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Thanks to things like the contraceptive mandate in the Affordable Care Act and Title X funding, access to birth control is, in theory, a right in the United States. But in practice, a vast majority of women who rely on publicly funded contraception in this country live in places where they can’t access the full range of options, according to the latest data from Power to Decide.
Since November 2016 (?), Power to Decide has been tracking the country’s “contraceptive deserts,” or counties where demand for publicly funded birth control is higher than the feasible supply. These are swaths of land where there aren’t enough clinics offering the full range of BC methods to meet the demand of women who need them. By Power to Decide’s latest estimation, 97 percent of women live in these contraceptive deserts.
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To illustrate how dire that is, Power to Decide keeps a color-coded map that tracks the number of clinics in each county. Dark magenta dots light up the counties that have zero health clinics offering the full array of contraception, while, on the opposite end of the spectrum, those that are the most saturated with clinics are dark purple. By Power to Decide’s math, 1.6 million women live in counties without a single health center that provides the full range of publicly funded birth control.
The map looks bad, but according to Ginny Ehrlich, CEO of Power to Decide, several federal initiatives could make it even worse. Like, the ongoing threats to overturn the Affordable Care Act and institute a “domestic gag rule,” which would prevent Title X funding from going to clinics that also happen to offer abortion services. If these were to pass, even more counties on this map would be magenta.
What the map doesn’t show as clearly is that the methods clinics are the least likely to carry in a contraceptive desert are the ones in increasingly high demand—like long-acting reversible methods such as IUDs and implants. “Any of the pink, yellow, and orange colors are counties in which not one provider offer the IUD and implant,” Ehrlich says. It also doesn’t mention that a majority of women who rely on publicly funded contraception are under 30 years old and women of color, who already face higher barriers to access.
Even for women who live in places with a few clinics (that aren’t colored in magenta), getting to the nearest clinic might mean a long drive—especially if you want an IUD or implant. Ehrlich points to the southern half of South Dakota and most of Texas, where the counties are spatially huge and the map indicates about 1,000 women in need per county with no access. For many women, there’s a trade-off between getting the option they really want—like an IUD—and getting one that’s the most readily accessible.
Access to only some of the methods available doesn’t really count as true access. The wide array of birth control options is great, but they weren’t designed to be only luxury items available to certain women who can actually get their hands on them. “We believe that all women deserve the birth control method that’s right for them,” Ehrlich says. “This precludes that access.”
If you want to make sure contraceptive deserts don’t grow any more, you can help out by donating to Planned Parenthood, volunteering at clinics in your area that receive Title X funding, or doing any one of the things suggested here.
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