Conservative attacks on birth control could threaten access (2024)

Since the Supreme Court overturned the right to abortion two years ago, far-right conservatives have been trying to curtail birth-control access by sowing misinformation about how various methods work to prevent pregnancy, even as Republican leaders scramble to reassure voters they have no intention of restricting the right to contraception, which polls show the vast majority of Americans favor.

The divide illustrates growing Republican tensions over the political cost of the “personhood” movement to endow an embryo with human rights, which has also animated the debate around in vitro fertilization. Mainstream medical societies define pregnancy as starting once an embryo has implanted in the wall of the uterus. But some conservative legislators, sharing the views of antiabortion activists, say they believe life begins when eggs are fertilized — before pregnancy — and are conflating some forms of birth control with abortion.

“Folks are trying to redefine when life begins, but it’s just not scientifically supported,” said Courtney Joslin, who leads public policy research on issues pertaining to women and families for the R Street Institute, a center-right think tank. “There’s just been a crowding-out effect where some far-right legislators have undermined Republicans’ ability to talk about birth control in a sensible and rational way.”

Republicans in at least 17 states have blocked largely Democratic-led attempts to pass laws assuring the right to birth control since 2022, according to a Washington Post examination of legislation. Most recently, Virginia Gov. Glenn Youngkin (R) vetoed a bill meant to ensure access to contraceptives, saying that while he personally supports such access, he was loath to “trample on the religious freedoms of Virginians,” including medical providers.

Former president Donald Trump recently suggested in a TV interview that he was open to restricting access to contraceptives. “We’re looking at that, and I’m going to have a policy on that very shortly,” Trump told KDKA News in Pittsburgh when a political editor asked whether he supported any restrictions on a person’s right to contraception. Pressed further, Trump said, “Things really do have a lot to do with the states, and some states are going to have different policy than others.”

Trump walked back his comments after his advisers briefed him about the blowback on social media, according to a person close to the Trump campaign who spoke on the condition of anonymity to discuss strategy. “I HAVE NEVER, AND WILL NEVER ADVOCATE IMPOSING RESTRICTIONS ON BIRTH CONTROL, or other contraceptives,” Trump wrote on his social media platform.

Democrats are seeking to capitalize on the moment. Senate Majority Leader Charles E. Schumer (N.Y.) announced that he expects to hold a vote Wednesday on the federal right to contraception, forcing lawmakers to take a stand.

In Missouri, state Rep. Tara Peters said she was shocked when the bill she co-sponsored to allow women to pick up a year’s worth of birth-control pills hit a wall of opposition from fellow Republicans, some of whom she said privately accused her of promoting a “Trojan horse” bill to access abortion drugs. Despite the fact that birth-control pills do not cause abortions, the bill died.

“It was Republican men,” Peters said. “It surprises me that the ones that know nothing about those types of things are the ones that are making the decisions.”

She noted that even after she attempted to educate them, a faction continued to spread misinformation equating the pill with abortion. She warned that could have political costs for the Republican Party.

“What better year to pass this legislation than an election year to show that we are making women a priority?” said Peters, echoing an argument made by former Trump adviser Kellyanne Conway.

Kelley Packer, a Republican former state representative in Idaho who served as vice chairwoman of the House Health and Welfare Committee, and two other Republican women formed the Idaho Contraceptive Education Network in December to protect access to birth control by combating misinformation that conflates contraception with abortion. Their primary target: legislators who do not understand the science behind how contraception works.

“We want to make sure that policymakers are making sound decisions based on facts,” Packer said.

Many Americans do not understand the difference between abortion pills, which end a pregnancy, and emergency contraception, which prevents it. Nearly three-quarters of Americans incorrectly think that emergency contraceptive pills can end a pregnancy in its early stages, according to a 2023 poll by KFF, a nonprofit focused on national health issues.

Antiabortion groups are stepping in to fill that knowledge gap with misinformation.

The Idaho Family Policy Center, an influential conservative Christian think tank, is recommending that state lawmakers ban access to emergency contraception and IUDs, which the group mislabels as “abortifacients” in a January policy paper outlining next steps “now that we’ve successfully eliminated elective abortion.”

“We’re not opposed to all types of birth control or family planning. We’re simply saying that state policy should be consistent and recognize the rights of all preborn children once fertilization has occurred and a new life has been created,” said Blaine Conzatti, president of the Idaho Family Policy Center.

Major medical societies say it is inaccurate to characterize emergency contraceptive pills, a backup birth-control method used within days of unprotected sex, and IUDs, which are long-acting and reversible, as causing abortions because neither of them end an existing pregnancy.

Emergency contraceptive pills such as Plan B and Ella work by inhibiting or delaying ovulation, thereby preventing sperm from fertilizing the egg.

