Fallout From Dobbs Decision Shows Increased Barriers To Contraception, Decline Of Sexual Activity In Arizona: Guttmacher

Report Projects Much Broader Consequences For People’s Reproductive Autonomy.

A Guttmacher Institute report based on surveys of reproductive-aged women in Arizona, Iowa, New Jersey and Wisconsin before and after the Dobbs decision overturning Roe v. Wade showed ripple effects on all aspects of reproductive care, including abortion, contraception and pregnancy care on people living in Arizona. 

The report found statistically significant evidence that barriers to accessing contraception have increased, sexual activity has declined, reports of receiving high-quality contraceptive care have decreased, and condom use has increased.

“The long-term impact on reproductive-aged women includes potentially shaping attitudes towards becoming pregnant, changing their sexual activity and contraceptive strategies, and impacting their ability to access necessary healthcare,” said Affirm CEO Bré Thomas. “Those outcomes only further emphasize the fact that we are living in a time when access to and protection of the right to contraception is more important than ever as it faces serious – I would even say dangerous – threats of being taken away.”

The Guttmacher Institute launched the Reproductive Health Impact Study (RHIS) after the 2016 election, in anticipation of federal and state efforts to change funding streams and service delivery for sexual and reproductive health care. 

The study has been tracking access to services and sexual and reproductive health outcomes from 2017 to 2024 to illuminate the impact of policy restrictions at multiple levels of health care. In doing so, RHIS has created a robust set of scientifically innovative findings that highlight the distinct but inextricably linked impact of these restrictions at the systems, health care provider and patient levels, all of which have implications for undermining people’s reproductive autonomy.

Research on the Trump administration’s 2019 Title X Final Rule, also known as the “domestic gag rule,” and related state polices provides evidence that policies seemingly aimed only at abortion can negatively impact health care systems and provider delivery of sexual and reproductive health care, as well as patients’ experiences of person-centered care and reproductive autonomy.

The report stated that, “as continued fallouts of the Dobbs decision on access to abortion occur, this research makes clear that access to broader contraceptive care is worsening,” adding that “policies that promote meaningful access to all forms of sexual and reproductive health care must be advanced to support all individuals’ rights to reproductive autonomy while mitigating inequity and inequality.”

Affirm is Arizona’s designated Title X agency, managing $6.1 million in grant funding to more than 50 Title X-funded health centers statewide providing services to an average of 35,000 people annually. Affirm has been actively involved in advocating for the Right to Contraception Act to codify the right to use and buy contraceptives and to protect medical professionals’ right to provide information about and prescribe contraceptives to patients.

Title X provides low- or no-cost services like birth control, sexually transmitted infection (STI) testing and treatment, pregnancy testing, counseling and other preventative services. Title X clients include youth, the uninsured and underinsured, low-wage earners, indigenous communities and other groups that have been systemically excluded from receiving care.

For more information about the Guttmacher Institute, visit