At first glance, what’s happening right now in Iowa looks like a rosy vision for the future of reproductive rights.
The Republican-controlled state Senate recently passed a bill that would increase access to certain types of contraception by allowing pharmacists to dispense it to patients without a prescription. Their GOP counterparts in the state House have included a similar provision in a larger health care bill. And Republican Gov. Kim Reynolds has indicated that the legislation is one of her top priorities this session.
But look elsewhere in Iowa, and you’ll get a different view. Earlier this month, the state attorney general’s office announced that it would suspend payments for emergency contraception for survivors of sexual assault. The medication had been funded through a program for crime victims, but the Republican attorney general is considering a permanent end to its provision. She is “carefully evaluating whether this is an appropriate use of public funds,” a spokesperson said in a statement.
In other words, counter to a refrain that has taken hold on the left since the overturning of Roe v. Wade, conservatives are not coming for birth control next. They’re coming for birth control now.
Some corners of the right are already in full-blown attack mode. Pulse Life Advocates, one of the Iowa-based anti-abortion groups that is advocating against the over-the-counter contraception bill, states on its website that “contraception kills babies.”
It’s relatively uncommon for an anti-abortion group to state its animus toward birth control so plainly. For years, the major players on the anti-abortion right have claimed to support contraception. They seem to understand that more than 90 percent of Americans are in favor of legal birth control and that most people opposed to abortion likely see contraception as an effective means of reducing demand for it.
In fact, when Democrats in Congress introduced a bill that would codify access to contraception in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, they were met with eye-rolling and denials on the right. “This bill is completely unnecessary. In no way, shape, or form is access to contraception limited or at risk of being limited,” said Florida Republican Rep. Kat Cammack, during debate on the House floor. “The liberal majority is clearly trying to stoke fears and mislead the American people.” The Democrats were like “the little boy who cried wolf,” said Republican Sen. John Cornyn.
Even among the politically sophisticated and catastrophically cynical, there remains a sense that, since contraception is so widely used and deeply integrated into American life, restrictions on birth control might be too politically unpopular for even far-right Republicans to attempt. About two-thirds of U.S. women of childbearing age use some form of contraception (including female and male sterilization).
But it would be foolish to believe Cammack and Cornyn’s mealy-mouthed reassurances. For one thing, Republicans weren’t willing to write the right to contraception into law: Republican Sen. Joni Ernst blocked the bill before it could come to a vote in the Senate. Conservatives have tried hard to maintain a veneer of rationality on the issue of contraception. But almost a year into the emboldened post-Dobbs anti-abortion movement, the cracks in that facade are starting to show.
Currently, the right to contraception in the U.S. rests on Griswold v. Connecticut, a landmark 1965 Supreme Court decision that is based, as Roe was, on the right to privacy. In a concurring opinion in Dobbs, Clarence Thomas wrote that the court “should reconsider” several precedents that concern the right to privacy—including the legality of gay intimacy, the right to gay marriage, and Griswold. And a growing number of Republicans are willing to state that Griswold was wrongly decided, including Republican Sen. Marsha Blackburn and former Arizona Senate candidate Blake Masters.
But the Supreme Court won’t even have to overturn Griswold for conservatives to curtail access to birth control. Across the country, they are executing a game plan that rests on three strategies: Conflate contraception with abortion, claim that birth control is dangerous to women’s health, and let right-wing judges do their thing.
In Idaho, for example, the No Public Funds for Abortion Act, which passed in 2021, doesn’t just prohibit state-funded student health centers from counseling patients on abortion. It bars them from distributing emergency contraception like Plan B, too.
These legislators are adopting the premise of nearly every anti-abortion group that claims to have no agenda on contraception: Usually, with a coy play on words, they claim that emergency contraception and IUDs—are not contraception at all. They categorize them as methods of abortion.
Anti-abortion advocates argue that pregnancy—and life—begin when an egg is fertilized, even before it has implanted in the uterus. And they say certain kinds of birth control function by preventing a fertilized egg from successfully taking hold in the uterine lining, thus ending an in-progress pregnancy and terminating a human life.
The American Association of Pro-Life Obstetricians and Gynecologists, for example, argues that both copper and hormonal IUDs “clearly can cause the death of embryos both before and after implantation” by affecting the lining of the uterus. The website of Americans United for Life says the group takes “no stance on the underlying issue of contraceptive use,” but states elsewhere that people who ingest emergency contraception “take the lives of their unborn children.”
