Last week, as soon as Sydney Phillip read about the leaked draft opinion suggesting the Supreme Court was poised to overturn Roe v. Wade, she booked an appointment to get an IUD.
Intrauterine devices are one of the most effective forms of birth control, and getting the long-acting contraceptive had been a floating item on her medium-term to-do list. She’s been using the birth control pill, a method that has about a 7 percent failure rate for typical use. The potential consequences of that margin of error felt tolerable — until now.
“I’ve spent a lot of my life trying to really establish my own sense of autonomy and make my own personal decisions,” the 26-year-old said. “Obviously, having a child and being pregnant is something where I want to have the most agency. I want to be more in charge of that decision, more than pretty much anything else.”
Phillip lives in Alabama, which passed a law in 2019 banning abortion unless when necessary to save a mother’s life, and it made performing an abortion a felony offense. A federal court blocked the law from taking effect, but a near-total ban on abortion is likely in the state if Roe is overturned.
“Protecting myself by getting an IUD and doing what I can to prevent myself from getting pregnant is at the forefront of my mind right now because of where I live,” Phillip said.
She’s not alone. Google searches for IUD, Plan B and contraception spiked in the week following the leak. Many users took to social media to announce they were stockpiling Plan B, also known as the morning-after pill, which can reduce the chance of pregnancy if taken after unprotected sex.
Some OB/GYNs have also reported an increase in inquiries about longer-acting contraception such IUDs, which are inserted into the uterus and can prevent pregnancy for five to 10 years, or birth control implants, which are flexible plastic rods inserted under the skin that release hormones and work for up to five years.
“I have gotten a lot of questions and comments on my social media about people feeling like they have to lock down a reliable long-acting birth control method ASAP before more of their reproductive rights are threatened,” said Jennifer Lincoln, an obstetrician in Portland, Ore., who offers advice and information on reproductive health to her 2.8 million followers on TikTok.
Lincoln said she and her colleagues experienced a similar surge in questions after Trump’s election in 2016 — a phenomenon that has been reflected in studies and other anecdotal accounts. One study found that in the 30 days after his election, insurance claims for IUDs across the United States rose more than 21 percent among women with commercial insurance.
Antiabortion activists are split on the issue of birth control: Smaller contingencies oppose contraceptives on religious grounds, while others believe that access to certain contraceptives is a vital way to prevent unintended pregnancies, and therefore abortions.
On its website, the antiabortion group Students for Life America lists out “abortifacient” types of birth control, including birth control pills and IUDs, and “non-abortifacient” types of birth control, including condoms and diaphragms. “Because our mission is to abolish abortion, Students for Life of America does not take a stance on the morality of non-abortifacient contraceptives,” the website reads. “But we are formally opposed to abortifacient varieties.”
The antiabortion organization National Right to Life said in a statement shared with The Washington Post: “National Right to Life does not take a stance on anything that prevents fertilization. However, National Right to Life does oppose any device or drug that would destroy a life already created at fertilization.”
The issue is being closely watched. Mississippi Gov. Tate Reeves (R) made headlines Sunday after refusing to address a question about whether his state would consider banning contraceptives such as Plan B or IUDs.
“My view is that the next phase of the pro-life movement is focusing on helping those moms that maybe have an unexpected and unwanted pregnancy,” Reeves said on CNN’s “State of the Union.” “And while I’m sure there will be conversations around America regarding [contraceptives], it’s not something that we have spent a lot of time focused on.”
Madeleine Klein, 44, has an IUD insertion scheduled for Thursday — an appointment she, too, made in the days following the leak. She said she is uncomfortable with even the remote chance of an unintended pregnancy.
“Nobody should have to be pregnant who doesn’t want to be,” Klein said. “We’re not baby-making factories.”
Klein lives with her cat in a vehicle she’s outfitted with a propane oven and a bed. The nomadic life suits her, but it also means she is frequently in different states — states she worries will suddenly have dramatically different abortion laws if Roe is overturned, she said.
Klein is also frustrated that an IUD is her best option; she worries about the potentially painful procedure (one study found that up to 17 percent of women experienced substantial pain), as well as the cramping that some patients report in the weeks and months after it.
“It’s scary,” she said. “I don’t want to have to do this, but I also really, really don’t want to get pregnant.”
Klein would consider a tubal litigation, she said, but without health insurance, she would not be able to pay out of pocket for the surgery, which permanently prevents pregnancy. The cost of an IUD insertion, however, will be covered by a clinic with a program for low-income women, she said.
Lincoln, the OB/GYN, said that with a failure rate of less than 1 percent, IUDs and implants are an attractive option for many people, especially because they can be removed if their plans change.
“We know from a public health perspective, when funding and access for these types of contraceptives go up, unintended pregnancies drop,” she said.
But while it’s a good time for people to assess their reproductive plans, Lincoln added, she said people shouldn’t panic and pick a method that isn’t right for them.
“A lot of my followers are commenting that they are now considering a tubal ligation because they are afraid if they don’t act now they may lose that option,” Lincoln said. “They want to ensure they’re using a method that can’t be taken from them.”
Lincoln cautions that people should consider tubal litigation only if they are certain they won’t want to conceive in the future.
Phillip said she feels confident about her decision to get the IUD but, like Klein, is nervous about the procedure itself. That is particularly true because, as a Black woman, her pain has often been dismissed in medical settings, she said. Studies show that Black patients are often undertreated for pain.
These same concerns are also part of what worries her about the possibility of getting pregnant. Black women in the United States are three times as likely to die of pregnancy-related causes than White women, according to the Centers for Disease Control and Prevention. And Phillip’s home state of Alabama has one of the highest maternal mortality rates in the country.
“It just seems like it’s more important than ever to make sure that I do what I can to protect my reproductive health, because I don’t know what options are going to be out there for me if I don’t — nobody else is going to protect me,” Phillip said.
While she is anxious about the appointment, Phillip is also eagerly awaiting the relief she anticipates she will feel when it’s finished.
“I like the idea of my future being open to interpretation,” she said, “open to whatever I decide it to be.”
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