Most women (73%) aged 18–44 in three US states prefer more than one source of contraception, according to new findings from Guttmacher’s Reproductive Health Impact Study.

Respondents’ preferences for where and how to get contraception included:

• In-person from a health care provider (24%)
• Offsite from a health care provider (i.e., telemedicine; 19%)
• Offsite without interacting with a health care provider (i.e., telehealth; 64%)
• At a pharmacy (71%)
• Through innovative strategies (e.g., nontraditional delivery options, drones, vending machines, bike messengers; 25%)

These findings from surveys conducted in 2019–2020 among 2,804 women in Arizona, New Jersey and Wisconsin highlight the importance of providing a variety of ways for people to obtain contraceptive care. The analysis, “Where do reproductive-aged women want to get contraception? Findings from Arizona, New Jersey and Wisconsin,” by Megan Kavanaugh and Mia Zolna, was recently published in the Journal of Women’s Health.

“Given ongoing political attacks on people’s ability to make their own reproductive decisions, it is critical to ensure that people can access their preferred contraceptive methods through their preferred sources of care,” says Megan Kavanaugh, principal research scientist at the Guttmacher Institute. “While birth control can never be a substitute for abortion access, ensuring a diversity of options through which people can access contraception is a key component of providing care that accounts for people’s individual needs and preferences.”

Individuals’ past experiences of contraceptive care played a role in their preferences regarding where and how to access contraception. People who had not previously received contraceptive counseling that focused on their individual needs and preferences (i.e., person-centered contraceptive counseling) were more likely to prefer telehealth (offsite without a health care provider) or innovative sources than those who had received this level of care.

Similarly, individuals who mistrusted the contraceptive health care system were significantly more likely than others to prefer to receive contraceptive care offsite through telehealth, telemedicine or innovative sources. In addition, LGBTQ+ respondents were more likely than straight respondents to prefer to obtain contraception without an in-person health care provider interaction. Mistrust in the contraceptive health care system is often rooted in past negative provider interactions and a history of reproductive injustices in this country that have been perpetuated against Black, Indigenous and other people of color, as well as people in sexual minority groups.

“Policies that prioritize the people who have experienced the most obstacles to accessing contraceptive care have the greatest likelihood of closing the gap between how people want to obtain contraception and how they actually get it,” says Kavanaugh. “Efforts to expand contraceptive delivery methods should not prioritize one method over others and should ensure that access to high-quality care is maintained across all options.”

About the Reproductive Health Impact Study

The Reproductive Health Impact Study analyzes the effects of federal and state policy changes on publicly funded family planning care in the United States. The study focuses on Arizona, Iowa, New Jersey and Wisconsin, and the Guttmacher Institute works with research, policy, grantee and provider partners in each state to document the impact of policies implemented from 2017 to 2022 on family planning service delivery and the patients who rely on this care.

Emerging findings from this study are building a robust evidence base that demonstrates the disruptions to care stemming from ideologically motivated policy attacks on reproductive health services and the detrimental impacts of these attacks on patients and providers. The study findings also significantly enhance the body of evidence regarding the impacts of the COVID-19 pandemic on sexual and reproductive health service provision.