling. Increased shares of girls with low incomes (16%) and uninsured ladies (21%), in addition to one in 5 ladies with disabilities say they obtained truthful or poor contraceptive counseling on a minimum of one merchandise.
A part of person-centered contraceptive counseling is letting sufferers say what issues to them about their contraception methodology and taking their preferences about their contraception significantly. Nevertheless, practically 1 / 4 (23%) of contraceptive customers say if they may use any kind of contraception methodology obtainable, they might use a unique methodology than the tactic they’re presently utilizing (Determine 14). That is comparable throughout age teams and race/ethnicity. Bigger shares of girls with low incomes say that if they may use any kind of contraception methodology obtainable, they might use a unique methodology than they’re presently utilizing in comparison with ladies with greater incomes (29% vs. 19%). Over three in ten (31%) ladies with Medicaid protection say they might use a unique methodology than the one they’re presently utilizing if they may use any methodology in comparison with one in 5 (20%) ladies with non-public insurance coverage.
Amongst ladies who aren’t utilizing their most well-liked methodology, practically one in 4 (23%) say they might use a companion’s vasectomy if they may use any kind of contraception, no matter value or different attainable obstacles (Determine 15). Contraceptive use is usually the accountability of girls as a result of extraordinarily restricted contraceptive strategies obtainable to males. For ladies or those that can get pregnant, avoiding being pregnant includes present process a process, or remembering to take a capsule day-after-day, or monitoring one’s cycle and for a lot of, dwelling with negative effects. Being able to depend on a companion’s vasectomy can take among the burden off those that are able to turning into pregnant. Practically one in 5 (18%) ladies who aren’t utilizing their most well-liked methodology (23% of contraceptive customers) say they might select to be sterilized, whereas 21% would use a long-acting reversible methodology, reminiscent of an IUD (14%) or implant (7%). These long-acting strategies may be interesting as a result of they can be utilized for 3 to 10 years and don’t depend on frequently remembering to take a each day capsule or get a periodic injection within the case of brief performing hormonal strategies. Amongst those that are usually not utilizing their most well-liked methodology one in 5 (19%) ladies would use a brief performing hormonal methodology, reminiscent of capsules (8%), injectables (5%), patch (2%), ring (2%), and emergency contraception (2%). Whereas one in ten (12%) would select a non-hormonal methodology, together with male condoms (6%), withdrawal (3%), and fertility awareness-based strategies (3%).
Concern about negative effects or beforehand skilled negative effects are main causes ladies are usually not utilizing their most well-liked methodology of contraception, with 1 / 4 (25%) of girls who are usually not utilizing their most well-liked methodology citing this as the rationale (Determine 16). Over 4 in ten (44%) Black ladies who are usually not utilizing their most well-liked methodology say concern about negative effects is the first cause in comparison with 18% of White ladies. Among the different high causes ladies are usually not utilizing their most well-liked methodology embody incapability to afford their most well-liked methodology (15%), their supplier recommending a unique methodology (10%), or their companion not wanting them to make use of their most well-liked methodology (8%).
The first causes for not utilizing their most well-liked methodology of contraception relies on the tactic they like to be utilizing. For many who desire to be utilizing a everlasting methodology, reminiscent of feminine sterilization or a companion’s vasectomy, the highest causes they don’t seem to be utilizing these strategies is affordability (26%) and their companion doesn’t need them to make use of this methodology (16%) (Determine 17). Amongst those that desire to be utilizing a long-acting contraceptive or hormonal methodology, 4 in ten (40%) cite concern about negative effects, 17% say their supplier really useful a unique methodology, 11% say medical circumstances make them ineligible, and 10% can’t afford their most well-liked methodology.