The Food and Drug Administration directly addressed the misinformation linking Plan B to causing abortions in a 2022 update on the agency’s website after reviewing “the best available scientific evidence” on the drug’s effects on fertilization and implantation. “Plan B One-Step will not work if a person is already pregnant, meaning it will not affect an existing pregnancy,” the agency said. “Evidence does not support that the drug affects implantation or maintenance of a pregnancy after implantation, therefore it does not terminate a pregnancy.”

Copper IUDs interfere with sperm’s ability to move, making it harder for them to reach the egg. Hormonal IUDs thicken cervical mucus to prevent sperm from fertilizing the egg and can also prevent ovulation.

“The definition of an abortifacient is something that is used to cause a termination of pregnancy. And so if a pregnancy does not exist yet, then something can’t be an abortifacient,” said Michael Belmonte, an OB/GYN in D.C. and a family planning expert with the American College of Obstetricians and Gynecologists (ACOG).

Because hormonal IUDs and birth-control pills can thin the uterine lining, which could prevent a fertilized egg from implanting, some antiabortion activists falsely claim that the birth-control methods cause abortions. Between 30 and 70 percent of fertilized eggs never implant successfully, even without birth control, according to Belmonte’s review of medical literature.

Laws restricting abortion access in some states, including Idaho, have defined life as beginning at fertilization, leaving the door open to potential birth-control restrictions, according to activists for and against abortion rights.

A 2023 Gallup poll found that 88 percent of Americans said birth control was morally acceptable, including 86 percent of Republicans and 93 percent of Democrats.

“It’s never wise for policy to get too far ahead of where legislators and the electorate is, but certainly encouraging families to reconsider their use of these abortifacient drugs is a high priority right now,” said Conzatti, referring to emergency contraception and IUDs.

Republican leaders and strategists insist there is no widespread effort to restrict access to birth control, calling it a conspiracy concocted by Democrats to gin up votes ahead of the presidential election.

“There is no formal organized movement to ban birth control, and to suggest so is political demagoguery,” said Roger Severino, vice president of domestic policy at the Heritage Foundation, a conservative think tank. “It’s silly to think contraceptives are at risk.”

Under the Affordable Care Act, the vast majority of insurers are required to cover most forms of birth control, including emergency contraception pills. The Heritage Foundation’s blueprint for a potential second Trump presidency would label Ella as a “potential abortifacient” to be removed from the contraception mandate, but Severino noted that the change would not restrict access for those who wished to pay for it.

One in five Americans say they believe access to birth control is under threat, according to a March KFF poll.

Birth-control advocates say that sentiment stems from Supreme Court Justice Clarence Thomas’s writing in his concurring opinion overturning Roe v. Wade that the court should reconsider decisions relying on the same legal precedent. That includes the court’s 1965 ruling in Griswold v. Connecticut guaranteeing the right to contraceptives.

The powerful Christian legal group Alliance Defending Freedom — whose lawsuit to limit access to mifepristone, a key abortion drug, is before the Supreme Court — has also labeled birth-control methods as abortifacients in various lawsuits. Bernadette Tasy, spokeswoman for the alliance, said in a written statement: “ADF is not working to ban contraception and has never done so.”

Tasy said the group worked with Oklahoma state Rep. Kevin West (R) on legislation proposed this year, which would prohibit emergency contraception and the prescription or sale of abortion medication, among other requirements. Tasy said ADF had helped draft language specifically protecting the use, sale, prescription or administration of contraception that does not “cause or induce an abortion,” which she told The Post was later modified against the group’s wishes.

Tasy did not specify what language in the bill ADF had objected to and did not respond to questions about whether the group considers emergency contraception an abortifacient. ADF lawyers have referred to emergency contraception as “abortion-causing drugs” in previous lawsuits.

The bill has not advanced. West’s office declined to make him available for comment.

In Louisiana, state Rep. Delisha Boyd (D) said her bill to protect contraception access had the momentum to pass — until the state’s top antiabortion group got involved.

The chairman of the Health and Welfare Committee, a fellow Democrat, texted her during a March committee hearing on the bill to share that Republican members had been receiving calls and texts from Louisiana Right to Life. Emergency contraception and IUDs, the group told legislators, are “backdoor” ways to abortion in a state that has banned the procedure, she recalled.

She had lost the votes needed to advance the bill.

“Republicans actually said that they agree with it, but they didn’t want the repercussions of what it would look like if they voted against Right to Life’s stance,” Boyd said.

Benjamin Clapper, executive director for Louisiana Right to Life, did not respond to requests for comment.

Neither did 11 of the 13 Republicans on the committee. One declined to speak. Another, Rep. Stephanie Berault, wrote in an email: “I support, and will continue to support, access to contraceptives that are widely available in Louisiana. This legislation was a solution to a problem that doesn’t exist.”

In Virginia, state Sen. Ghazala Hashmi (D), lead sponsor of the state’s right to contraception legislation, said Republicans who claim they will not limit access to birth control despite voting against its protection are misleading the public.

“They said the same thing about Roe v. Wade — that no one’s coming after this protection that was established law for decades,” she said. “And here we are.”

Josh Dawsey contributed to this report.