American women may soon lose access to what has been a mainstay of reproductive healthcare for the past two decades: mifepristone, one of the drugs used in medical abortions, which constitute about half of all abortions in this country. A Texas judge is expected to rule imminently in a case against the FDA’s 2000 authorization of mifepristone, which is also used to manage miscarriages and other conditions.
Many women had already adjusted their contraceptive plans due to the 2022 U.S. Supreme Court ruling to overturn Roe vs. Wade, and birth control issues contribute to many women’s negative experiences with healthcare providers.
Limits on access to birth control and previously approved abortion medications may be particularly problematic for American women in light of a new study that shows more women are delaying or avoiding pregnancy due to the Covid-19 pandemic.
The study, published by researchers at the University of California San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH), showed that the pandemic affected women’s attitudes towards pregnancy and fertility. Specifically, the pandemic appears to have suppressed the desire to get pregnant for many. Those changes in fertility preferences appear to have persisted for a majority of women.
Researchers surveyed more than 2,000 U.S.-based women between the ages of 18 and 45 in July 2020 and again in January 2021 to understand any changes in respondents’ fertility preferences.
The survey asked respondents to share how their feelings about having a child (or another child) may have been affected by the pandemic. Respondents were categorized as those who had no change in attitude, those who wanted to delay having a child, those whose desire to have a child had decreased, and those whose desire to have a child had increased due to the pandemic.
In the first survey, nearly half (44%) of women said the pandemic had not impacted their fertility preferences, while 28% said they wanted to delay getting pregnant and 23% said they had less interest in having a child. Only 5% said they were more interested in having a baby as a result of the pandemic.
The women who reported no change in fertility plans or preferences during the pandemic were more likely to be older, white, not living with a partner, and either childless or already parenting two or more children. They were less likely to have experienced financial hardship during the pandemic and less likely to have lived under pandemic restrictions.
By the second survey six months later, 68% of the women who had initially reported that the pandemic had decreased their desire to have a child continued to report feeling that way in the follow-up survey.
According to Leah Koenig, study author and ANSIRH data analyst, the decreased desire for children respondents reported has caused a greater need for contraception and abortion care. Those needs will be even greater in some populations, such as women of color and women who experienced more negative financial impacts as a result of the pandemic.
Overall, nearly half of the women who responded to both surveys were less likely to want to have a child or more likely to want to delay having a child. These women were more likely to be younger, women of color, parenting one child, and to have experienced loss of income.
Researchers found that women who lost income during the pandemic were more likely to want to delay or avoid getting pregnant, though overall income level was not associated with changes in fertility preferences.
More than one-quarter (29%) of women who had initially reported wanted to delay or avoid pregnancy moved into the ‘no change’ group in the second survey. By the second survey, the percent of women who reported no change in their fertility plans reached nearly half.
These attitude shifts among women about having children raise the stakes even higher on the pending court decision about access to medication abortion.
“Attacks on abortion care, including this attempt to ban mifepristone, will only make it harder for women to manage their reproductive health and determine their own future,” Koenig said.