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The Supreme Court’s decision to strike down the fundamental right to abortion is fueling fears among some Americans that restricting access to contraceptives could be the next step.

Birth control remains legal in the United States, but abortion rights advocates and medical providers have warned that a reversal of deer could be applied to reduce access to contraception. For many, this fear was confirmed by the concurring opinion of Justice Clarence Thomas, in which he said the High Court should review past decisions, including one which protected the right to obtain contraception.

Some state lawmakers may also seek to restrict access to birth control. Most medical providers agree that birth control methods only work to prevent a pregnancy before it begins, but some anti-abortion organizations oppose certain birth control methods, saying they can end a pregnancy. pregnancy rather than preventing it.

With the annulment of Roe v. Wade, the legality of abortion was left to the states. Some fear that access to certain types of contraception is next. (Video: Julie Yoon, Hadley Green, Sarah Hashemi/The Washington Post)

Reacting to the reversal of Deer, Jennifer Lincoln, a board-certified obstetrician/gynecologist in Portland, Oregon, said, “The next step will be emergency contraception and IUDs, then all hormonal contraceptives. This is full reproductive control, so it’s just the next logical step for [conservatives].”

Since Politico issued a leaked draft notice suggesting deer would be reversed, Lincoln said she had received an influx of questions on social media about how to access long-acting birth control methods such as IUDs — and how long that access might last. . Google searches for the IUD, plan B and contraception have increased in recent weeks, with many people on social media wondering if they should start stocking up on emergency contraception or plan B in case they would cease to be available.

Anne Cavett, nurse practitioner and clinical services coordinator at Planned Parenthood of Metropolitan Washington, thinks those fears are well-founded: “I don’t think it’s alarmist to worry about it getting worse,” she said.

Cavett added that over the past few weeks, more and more people have requested long-acting contraceptives at his clinic, and many patients have expressed concern about how long they will be available. Some patients, she said, came to replace their IUD before the expiration date; they are afraid that this is their last chance.

“I think overwhelmingly that when someone learns that the right to abortion has been taken away, there is a fear that you will lose the right to your bodily autonomy and the ability to make your own decisions,” Cavett said.

Some anti-abortion organizations oppose certain birth control methods. Most medical professionals believe that a pregnancy begins when a fertilized egg implants in the uterus, but some opponents of abortion believe that it begins as soon as an egg is fertilized by sperm.

“We are not taking a position on contraception – which prevents pregnancy – but on abortifacients which have deliberately in their design the ability and purpose to end the life of an unborn baby,” said Kristi Hamrick, spokesperson for the anti-abortion organization Students. for Life of America.

The list of “abortifacients” that Students for Life of America oppose includes birth control pills, IUDs, and Plan B. They take no position on condoms, sterilization (tubal ligation or vasectomies), or the rhythm method. – which involves tracking menstrual cycles and monitoring body temperature and is about 76% effective in preventing pregnancy.

According to the American College of Obstetricians and Gynecologists, emergency contraception like Plan B is sometimes confused with medical abortion. But “medical abortion is used to terminate an existing pregnancy, while emergency contraception is only effective before a pregnancy is established.” The organization also claims that the copper IUD works by “affecting sperm viability and function”, not by preventing implantation.

“This misinformation is what lawmakers use to make their case – that IUDs and emergency contraceptive pills are abortifacient,” Lincoln said. “They’re using it directly as a way to then write laws to ban access to these drugs. This will lead to less access and therefore more unplanned pregnancies and people seeking abortions.

IUDs are one of the most effective forms of birth control, lasting up to a decade, according to the Centers for Disease Control and Prevention. More than 10% of American women using contraception rely on long-acting reversible methods like IUDs. They’re also used to treat heavy menstrual bleeding, in some cases even helping to prevent the need for a hysterectomy, Lincoln said. There are two types of IUD: copper, which prevents sperm from reaching an egg, and hormonal, which thickens cervical mucus and blocks sperm. In some rare cases, IUDs can prevent a fertilized egg from implanting in the uterine lining.

Emergency contraceptives, on the other hand, delay ovulation after unprotected sex, so there is no egg to meet the sperm. Nearly one in four women between the ages of 20 and 24 have used emergency contraception, according to the Center for Disease Control.

Thomas’ concurring opinion has caused abortion advocates to fear that the right to obtain birth control could potentially be overturned by the court.

“In future cases, we should reconsider all substantive due process precedents of this Court, including Griswold, Lawrenceand Oberefell“, wrote Thomas. Griswold refers to Griswold v. Connecticut, the 1965 ruling that struck down a Connecticut law that prohibited the purchase of anything that “prevents contraception,” thus enshrining the right of married couples to purchase and use contraception. In 1972, Eisenstadt v. Baird extended this right to unmarried persons. (Lawrence and Oberefell are related to same-sex relationships and marriage.)

But Thomas’ opinion is not the first sign that some states may be restricting access to contraceptives. In Idaho, House State Affairs Committee Chairman Brent Crane (right) announced plans shortly after the draft opinion was leaked to hold hearings on the birth control ban emergency, and possibly IUDs. He later clarified that he was not talking about IUDs, but was open to holding hearings on “the issue of abortifacients”.

Last month, Louisiana lawmakers introduced a bill defining “human personality” as beginning at the time of fertilization, which some experts say could be used to target Plan B or IUDs. And last year, Missouri lawmakers tried to block Medicaid from covering Plan B and IUDs.

It is not yet known whether these efforts will succeed in blocking access to contraception, but medical providers say birth control is already difficult to access in much of the country.

“There are a ton of challenges and barriers that people face in accessing birth control in this country — and it’s awful,” Cavett said.

Low-income people and people of color are more likely to live in “contraceptive deserts,” or areas where there aren’t enough clinics to offer contraceptive options, according to one study. For the more than 30 million Americans without health insurance, contraceptives may be unaffordable. And even among women with private insurance, one in five still pays for their contraceptives entirely or partially out of pocket, according to the Kaiser Family Foundation.

It’s important for people to know that all birth control methods continue to be legal, Lincoln said. She warned, however, that this might not be the case forever – and encouraged people to consider their birth control options.

Lincoln has launched a website where people can order birth control pills, emergency contraception and abortion drugs, and other abortion advocates are stepping up efforts to increase access to birth control on the internet.

For the 21 million Americans without broadband connectivity, even this plan, however, can present challenges.

“There’s already an inequity between who can and can’t access these methods,” Cavett said. “It is inevitably black and brown people, trans and non-binary people, people who live in rural areas, people with low incomes. These are all the people who are already overloaded by this.