The Future of Birth Control Access

This post was originally published on Healthy Futures, a research-driven health equity Substack written by Julia Craven.

Contraceptive access in the U.S. appears to be at a political impasse. Republican control of the White House and Congress, alongside a conservatively skewed Supreme Court, has provided conservative policymakers with immense latitude to influence the accessibility and availability of reproductive health services—including abortion, contraception, and maternity care—on a national scale, potentially impacting even states where the state constitution protects the right to such care.

Then there’s Project 2025, the de facto guidebook for this Trump Administration, which has some concerning recommendations to redefine federal policies on contraception and abortion. The 922-page document suggests:

• Recasting the Department of Health and Human Services as the "Department of Life” in an unambiguous rejection of the fact that abortion is healthcare.
• Reinstating moral exemptions to cover contraceptive access under the Affordable Care Act.
• Preventing federal dollars from paying for or “promoting” abortions.
• Reversing FDA approval of medication abortion.
• Stopping providers who offer elective abortions from taking Medicaid.
• Defunding abortion providers.
• Removing Medicaid funds from states that mandate abortion coverage in private insurance plans.

Medicaid covers more than 16 million people of reproductive age.

Since his inauguration, President Donald Trump has begun work to legally dismantle strides made in advancing gender equality. One of the numerous executive orders serving as brazen attacks on transgender people threatens to end gender transitions for people under the age of 19 by mandating that federal insurance programs exclude coverage for gender-affirming care. (The orders have led to some medical institutions pausing care for trans patients.) Another strictly and falsely aligns gender identity with biology, stating that there are only two genders, male and female—all under the guise of protecting women’s rights.

Considering the concerns that birth control access will become more restricted going forward—and the fact that Google searches, requests for, and sales of birth control and abortion pills have spiked following the 2024 election— I interviewed Dr. Kameelah Phillips, an OB/GYN with over 13 years of experience in private practice. She also founded Calla Women's Health and believes that educating women and girls about their bodies is the core practice philosophy.

“In my practice, I generally walk through all the contraceptive options,” she wrote. “Still, I typically (and more frequently) find patients who want to have more conversations about longer-acting options, like the arm implant, NEXPLANON, and IUDs, which do not require daily, weekly, or monthly dosing.”

Dr. Phillips answered a few questions over email about current contraceptive options, how she works to counter misinformation in her practice, and more.

This interview has been edited for length and clarity.

Julia: Given the current political climate, what steps should people take now to secure their reproductive health options?

Dr. Phillips: Right now, it is important to focus on the birth control options available and what women can do to prevent an unintended pregnancy. Women should talk with their healthcare provider about what they want in a birth control method, including effectiveness, safety, availability, and duration of use.

Contraceptive effectiveness depends on how consistently and correctly the method is used. I find that women who tend to miss the pill or are seeking a form of contraception that they don’t have to take or insert often should consider a long-acting reversible contraceptive (LARC) like the arm implant or an IUD, which does not require daily, weekly, or monthly dosing.

What resources do you recommend for people who are concerned about future access to birth control?

Women should conduct their own research by turning to trusted, medically-reviewed, and evidence-based sources of information. This unbiased information is important to present all the facts about contraception. In addition to this, women should feel empowered to speak to a healthcare professional about any concerns or questions they may have.

During appointments, I recommend patients use direct, specific language to clearly communicate what they need. I encourage patients to bring their full selves to the visit so I can understand all the aspects of their lives that influence their decision-making. If something doesn’t make sense or you need more information, feel free to ask follow-up questions until you are comfortable with the counseling you’ve received.

Misinformation has many of us in a chokehold, especially in health, science, and wellness spaces. Have you seen misinformation about birth control online impact your patient's choices?

In my practice, I have seen misinformation cause confusion about birth control options. I am finding misinformed conversations related to potential side effects of hormonal birth control and impacts on future fertility are becoming more prevalent among my patients. Through my professional experience, and generally speaking based on available evidence, birth control typically does not cause infertility. Women can often get pregnant soon after stopping birth control, and as an example, with the arm implant, a woman may get pregnant as early as a week after the removal of the implant.

There’s a law in Indiana, for instance, that limits Medicaid’s coverage of LARCs to subdermals based on the lie that IUDs cause abortion. With this in mind, how can people better identify and push back against misinformation about contraceptives, especially when it’s beginning to influence policy?

As healthcare professionals, we know we can’t keep our patients from misinformation on social media, so I make it a point to discuss what they are hearing from friends and online because it gives us a starting point for an important conversation. Some questions I may ask include, “Tell me what research you’ve done. What are you most interested in talking about today? What birth control method do you feel is right for you?” This opens the door to open, honest conversations and makes space to discuss all the forms of birth control—even if she may not use them—not only to correct misinformation but to properly educate her on the options that are available.

It’s critical we continue working together to bust myths and correct misinformation about birth control. I also ask patients to serve as birth control myth-busting ambassadors. This includes not forwarding content they know (after our conversations) is medically incorrect, challenging friends and family who spread misinformation about reproductive rights and birth control, and encouraging their community to seek out medical professionals should they have questions or concerns about birth control rather than lean on social media for advice.

Contraceptive access has long been a racial justice issue. Walk us through the racial and socioeconomic disparities here.

Racial and socioeconomic disparities in contraceptive access stem from historical injustices, systemic barriers, and policy-driven inequities that continue to affect marginalized communities. These injustices have influenced the doctor-patient relationship, hindered our trust in the medical establishment, and restricted access to contraception—which should not have any racial or socioeconomic barriers. More than ever, it is important to continue advocating for equitable access to reproductive healthcare. That’s why, today, we must ensure that women have access to accurate information and a full range of contraceptive options so they can make informed choices for their reproductive health.

To combat medical mistrust with my patients, I try to create a safe space during appointments where my patients can feel comfortable sharing their concerns. The most important part for me is to keep an open dialogue with my patients and to assure them that if they are uncomfortable, do not understand the information I am providing, have questions, or for any reason, they alert me. I also actively listen so we can make a shared decision on what birth control method is best to help meet their personal health needs and long-term goals.

How is tech shaping the future of birth control?

Digital health platforms and telehealth are helping the way people access contraception counseling, making it easier for women to get the information they need. Even these outlets, however, have to be vetted as misinformation or misdirection is still possible. Digital and telehealth—while often convenient—can still be challenging for some populations.

It’s still important for women to prioritize an in-person, annual visit. But you don't just have to see your gynecologist for annual well-woman visits. You can schedule a separate time to discuss your health and contraceptive needs, especially if you’re interested in exploring a new method.

What advancements are being made in birth control technology? Are there any new methods on the horizon?

This is a great question, and as of right now, I am not aware of any new, recent FDA-approved advancements in birth control. While there have been recent approvals, there continues to be research to expand indications.

Over the course of my career, we’ve seen new forms of birth control become available, and options receive additional new indications for use.

When we think about the LARC class specifically, we have various options now available ranging from 3 to 10 years of use, with some being non-hormonal, combined hormonal birth control (including estrogen and progestin), and progestogen-only. For example, the non-hormonal IUD can be used for up to 10 years. A non-uterine option is the arm implant, which provides up to 3 years of pregnancy and is progestogen-only.