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Investing in Reproductive Health

Contraceptive Use and Preference Fulfillment Among Low-Income Individuals Across State Policy Contexts

Bibliographic Data

ID11290549
AuthorsHannah Olson (0000-0002-1334-5396, Guttmacher Institute, corresponding author), Ayana Douglas-Hall, Ayana Douglas‐Hall (Guttmacher Institute), Madeleine Haas (City University of New York), Megan L Kavanaugh (0000-0002-9888-4304, Guttmacher Institute)
Year2026
Volume45
Issue1
Publication date2026-02-01
Open AccessYes
TypeARTICLE
VenuePopulation Research and Policy Review (JOURNAL)
Journal identifiersISSN: 0167-5923 • E-ISSN: 1573-7829
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s11113-025-09980-0
OpenAlexW4416936129
LanguageEN
Citations received1
References cited17

While most people with the capacity for pregnancy in the United States use some form of contraception, accessing high-quality provider-based contraceptive care can be difficult for people with limited resources. Since the early 1970s, Medicaid and Title X have provided individual and systems-level funding for contraceptive care and other vital sexual and reproductive health services to those with financial need, but such investments vary by state. Using data from 5208 individuals with a likely need for public support for family planning from 26 states that fielded the Behavioral Risk Factor Surveillance System’s family planning module in 2022, this study investigates the relationship between public policies and funding streams in support of sexual and reproductive health services at the state-level with individual contraceptive use and preferences. Using bivariate and multivariable logistic regression, we find that, among people with a likely need for public support for family planning, those living in states with more expansive Medicaid eligibility policies and more funding for Title X service grants and Title V maternal child health block grants were more likely to use contraception and have their contraceptive preferences fulfilled than individuals in states with higher Medicaid eligibility thresholds or less funding for the provision of these services. These findings highlight the importance of continued investment in family planning and related services to meet the contraceptive needs and preferences of people at risk of pregnancy in the United States and ensure greater equity across our society in people’s ability to exercise their reproductive autonomy

Family planning · Fertility · Health care · Lesbian · Medicaid · National Survey of Family Growth · Population · Public health · Reproductive health · Service (business · Global Maternal and Child Health · Reproductive Health and Contraception · Reproductive Health and Technologies

  • Where U.S. Women Obtained Contraceptive and Related Care and How They Paid for It in 2022–2023

    Open Access•Hannah Olson, Mia Zolna•Women s Health Issues•2026

  • Patient-centred access to health care

    Open Access•Jean-Frédéric Levesque, Mark F Harris et al.•International Journal for Equity…•2013

  • Coverage Effects of the ACA's Medicaid Expansion on Adult Reproductive-Aged Women, Postpartum Mothers, and Mothers with Older Children

    Open Access•Lindsey Rose Bullinger, Katie Simon et al.•Maternal and Child Health Journal•2022

  • Women’s reproductive health and economic activity

    Open Access•Jocelyn E Finlay•World Development•2021

  • A Prospective Cohort Study of Changes in Access to Contraceptive Care and Use Two Years after Iowa Medicaid Coverage Restrictions at Abortion-Providing Facilities Went into Effect

    Open Access•Megan L Kavanaugh, Mia Zolna et al.•Population Research and Policy…•2022

  • Removing Barriers to Adolescents' Access to Contraceptive Information and Services

    Open Access•Akinrinola Bankole, Shawn Malarcher•Studies in Family Planning•2010

  • Payment for Contraceptive Services in Safety Net Clinics

    Blair G Darney, Frances M Biel et al.•Medical Care•2020

Citations per year1
Citation span2026 - 2026 (1)
Highly citedNo

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