The latest version of CAI’s opposition report addresses the ways the opposition landscape has shifted in the aftermath of a major U.S. election. It also provides an update on public opinion and public confusion about differing political and personal viewpoints concerning contraception.

Contraception remains one of the most popular areas of agreement in an often polarized country. Yet attacks on access to contraception continue to escalate, and the future of contraception and IVF remain uncertain. This report sheds light on the people and groups that are driving contraception opposition, as well as the core debates about both contraception and IVF. Considering that a second birth control pill is being reviewed by the FDA for over-the-counter use, this report also addresses opposing viewpoints on regulation and contraception.

Absolute bipartisan unity: Do not make access to contraception harder

Only 3% of voters want lawmakers to make it harder to access contraception. Most want lawmakers to make it easier — it is extremely unpopular to make access more difficult. 

Source: CAI x Bellwether, December 2024 poll: “Public Opinion on Contraception & IVF”

As The Washington Post reports, “far-right conservatives are sowing misinformation that inaccurately characterizes IUDs, emergency contraception, even birth control pills as causing abortions.” 

These anti-contraception campaigns are blocking pro-contraception legislation and promoting anti-contraception measures.

Most abortion opponents have coalesced around a strategy to limit contraceptive access in four ways:

1. Alter the definition of pregnancy used by the government and the medical community so that common forms of contraception can be regulated by abortion laws or  excluded from state laws and programs intended to promote access to contraception; 

2. Undermine contraceptive access funding programs;

3. Use religious and moral exemption provisions that allow professionals to refuse to provide or sell contraceptives;

4. Implement age restrictions (parental notification provisions) that limit who can access contraception.

Many groups oppose all nearly contraceptive methods with the potential to prevent implantation in the uterus; some have aligned only on two methods, emergency contraception and the IUD, as illustrated in the chart below:

Many politicians and leaders claim to be neutral on contraception — but only on the condition that some common forms of contraception are redefined as abortion, which would potentially be subject to laws that limit or ban abortion. Some conservatives are championing non-medical terms such as “pre-implantation chemical abortion,” “abortifacient contraception” or “potential abortifacient.”  

The following chart illustrates this anti-contraceptive battleground (video explainer here)

Many groups that claim contraceptive neutrality in fact favor reduced access to contraception. In addition to opposing access efforts, they reclassify common contraception as abortion. For example, two anti-abortion groups, Susan B. Anthony Pro-Life America and National Right to Life, have repeatedly claimed publicly that they are “neutral” on contraception. Yet both groups advocate for limiting access to certain methods of contraception; for changing the legal definition of contraception, which could eliminate common forms of contraception; and for limiting the type of providers that could prescribe contraception.

One challenge is the way “neutrality” is defined. Some conservatives and journalists have argued that opposing contraception equates to advancing efforts to make contraceptives illegal. In this framing, groups can claim to be “neutral” while running campaigns to prevent people from accessing certain FDA-approved contraceptives.  

A more accurate definition of “neutrality” is to have no positions on contraception, contraceptive methods or the definition of “contraception.”  

For many years, abortion opponents have falsely claimed that certain emergency contraceptives — including the drug ulipristal acetate (UPA) used in the FDA-approved emergency contraception pill Ella — can also be used to spur an early abortion. This medical fallacy has been used by highly influential groups to derail support for legislation that would expand access to contraception. In fact, taking Ella while pregnant will have no impact on a pregnancy.

In contrast to other types of emergency contraception that are available over the counter, Ella is  only available with a prescription from a provider. Ella prevents pregnancy — it will not impact an existing pregnancy. 

The disinformation about the drug used in Ella, UPA, is rooted in new research which demonstrates that UPA, when taken at a higher dose and in combination with misoprostol, can be effective for medication abortion. 

“Critically, this study does not conclude — and should not be misrepresented as concluding — that emergency contraception causes abortion. — ACOG statement 

Messaging advanced by “pro-life” advocates often uses terms that have a wide range of meanings to different people and groups, such as “when life begins” and “conception.” These terms are not synonymous with when pregnancy medically begins, and have the effect of blurring a political debate about contraceptive access.

This approach aims to replace policy that relies on established medical science about pregnancy with policy that reflects a particular religious interpretation of “life.”

A December 2024 survey showed there is no consensus about the meaning behind the most commonly used terms in debates about contraceptive policy. U.S. adults have a wide range of personal definitions for when pregnancy begins, for the meaning of the term “conception” and for the meaning of the term “life.” 

However, adults in the U.S. have broad consensus about the central questions in most contraceptive policy debates:

• Only 3% of  voters overall want lawmakers to make it harder to access contraception.

• Only 26% of voters overall agree with using personal opinion rather than medical science to guide contraceptive policy.

• 75% of voters overall oppose reclassifying come contraception as abortion, including emergency contraception — this includes majorities across party lines.

Following the November 2024 national election, voters held strong opinions about their support for access to contraception and universally did not want policymakers to reduce access to abortion. 

Bipartisan majorities find it personally important that the country makes it easier to access contraception. 
The gender gap is most prominent among Republican women, who are 15 points more likely than Republican men to find increasing access personally important. 

Source: CAI x Bellwether, December 2024 poll: “Public Opinion on Contraception & IVF”

Includes condoms, IUDs, birth control pills, emergency contraception and “other” forms of contraception.

Nevertheless, significant concerns persist about potential rollbacks to contraception. Such actions could have a disproportionate impact on people who access birth control via publicly funded programs and those who live in contraceptive deserts, thereby furthering access equity challenges. 

From religious and moral exemptions, to redefinitions of reproductive health terminology with legislative repercussions, here are some of the possible scenarios that could take shape over the next four years:

Many conservative lawmakers and anti-abortion/anti-contraception institutions and leaders have advocated for reducing access to certain contraceptive options, policies that are deeply unpopular with voters.

During President Trump’s first term, the U.S. Department of Health & Human Services created a Conscience and Religious Freedom Division and issued new rules that allowed more employers to be exempt from offering no-cost contraceptive healthcare plans to employees, among similar actions.

Under the Trump-Pence administration, the HHS enforced the “Compliance With Statutory Program Integrity Requirements” — a regulation for Title X, the only federal family planning program, which significantly reduced access to contraceptive care for many low-income and uninsured people. While the Biden-Harris administration finalized a rule in 2021 that restored the Title X program’s requirement that pregnant patients be offered information about abortion and other reproductive health services, renewed attacks on Title X are expected.

Following President Trump’s suspension of foreign aid in January 2025, reproductive care has taken a particular hit on a global scale: According to Guttmacher, “130,390 women get contraceptive care each day under US-funded programs.” As of mid-February, court challenges from several organizations resulted in a temporary restraining order on this freeze, as the case now moves through the courts. 

Concerns have escalated about potential threats to Supreme Court protections for contraception, including the Griswold v. Connecticut decision that guarantees legal access to contraception.

• Legal experts have asserted that a footnote in Justice Alito’s majority opinion in the case of Burwell v. Hobby Lobby Stores, