Developing a Post-Roe Contraceptive Access Strategy

**Read the Updated Post-Roe Contraceptive Access Strategy Findings Report**

The Findings Report can serve as a resource to anchor and inform discussions on how access to contraception may shift in a post-Roe environment, and which strategies may help preserve or advance contraceptive equity moving forward. The updated version of the Findings Report features a section on research priorities to advance post-Roe contraceptive access. Scroll down to learn more about our approach and available resources.

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Background

In June of 2022, the Supreme Court of the United States overturned Roe v. Wade and the constitutional right to abortion in its ruling in Dobbs v. Jackson Women's Health Organization. This decision eliminates longstanding federal standards for abortion access and enables states to severely restrict and even ban abortion.

Though the Dobbs decision focused on abortion, its rationale coupled with responses from lawmakers, clinicians, and advocates underscore the precarity of contraceptive access, which has long been limited by existing policies and uneven resources.

Given shifts in abortion access and privacy rights and state attacks on contraception, coordinated strategies to preserve and expand access to contraception are more important than ever.

The Coalition to Expand Contraceptive Access (CECA) is bringing together evidence and diverse stakeholders to understand the potential impact of these shifts, consider how best to shape a responsive, proactive, and collaborative strategy, and help align the work of various coalitions, organizations, federal agencies, and individuals.

**Values-Aligned Vision for a Post-Roe Contraceptive Access Strategy**

We envision a world where everyone who wants contraception can access person-centered, comprehensive contraceptive information, products, methods, and/or services that work best for them—when, how, and where they want it, free of barriers and bias.

Contraception is part of routine healthcare, and it should be accessible to all people for any reason, not only to prevent pregnancy.

Finally, any approach to contraceptive access must align with the values of reproductive justice; contraception cannot be presented as a remedy to abortion restrictions, as a means to reduce abortion rates, or an alternative to comprehensive sexual and reproductive healthcare access, including abortion care.

Approach

As initial steps, CECA:

Conducted an environmental scan to understand the potential impact of Dobbs and other threats to contraceptive access at federal and state levels, as well as current efforts underway to protect and expand contraceptive access.
Convened a “Summit” of stakeholders to analyze the current and anticipated contraceptive access landscape and to determine a strategy to address the most pressing threats and promising opportunities.
Developed a Findings Report, including equity-informed principles, focus areas and goals, potential actions, and dissemination and implementation considerations.

Five focus areas and goals emerged from this process, were refined by key stakeholders, and can contribute to shaping a responsive, proactive strategy.

Secure the right to contraception as part of a broader right to reproductive freedom.

1

Secure and preserve protections for the right to contraception at both the federal and state level.

Address misinformation and disinformation related to contraception among providers, users, and the broader public.

2

Provide clear information about contraception, including clarifying the mechanisms of action, legality, availability, and parameters of safe disclosure of contraception, to various audiences.

Improve and enhance infrastructure for contraceptive care.

3

Improve the capacity of the workforce and guard against erosions to quality contraceptive care, including the reach of religious/moral refusal policies and crisis pregnancy centers.

Promote research and innovation in all aspects of contraceptive care.

4

Advance sexual and reproductive health equity for all, including individuals most impacted by inequities in contraceptive access.*

5

Advance novel approaches and research innovation in all aspects of contraceptive care to remain current with scientific evidence and changes in the healthcare system and better meet people’s diverse needs and preferences.

Prevent deepening inequities in contraceptive care and provide specific protections to those disproportionately impacted by Dobbs.

*Individuals most impacted by inequitable contraceptive access may include, for example, young people, people with disabilities, Black, Indigenous and other people of color, LGBTQ people, people with low incomes, and those living in restrictive and/or rural areas.

Defining principles that uphold equity in a post-Roe strategy is especially crucial in the sexual and reproductive health sphere given historical and ongoing injustices.

These five principles center reproductive justice and human rights and are based on CECA’s past work and expert colleagues’ input. They are guiding development efforts and are intended for the intentional and purposeful upholding of SRHE as partners continue identifying priorities, designing and implementing actions, and further shaping a comprehensive strategy.

Equity-Informed Principles to Guide a Post-Roe Strategy

Ground this work in a holistic vision of sexual and reproductive health that centers justice, equity, autonomy, and choice.
Interrogate and re-evaluate the policies, programs, and practices that have guided us.
Honor and embrace communities as equal partners throughout the process.
Understand and reflect the impact of the historical, sociocultural, political, and economic contexts that influence the lived experiences of community members.
Design a strategy that can impact the lives of individuals and communities through changes in systems, policies, and practice.

The role of research is especially critical in the post-Roe environment, where emerging data and anecdotal evidence already suggest growing inequities in contraceptive access, policies, and service provision.

CECA has identified six research priorities that reflect pressing gaps and needs in contraceptive access research. The list emerged from the findings of the environmental scan and formative discussions with researchers, legal and policy experts, reproductive justice advocates, and private sector partners in the contraceptive access space. This expands upon the needed research identified in CECA’s Priority Roadmap for Policy-Ready Contraceptive Research, published in 2021, and reflects the equity-informed principles for contraceptive access research.

Research Priorities to Advance Post-Roe Contraceptive Access

How have the Dobbs decision and other restrictive SRH policies affected access to, preferences for, use of, and provision of contraception?
What is the extent, nature, and impact of misinformation and disinformation on the public, providers, and policymaking?
What is the current state of the contraceptive care workforce and how has this been affected by Dobbs and subsequent SRH policy restrictions?
What is the impact of new delivery approaches on contraceptive access?
What new approaches are needed to meet people’s contraceptive needs?
How can we use person- and equity-centered measurement to better reflect people’s lived experiences of sexual and reproductive experiences and health?

Federal policymakers and agencies

State-level lawmakers and advocates
Reproductive health, rights, and justice leaders
Clinicians and representatives of clinical organizations

Stakeholders

Intended to be applicable to a wide variety of stakeholders, the Post-Roe Contraceptive Access Findings Report is especially geared toward:

Private industry leaders

Researchers
Legal experts

Recommendations and Resources

Findings Report - Updated August 2024

This report can serve as a resource to anchor and inform discussions on how access to contraception may shift in a post-Roe environment, and which priority focus areas and potential actions may help preserve or advance contraceptive equity moving forward. This exploratory work specifically engages both public and private sector organizations, as all have a role to play in advancing contraceptive access and sexual and reproductive health (SRHE) more broadly. These findings can help align the work of various coalitions, organizations, federal agencies, and individuals and serve as a resource and supportive structure for the reproductive health, rights, and justice fields.