Setting aside the question of whether a free-floating fertilized egg even constitutes a pregnancy, never mind a life, these right-wing claims are untrue: The FDA confirmed in December that Plan B does not work this way, and while the uterine environment created by the copper IUD may be less hospitable to a fertilized egg, this is not its primary method of action—it impedes the motility and viability of sperm, making it difficult and rare for fertilization to occur.
But bad science is a feature, not a bug, of the right-wing approach to reproductive health care. And as usual, Republican lawmakers are taking their cues directly from the most extreme anti-abortion advocacy groups. Two years ago, in Missouri, Republicans tried to ban public funding for IUDs and emergency contraception in a bill that would have made those forms of birth control ineligible for Medicaid coverage. (“Anything that destroys that life is abortion, it’s not birth control,” said the state senator who spearheaded the legislation.) During the 2022 appropriations process in Congress, Rep. Lauren Boebert attempted to bar federal funds from being used on “abortifacient contraceptive drugs,” and Republican Rep. Matt Rosendale proposed adding emergency contraception to a provision prohibiting the federal funding of abortion.
Students for Life, a radical anti-abortion organization that many consider the future of the movement, goes even further than the IUD and Plan B. At the March for Life this January, a spokesperson for the group deflected when I asked her for the group’s position on birth control. “We do not have an official stance on all forms of contraception,” she said. However, the organization’s website classifies all hormonal contraception—including the pill, the patch, the ring, and the hormonal IUD—as abortifacients (contrary to the actual mechanisms of the drugs). It also displays several paragraphs on the health risks of hormonal contraception and discourages its use for other medical conditions like endometriosis and polycystic ovary syndrome. “Birth control disrespects women,” it states.
This points to another strategy conservatives are embracing in their mounting efforts to restrict contraceptives: fearmongering about their safety, a time-honored entry in the anti-abortion playbook. In the years before Roe was overturned, GOP-controlled state legislatures imposed superfluous requirements on abortion clinics under the guise of improving patient safety. More recently, right-wing plaintiffs brought a case to an extremist federal judge that claimed, against all available evidence, that the abortion medication mifepristone was too dangerous to have warranted the Food and Drug Administration’s approval in 2000. The judge agreed with those plaintiffs earlier this month, and the Supreme Court determine today whether his ruling will stand.
Groups like the Catholic Medical Association—one of the organizations behind the mifepristone case—are already publicly wringing their hands over the side effects and risks of hormonal contraception. And on conservative TikTok and other social media platforms, there has been a recent uptick in disinformation about contraception, often disguised as #wellness content. Users are spreading false claims that taking the pill can lead to infertility and that the copper IUD can cause copper poisoning.
“That, to me, is really concerning,” said Mara Gandal-Powers, director of birth control access at the National Women’s Law Center. Whether it’s a genuine misreading of the science or a deliberate lie disseminated for political purposes, “it manipulates the public into a place where they may be, three to five years from now, feeling differently about a restriction on contraception that, today, would not fly at all.”
But public buy-in is a nice-to-have, not a need-to-have, for the anti-abortion right, thanks to its power in the courts. Late last year, a federal judge appointed by Donald Trump—the same one who recently moved to invalidate the FDA approval of mifepristone—considered a case brought by a Texas father who argued that Title X, a federal program that provides free contraception, violated his rights as a Christian parent by hypothetically making birth control available to his three adolescent daughters without his consent. The judge agreed, ruling that Texas minors must have parental permission to get contraception at federally funded clinics.
It is possible that Republican lawmakers, with their eyes on reelection, will be less willing to pursue sweeping restrictions on birth control than the federal judges sitting pretty with their lifetime appointments. But the GOP agenda on reproductive health care is already far more radical than public opinion would dictate. Most Americans—including majorities of people in states that have enacted new abortion bans in the wake of Dobbs—opposed the overturning of Roe v. Wade. That hasn’t stopped Republicans from pursuing blanket bans in every GOP-controlled legislature in the country.
With contraception, legislators will start the same way they did with abortion: Banning certain types of care, passing parental consent laws, and stripping public funding so that patients on Medicaid lose access to the most effective contraceptives. And why shouldn’t they? It’s worked for them before.