Contraceptive care is a vital element of general well being look after many individuals. Federal and state insurance policies form entry to and the supply of contraceptive care, however components comparable to supplier traits, in addition to particular person preferences and experiences additionally impression contraceptive selections and use. This report supplies a detailed examination of reproductive age (18-49) females’ (together with those that establish as girls and different genders) experiences with contraception, insurance coverage protection, contraceptive preferences, and interactions with the well being care system primarily based on an evaluation of the 2022 KFF Ladies’s Well being Survey, a nationally consultant survey of females ages 18 to 64 within the U.S.
Use of Contraceptives
The vast majority of females 18 to 64 (90%) have used contraception in some unspecified time in the future of their reproductive years and lots of have used a couple of contraceptive technique all through their lifetime (76%). Folks’s wants and preferences for several types of strategies can change and speaks to the significance of getting a broad vary of contraceptive choices obtainable. Not surprisingly, most individuals use contraception to forestall being pregnant (85%), however 4 in ten additionally say that they use contraception for one more purpose comparable to managing a medical situation or stopping a sexually transmitted an infection (STI).
Not all individuals who need to stop being pregnant use contraceptives. One in six (17%) sexually lively females who say they aren’t making an attempt to get pregnant are usually not utilizing contraception. There are lots of explanation why individuals could not use contraceptives, starting from issues about unwanted effects, lack of need to make use of a way, to those that aren’t making an attempt however wouldn’t thoughts in the event that they bought pregnant or have non secular causes.
Contraceptive Protection
Though the ACA has required contraceptive protection for over a decade, many nonetheless have no idea in regards to the coverage and a few privately insured females are nonetheless paying for his or her contraceptives. 4 in ten (41%) females of reproductive age have no idea that the majority insurance policy are required to pay the total price of contraception for ladies.
Whereas most females (70%) with personal insurance coverage say their insurance coverage coated the total price of their most up-to-date contraception technique, 1 / 4 say they paid at the least a part of the price out-of-pocket. Of those that paid out of pocket, 16% say it was as a result of they needed a sure model of contraception that was not coated by their plan (though their plan ought to cowl it if their supplier recommends it for them). Others say it’s as a result of their prescribing supplier (10%) or pharmacy (5%) was out of community. Half didn’t know why they needed to pay.
Price is usually a barrier to contraceptive use for some. One in 5 uninsured females of reproductive age say they needed to cease utilizing a contraceptive technique as a result of they couldn’t afford it. A smaller share of these on Medicaid (6%) or with personal protection (3%) cited price as a barrier to continued use. For low-income girls, 17% stated price was the main purpose they weren’t utilizing their most well-liked technique.
Contraceptive Preferences and Facet Results
Total, one quarter of females who’re utilizing contraception are usually not utilizing their most well-liked technique. The main purpose for that is concern about unwanted effects, a theme that comes up in lots of points of contraceptive care. Nearly one-third of contraceptive customers (31%) say they’re experiencing unwanted effects from their present technique, and simply over half (52%) say the unwanted effects are extra extreme than they anticipated.
Simply 30% of females say they obtained all the data they wanted earlier than selecting their contraception technique. That is even decrease amongst Asian/Pacific Islander females, simply 12% of whom say that they had all the data they wanted earlier than selecting a way, in comparison with greater than 1 / 4 of Hispanic (26%) and Black (28%) females and one-third of White females (34%). Particular person-centered contraceptive counseling is a key factor to assuring individuals can choose the contraceptive technique that fits them. Nevertheless, solely 40% of these receiving contraceptive care fee their most up-to-date contraceptive counseling as “glorious.”
Accessing Contraception
The vast majority of reproductive age females get their contraception care at a health care provider’s workplace (77%) and like to get their care there, whilst extra providers have turn out to be obtainable on-line with rising numbers of on-line contraception platforms. Many additionally depend on clinics and well being facilities for his or her care, significantly those that are low-income, uninsured, Black or Hispanic. Far fewer (7%) have obtained a prescription or obtained a well being care service from a web based firm within the prior 12 months. Comfort is the principle purpose those that would like to get their contraception care from a web based firm cite for his or her choice.
Emergency contraceptive capsules (EC) are an efficient type of again up contraception, however a large minority of people that would possibly profit from them don’t know the place to get them or that they’re obtainable over-the-counter. Emergency contraceptive capsules, which could be taken to forestall being pregnant after a contraceptive failure or unprotected intercourse, have been obtainable over-the-counter for greater than 15 years. One in 4 reproductive age females (27%) both don’t know EC capsules can be found over-the-counter or have by no means heard of them. Amongst those that have heard of EC capsules and will turn out to be pregnant, three in ten (31%) don’t know the place they might get it.
Not solely was there a lack of expertise about the place to get emergency contraceptive capsules, however even earlier than the Supreme Courtroom overturned Roe v. Wade, few knew the place they might get an abortion in the event that they wanted one. Previous to the ruling in Dobbs, simply one-quarter (26%) of females ages 18-49 stated they knew what clinic or well being care supplier they might go to for an abortion in the event that they needed or wanted one. Smaller shares of females dwelling in rural areas, the place providers are extra restricted, knew the place they might go to get an abortion in comparison with females dwelling in additional city areas (16% vs. 28%).
Entry to abortion and contraception continues to stay on the middle of coverage debates throughout the nation. Not solely has abortion entry been banned in lots of states, however entry to efficient strategies to stop being pregnant, like emergency contraceptive capsules and long-acting reversible contraception (comparable to IUDs), can also turn out to be restricted. Medical doctors and well being care suppliers are trusted sources of knowledge for many individuals, which suggests they might play an vital position in filling info gaps and addressing misinformation. Whereas the ACA preventive providers protection requirement has markedly improved the affordability of contraceptives, the coverage is being challenged but once more within the courts by those that object to preventive providers comparable to contraception on non secular or ethical grounds. The outcomes of those debates, together with state, federal and personal sector actions will proceed to form the supply and use of contraceptive look after hundreds of thousands within the years to return.
This work was supported partly by Arnold Ventures. KFF maintains full editorial management over all of its coverage evaluation, polling, and journalism actions.