The Growing Crisis of Contraceptive Deserts

Two years after the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision overturned the constitutional right to abortion, the fallout has extended well beyond abortion access. A quieter crisis has emerged: the widening gap in access to contraceptive care.

Nineteen million women of reproductive age in the United States now live in “contraceptive deserts” — areas where they lack reasonable access to a health center offering the full range of birth control options, according to Power to Decide. And the landscape is getting worse, not better.

What’s happening

A study by the Guttmacher Institute found that since Dobbs, women are struggling more than ever to access their preferred contraceptive methods. OB-GYNs are increasingly choosing not to practice or train in states with restrictive abortion laws, deepening the shortage of reproductive health providers in precisely the regions where they are most needed. The decision has also sparked confusion and misinformation about the legality of contraception in states where abortion is now prohibited — particularly around emergency contraception like Plan B — leaving women uncertain about what options are even available to them.

The numbers tell the story. In states with the strictest bans, birth control prescriptions dropped 5 percent in the first year after Roe v. Wade was overturned. Emergency contraception prescriptions plummeted by 65 percent in those same states compared to states with more moderate restrictions.

Who is most affected

The difficulties in accessing contraception have always been felt most acutely by underserved communities, and Dobbs has deepened those disparities. Women of color, those with lower incomes, and immigrant women report higher rates of difficulty obtaining contraception and lower satisfaction with the care they receive. These groups also experience higher levels of misinformation about available services and face significant delays in accessing their preferred methods. For women born outside the U.S. and those with low incomes, navigating a fractured and confusing healthcare system is an added barrier on top of the clinical one.

The role of narrative

Policy restrictions and provider shortages are part of the crisis. But so is the narrative landscape. Misinformation about contraception — its safety, its legality, its availability — is spreading faster than accurate information can counter it. On social media platforms, misleading content about birth control has accumulated billions of views, reshaping what young people believe about their own reproductive options.

This is the gap that PMC’s work addresses. When misinformation drives fear and confusion, and when social norms make it harder for women to seek the care they need, narrative change becomes a public health intervention. PMC’s approach — using entertainment to counter mis/disinformation with evidence-based, culturally resonant storytelling — is designed for exactly this kind of crisis: one where the barriers are not just structural but perceptual. Shifting what people believe about contraception — that it is safe, that it is their right, that it is ordinary and essential — is a necessary complement to the policy and service-delivery work that the SRHR field has historically prioritized.

Access to contraception has long been considered a fundamental component of reproductive health care. As that access erodes for millions of women across the country, the fight to protect it requires every tool available — including the stories we tell.