Iowa women less likely to access birth control since Roe v. Wade overturned

New research has found contraceptive access in Iowa was negatively affected after the U.S. Supreme Court overturned Roe v. Wade.

Since the 2022 decision, women in Iowa and in three other states saw an overall decline in access to contraceptives and reported a drop in the quality of the care they did receive, according to a new study from the Guttmacher Institute, a research nonprofit that supports legal access to abortion and contraceptives.

According to the researchers behind the study, access to abortion and other types of reproductive health care, including birth control, go hand and hand. When the U.S. Supreme Court opened the door to states to enact restrictions on abortion within their jurisdiction, it also had has consequences on other health care

“We interpret these findings as demonstrating that the sexual and reproductive health care system is really being constrained in its ability to meet people's broad sexual and reproductive health needs,” said Megan Kavanaugh, co-author of the study and principal research scientist at Guttmacher.

What did the Guttmacher study find?

In June 2022, the U.S. Supreme Court ruled that the U.S. Constitution does not guarantee a right to abortion, overturning the landmark Roe v. Wade case that established that right five decades ago.

Researchers surveyed women aged 18-44 years in Iowa, Arizona, New Jersey and Wisconsin. The first survey took place in 2021, before the U.S Supreme Court's decision. The second survey took place shortly after that decision in 2022.

Overall, survey respondents in all four states saw a decline in the number of women who received contraceptive care recently.

According to the study, the percent of Iowans who reported delays or trouble accessing their preferred contraceptive method rose from 7% to 10% after the decision.

Kavanaugh added that survey results don't indicate that, for the most part, women have not changed their preferred birth control method in light of recent events.

Among those who were able to access care, survey respondents reported that they believed the quality of care had decreased. In Iowa, the percentage of women who reported receiving high-quality care dropped from 58% in 2021 to 48% in 2022.

At the same time, the researchers noted that patients' use of condoms increased during this time period.

“This might be one flag indicating that people are having more trouble accessing contraceptive methods that do require interaction with a health care provider," Kavanaugh said.

The three other states included in the study saw similar results, indicating the challenges are not unique to Iowa.

What's causing these challenges to accessing care?

Since Roe v. Wade was overturned, nearly two dozen states enacted bans or further restrictions on abortion. Another handful of states, including Iowa, have approved bans but are awaiting decisions from the courts to determine whether those restrictions will go into affect.

Because of these restrictions, Kavanaugh said health care centers that provide abortion may be forced to close or otherwise restrict their services. That in turn cuts off access to women seeking contraceptive care, and otherwise creates long wait-times at clinics that remain open.

Kavanaugh said some patients are traveling to health care centers in states that don't have restrictions in place, which puts greater strain on existing resources. As a result, women in those states can experience more issues in accessing that health care.

The results also come years after Iowa redrafted a safety net program that provides family planning services, including birth control, to low- and moderate-income Iowans. State officials opted to end participation in a federal program, instead creating a state-run family planning program that explicitly bars abortion providers, such as Planned Parenthood, from participating.

Since that shift in 2017, participation in that program dropped 83%, state data shows. At the same time, the state program has paid for fewer family planning services in Iowa, such as birth control, routine exams and testing for sexually transmitted infections, among other sexual and reproductive health services.

More: Iowa blocked abortion providers from family planning funding. How has that impacted Iowans?

Iowa legislation aims to expand contraceptive access

One of Iowa Gov. Kim Reynolds' long-time proposals would make birth control available to Iowans without a prescription. Under her bill, Iowans aged 18 and older could purchase birth control pills, birth control patches and vaginal rings at local pharmacies without first seeing a doctor.

A March Des Moines Register/Mediacom Iowa Poll found 79% of Iowans support making birth control pills available without a prescription in the state. 19% oppose the idea, and 3% aren’t sure.

Despite the support from most Iowans, the proposal has split Republicans at the Legislature. A bill on this measure failed to advance before a legislative deadline.

More: Most Iowans support Kim Reynolds’ prescription-free birth control plan, Iowa Poll finds

What abortions laws are in effect in Iowa?

Abortion is current legal in Iowa up to 20 weeks of pregnancy.

Last year, Gov. Kim Reynolds signed a bill into law — dubbed by Republicans as the "fetal heartbeat" law — that would ban nearly all abortions after a fetal cardiac activity is detected. Doctors say that fetal cardiac activity can be detected starting at about six weeks of pregnancy.

The law does include narrow exceptions for rape, incest, fatal fetal abnormalities and to preserve the life of the pregnant person in cases of a medical emergency.

Enforcement of that law has been temporarily blocked by a Polk County district court judge until a legal challenge over the ban is settled.

The Iowa Supreme Court is expected to issue a decision on whether the law should be allowed to go into effect by the end of June 2024.

Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm

This article originally appeared on Des Moines Register: Study: Birth control access in Iowa has been hurt by Roe v Wade ruling