Abstract
The overturning of Roe v. Wade in the 2022 Dobbs v. Jackson Women's Health Organization decision has had vast impacts on abortion access across the United States, but less is known about the wider impacts on people's contraceptive access. We draw on cross-sectional survey data representative of reproductive-aged women in Arizona, Iowa, New Jersey, and Wisconsin at two time points—one prior to and one following the Dobbs decision. We examined changes between these two time points in key sexual and reproductive health metrics and, at the post-Dobbs time point, differences in these metrics across age, sexual and gender minority status, nativity, and income status. Between these two time points, we found statistically significant evidence that sexual activity declined, barriers to accessing contraception increased, reports of receiving high-quality contraceptive care decreased, and condom use increased. As continued fallouts of the Dobbs decision on access to abortion occur, this research makes clear that access to broader contraceptive care is worsening. Policies that promote meaningful access to all forms of sexual and reproductive health care must be advanced to support all individuals' right to reproductive autonomy while mitigating inequity and inequality.
Introduction
A rapidly growing body of research highlights how the overturning of Roe v. Wade in June 2022 has led to massive disruptions in sexual and reproductive health (SRH) care, from upending abortion access in entire regions of the country1 to worsening an already dire maternal health crisis in many states.2 One issue that is less well understood is how the Dobbs v. Jackson Women's Health Organization Supreme Court decision may have contributed to changes in people's SRH outcomes beyond abortion. Since decisions around abortion are not isolated from decisions about the rest of one's reproductive health, we anticipate that the Dobbs decision could have much broader consequences for people's reproductive autonomy—including potentially shaping attitudes toward becoming pregnant, changing their sexual activity and contraceptive strategies, and impacting their ability to access necessary health care. Although a variety of media reports have highlighted anecdotal stories and small studies describing just these sorts of changes,3-5 more population-based evidence is warranted.