For many, accessing birth control has become increasingly challenging. Power to Decide reports that in Indiana, 428,540 women of reproductive age live in "contraceptive deserts," counties with insufficient access to health centers offering a full range of contraceptive options. Of these, 99,870 reside in counties without a single center providing comprehensive contraception services.
In March 2024, Indiana Gov. Eric Holcomb signed House Enrolled Act 1426 into law, restricting postpartum contraceptive options for Medicaid recipients. In June, U.S. Senate Republicans, including Indiana Senators Mike Braun and Todd Young, voted to block the Right to Contraception Act (S.4381), further limiting access to contraception.
As contraception access faces growing legislative restrictions across the United States, Indiana has emerged as a battleground. State laws threaten to limit birth control options and create significant obstacles for women seeking comprehensive reproductive healthcare in the state. Many reproductive freedom advocates say these developments signal a concerning trend in the erosion of contraception rights that would impact hundreds of thousands of Indiana residents.
Lilly Lowe, a labor and delivery nurse at Riley Hospital for Children in Indianapolis, sees these challenges firsthand as she cares for women impacted by existing abortion bans. The law in Indiana prohibits abortion in most cases, with exceptions only to prevent serious health risks to the mother. If a lethal fetal anomaly is detected, abortion is allowed before 20 weeks of gestation and up to 10 weeks in cases of rape or incest.
“I work with many patients who suffer from severe pregnancy complications, often resulting in medical termination due to the survival rate of the fetus being less than 20% in the first month,” Lowe said. “Access to contraceptives is extremely important for preventing these dangerous pregnancies.”
Contraceptives are methods or devices used to prevent pregnancy by inhibiting fertilization or implantation. Common forms include birth control pills, intrauterine devices (IUDs), condoms and implants, each offering varying levels of effectiveness and accessibility.
The U.S. Supreme Court’s 1972 ruling in Eisenstadt v. Baird legalized birth control for unmarried individuals and sparked a broader conversation about autonomy, freedom and equality, establishing principles of individual privacy and equality under the law. This precedent was cited in subsequent cases, including Roe v. Wade, which established legal abortion rights nationwide.
Then, in 2022, the Supreme Court overturned Roe v. Wade, dismantling decades of precedent protecting abortion rights.
The shockwaves of that decision extended far beyond abortion rights, prompting fears from Indiana residents that other rulings safeguarding personal freedoms could be overturned next. Among them is Eisenstadt v. Baird.
Laws and misinformation threaten contraceptive access
While Eisenstadt v. Baird established widespread access to contraceptives, recent legislative measures have already impacted availability.
For instance, the 2019 “domestic gag rule” on Title X has had a significant impact. It barred Title X-funded health centers from discussing or referring patients to abortion services, even if requested, and prohibited them from sharing resources with abortion providers. The regulation forced many clinics to leave the Title X network, a federal program offering family planning and preventive health services, primarily for low-income families.
These clinics play a crucial role in providing contraceptive care, as their doctors often prescribe and distribute birth control methods such as pills, IUDs and implants. As a result, patient access to clinics plummeted from 3.9 million annually to just 1.5 million by 2020. Though the regulation was reversed in 2021, ongoing funding issues and restrictive state policies continue to limit the availability of these services.
According to the Indianapolis Recorder, Indiana House Enrolled Act 1426, passed in February 2024, has become central to the national debate over reproductive rights, as it restricts Medicaid recipients' postpartum contraceptive options to only subdermal implants, explicitly excluding IUDs. The legislation initially included IUDs, but it was amended after anti-abortion groups falsely claimed that IUDs cause abortions. An IUD is a small, T-shaped plastic or copper device inserted into the uterus to prevent pregnancy, either by releasing hormones or through the sperm-blocking effect of copper.
This exclusion has raised alarms among Democratic lawmakers and healthcare professionals, who argue that limiting contraceptive options for low-income women not only restricts their access to effective family planning but also perpetuates damaging stereotypes about their ability to make informed healthcare decisions.
In June, U.S. Senate Republicans blocked the Right to Contraception Act (S.4381), which Democrats argued would protect contraception access nationwide. However, opponents, including anti-abortion rights groups, claimed the bill would mandate federal funding for abortion providers like Planned Parenthood by prohibiting selective funding.
The procedural vote fell short at 51-39, with Senators Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) supporting Democrats.
Indiana Senators played key roles, as well. Todd Young (R-Indiana) voted against the bill, while Mike Braun (R-Indiana) did not vote, aligning with a conservative stance against expanding reproductive freedoms.
For Lowe, these restrictions are deeply personal. Working at a level four perinatal center, which specializes in comprehensive medical and surgical care for critically ill mothers and infants, Lowe sees significant socioeconomic disparities among her patients.
“A large portion of the patients we get don’t even have a crib or car seat for their baby,” she said.
This issue extends beyond preventing pregnancy, as many women use contraceptives to regulate menstruation or manage health conditions. But as misinformation spreads, some lawmakers and activists are wrongfully labeling some methods, like IUDs, as abortifacients, according to the International Planned Parenthood Federation. In an interview with the Indiana Daily Student, a representative from Students for Life at IU expressed concerns with how contraceptives are used and impact the body’s natural processes.
“If they’re considering an embryo as human life, then you’re going to have issues with an IUD because it prevents a fertilized egg from implanting,” Jennifer Maher, an IU professor specializing in feminist theory and gender studies, said.
Barriers to contraception access in the U.S.
According to the Guttmacher Institute, a leading research organization in reproductive health, over 19 million women of reproductive age in the U.S. live in “contraceptive deserts” — counties with insufficient access to health centers offering a full range of contraceptive options.
“We’re not just talking about access to birth control,” Maher said. “Women in these counties need to take time off work, arrange childcare and travel long distances just to access basic healthcare.”
According to Maher, the reality is that contraceptive deserts don’t only impact low-income women eligible for publicly funded services. These centers are also vital for women who wish to maintain privacy by not disclosing their contraceptive use to insurance providers or who face pressure from a partner to avoid birth control.
Maher said these restrictions go far beyond basic access. She pointed to Project 2025, a 900-page conservative “presidential transition” plan crafted with input from several President-elect Donald Trump-appointed cabinet members. The plan, intended as a blueprint for the first 180 days of a Republican administration, includes efforts to “curb the abuses” of the Affordable Care Act. Maher warned that these policies could worsen access to reproductive healthcare for women nationwide.
Laura Forbes, communications manager for the American Civil Liberties Union of Indiana, expressed similar concerns about contraception access in Indiana. She said regardless of whether Project 2025 is fully implemented, the ACLU may be fighting for contraception access in Indiana anyway.
“It’s something we’re really going to be keeping an eye on here at the state level,” Forbes said.
