Disparities in Reproductive Care: Examining the Gaps in U.S. Family Planning Services

Limited Access to Family Planning Amid Rising Abortion Restrictions

A recent report highlights a significant challenge in women’s healthcare: most women in the U.S. are not accessing family planning services, even as abortion restrictions continue to grow. This gap in care has profound implications for reproductive health and autonomy.

Family Planning Services Underutilized

According to the CDC, only 35.7% of women aged 15-49 accessed family planning services, such as birth control, sterilization, and counseling, in 2022 and 2023. This low rate persists despite research showing that these services help prevent over 1.5 million unintended pregnancies annually.

These services are often a critical touchpoint for women within the healthcare system, yet barriers such as cost, education, and systemic inequities restrict access.

The Impact of Abortion Bans

Since the Supreme Court’s 2022 Dobbs decision revoked federal abortion rights, over a dozen states have implemented near-total abortion bans. This legal shift has forced 76 independent clinics to close or pivot away from providing abortion care, leaving 14 states without any abortion services.

Robin Marty, Executive Director of WAWC Healthcare in Alabama, explained her clinic’s transition from abortion services to a focus on family planning. Marty noted that many patients seeking abortions lacked access to contraception, exacerbating unintended pregnancies.

Inequities in Access

The CDC report revealed significant racial and economic disparities in family planning access:

• Nearly 40% of White women accessed family planning services, compared to 35% of Black women and 32% of Hispanic women.
• Only 21% of Black women and 20% of Hispanic women received birth control, compared to 27% of White women.
• Higher-income and more-educated women were significantly more likely to access family planning services.

Shifting Trends in Contraception Use

The data also indicate that women in states with strict abortion laws are less likely to obtain prescription birth control. However, use of emergency contraception and sterilization procedures has risen since the Dobbs decision.

Overall, birth control prescriptions remain the most common service, accessed by 24% of women. Emergency contraception and sterilization procedures were far less frequent, with just 4% and 3% of women, respectively, utilizing these options in 2022 and 2023.

Expanding Access and Persistent Challenges

Efforts to broaden access to contraception continue to gain traction:

• Opill, the first over-the-counter daily oral contraceptive approved by the FDA, became available in 2023, offering a new option for women without requiring a prescription.
• The Biden administration has proposed a rule mandating private insurance plans to cover over-the-counter contraception at no cost.

Despite these advancements, challenges remain. Title X, a federal program funding family planning and preventive care, has yet to recover fully from cuts implemented during the Trump administration. A recent KFF analysis found that at least 1.1 million fewer people were served by Title X in 2023 compared to pre-2019 levels.

Building Trust and Expanding Reach

In Alabama, WAWC Healthcare now serves over 1,000 people monthly—far surpassing its numbers from two years ago. Marty attributes this growth to community trust and improved fundraising, allowing the clinic to support more individuals.

“Our goal is to help people make the healthiest decisions they can and support them throughout their reproductive lives,” Marty emphasized.

This evolving landscape underscores the critical need for accessible and equitable family planning services amid growing restrictions on reproductive rights.

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