New York—The COVID-19 pandemic has prevented or delayed as many as half of family planning patients in a diverse group of US states from getting birth control or related sexual and reproductive health care—and those who experienced financial hardship were particularly affected—according to a new Guttmacher Institute study released today.

The study—conducted in three states between May 2020 and May 2021—examines access to contraceptives and other sexual and reproductive health care among almost 1,500 patients at more than 50 publicly funded clinics in Arizona, Iowa and Wisconsin.

The study finds that 57% of family planning patients in Arizona, 38% in Iowa and 30% in Wisconsin faced delays in, or barriers to, obtaining birth control or related care. In addition, patients who experienced financial hardship had higher odds of experiencing these delays or barriers than those who did not—six times higher in Wisconsin and three times higher in Arizona.

“The COVID-19 crisis has curtailed access to contraceptives and other sexual and reproductive health care in states nationwide—particularly for people who were hard hit by the pandemic’s negative financial and employment effects—and our study documents these impacts in three states,” says Megan Kavanaugh, principal research scientist at the Guttmacher Institute. “This has deep and wide-reaching impacts for people who need and deserve access to high-quality, affordable birth control and other care so they can make the fundamental choice about if and when they want to be pregnant and have children.”

COVID-19 is making health disparities worse

This three-state study follows two Guttmacher national surveys, conducted in 2020 and 2021, that found  the pandemic had widespread impacts on respondents’ ability to get birth control and related care. The severity of those impacts lessened during the course of the pandemic, but the effects were still present in 2021, when 19% of respondents said they had trouble getting their contraceptives or other sexual and reproductive care.

The two national surveys also found that COVID-19 continues to have a disproportionate impact on those already marginalized as a result of their race, income or sexual orientation. Guttmacher’s new state study echoes these findings, demonstrating the ongoing challenges of the pandemic at the state level. For instance, LGBQ+ patients in Iowa had higher odds than their straight counterparts of experiencing delays in care.

“The COVID-19 pandemic disproportionately affects the sexual and reproductive health of people of color and those who are LGBTQ, have lower income or are facing financial and employment difficulties,” says Dr. Kavanaugh. “Addressing these inequities is crucial to ensuring that all people can decide when, whether and how to become parents, and have the support they need to take care of their families.”

The new three-state study is part of the Reproductive Health Impact Study, a multiyear comprehensive research initiative that analyzes the effects of federal and state policy changes—including the restrictions the Trump-Pence administration imposed on the Title X national family planning program—on publicly funded family planning care in Arizona, Iowa, New Jersey and Wisconsin. More findings from this project will be released later this year.

“State and federal policymakers must take steps to expand and support access to the full range of sexual and reproductive health care, especially for individuals who experience the greatest barriers to care,” adds Dr. Kavanaugh. “Policymakers should also support efforts to expand access to sexual and reproductive care in innovative ways and through a diversity of options—from in-person care to telehealth—with particular attention to the needs of individuals with fewer resources.”