Since the Supreme Court overturned Roe v. Wade in June 2022, all eyes have turned to contraception. Though a hotly contested topic for decades, birth control is often presented as a simple solution for family planning. Both anecdotal evidence and media representation of contraception categorize it as an easy, one-size-fits-all process. This portrayal, however, is false.

Krystale E. Littlejohn, author of Just Get on the Pill, notes that “dissatisfaction with available methods (from side effects or the hassle of use), challenges getting partners to cooperate with using condoms, and access issues like getting to the clinic regularly to refill a prescription or get another shot” are consistent obstacles. Additionally, individuals who seek birth control run into other barriers—some new since the overturning of Roe, others more long-standing.

The effects of overturning Roe on contraception

A few states’ post-Roe legislation banning abortion has left many medical and legal professionals confused about which birth control methods, reproductive health procedures, and medications are still legal. Medications, procedures, and techniques related to intrauterine devices (IUDs) and miscarriages fall into gray areas with respect to new anti-abortion laws. 

IUDs are in the hot seat in states like Arkansas where abortion laws claim life starts at conception—a process that IUDs can technically interrupt by stopping a fertilized egg before it implants in the uterine wall. Arkansas, as well as other states like Louisiana, have proposed bills that would indirectly outlaw this form of birth control, as well as cause federal repercussions for potentially ending a pregnancy. The situation illustrates the ways in which anti-abortion legislation is already filtering down to affect contraception.

Those who are already pregnant may also suffer legal ramifications after miscarrying. Some miscarriages require a procedure called a dilation and curettage (or D&C), which is also performed for some abortions and is now a source of legal confusion in states with abortion bans. 

Doctors assert that these pieces of legislation put their power and expertise as medical professionals in jeopardy. Post-Roe, standard procedures can become felonies, and physicians claim that, unfortunately, abstaining from certain procedures is the only way to avoid jail time and a revoked license. 

Education, access, and stigma

Even before recent legislative changes, birth control wasn’t an easy solution to family planning. Comprehensive sex education, including birth control education, is only available in some public schools nationwide. Certain states—like Kentucky, Mississippi, and Oklahoma, which have also instituted strict bans on abortion—stress abstinence-based sex education. In these curricula, young people are taught to avoid sex before marriage but are not given information about birth control beyond being taught that it’s immoral.

The trial-and-error process of finding a method of birth control can be discouraging. For many people, hormonal contraception is the method of choice because of its effectiveness. However, hormonal birth control can also change the body dramatically during an individual’s adjustment period to the medication. Potential temporary weight gain, and even the prospect of weight gain, will stop a person from using contraceptives altogether.

Even after long deliberation, a person’s preferred method of birth control can be vetoed by a physician making a judgment call based on arbitrary social norms, such as a woman’s age or marital status. Many doctors, for example, recommend against tubal ligations in younger women and people assigned female at birth (AFAB). “Coercive language and practices in our policy prescriptions and care delivery” ultimately control outcomes, Littlejohn insists. It seems that the more permanent (and effective) the contraception, the more difficult it is to get. 

Many transgender men also have issues finding methods of contraception that work for them because they struggle to find providers who will give them adequate care—let alone care for them at all. “These issues,” Littlejohn elaborates, “are intertwined in the fight for reproductive justice and ensuring that people have the right to have children, not have children, and parent the children they have in safe and healthy environments.”

“Responsibility” and societal norms

Though more than one person is involved in conceiving a fetus, women and people AFAB are considered responsible for seeking out and staying consistent with birth control. There’s a common notion that contraception is for “the woman’s sake,” absolving male and masculine sex partners from the responsibilities of preventing pregnancy. 

Though there are a few methods of birth control available for men and people assigned male at birth, the overwhelming cultural expectation dictates that people AFAB should be responsible for implementing contraception (with the exception of condoms).  

Birth control is not an “easy” solution to a post-Roe society. Though reproductive health care would benefit greatly from a focus on contraception, birth control is not, has not, and will not be a sustainable solution for many women and people AFAB. Systemic reproductive care issues and social norms often make birth control a one-sided responsibility. As Littlejohn says, “we have to see contraception as a tool for liberation, rather than [for] coercion and control.”