Contraceptive Access in the United States

03.05.09 - The right to obtain and use contraceptives is part of the fundamental right to privacy guaranteed by the United States Constitution. The Supreme Court has stated that this right extends not only to married adults, but also to unmarried persons, including teens. Despite the existence of that right, it is evident that contraception needs in the country are not met:

  • Half of the six million pregnancies in the U.S. each year are unintended.
  • About one-third of girls get pregnant in the United States before the age of twenty; the vast majority of these pregnancies are unintended.

In addition, the rates of unintended pregnancies are significantly higher for poor women and women of color.

  • Funding for the U.S. government's Title X program, which funds low-cost, confidential family planning services, is 61% lower today in constant dollars than it was in 1980
  • Some governments have enacted refusal clauses (or so-called "conscience clauses") which permit pharmacists and health care providers to refuse to dispense medication, including contraception, the use of which conflicts with the provider’s religious or moral beliefs
  • The U.S. government has placed obstacles in the path of minors and  immigrants seeking emergency contraception ("EC"), despite the scientific evidence supporting easy access
  • Some employers that provide otherwise comprehensive health insurance benefits carve out an exception for contraception and refuse to insure it.
  • Some religiously-affiliated healthcare systems refuse to provide certain contraception and related services.

Protecting women's access to contraception is a top priority for the Center. The Center has undertaken a variety of initiatives to make contraception more readily available. For example, when EC was available only by prescription in this country, the Center filed a citizen petition with the U.S. Food and Drug Administration on behalf of over 70 medical and public health organizations seeking to make EC available over-the-counter (OTC). In 2005, after years of inaction and political maneuvering by the FDA, under the influence of the White House, the Center filed a lawsuit against the FDA. In 2006, the FDA agreed to permit EC to be available without a prescription, but only to women 18 or older and only behind pharmacy counters. In March of 2009, the court ordered the FDA to approve Plan B for those 17 and older without a prescription and to reconsider the citizen petition and all age and point-of-sale restrictions. In the months that followed, the FDA approved Plan B OTC for those 17 and older, but has still failed to reconsider and remove the unique age and point-of-sale restrictions currently placed on OTC access to EC. Accordingly, on November 16, 2010, the Center asked the court to rule that the FDA is in contempt of court and to order the FDA to act within a specified time.

The Center also works to promote state legislation aimed at increasing access to EC through: public education programs; requiring access to EC in emergency rooms for victims of sexual assault; and permitting pharmacists to provide EC to all women who need it (including minors) without a prescription.

The Center also advocates for increased contraceptive funding in Title X in order to improve access to contraception for low-income women, and supports efforts to require employers to include contraceptive coverage in their health insurance benefits. Read about the Center's involvement in two cases that upheld the constitutionality of "contraceptive equity laws" in Catholic Charities of Sacramento v. Superior Court of Sacramento and Catholic Charities of the Diocese of Albany, et al. v. Serio.

If your employer excludes contraception from its health insurance benefits and you are interested in talking to someone about what you can do to change that policy, contact the U.S. Intake Attorney at 917-637-3600 or email us as we may be able to help.

Read Timeline: The Fight for Emergency Contraception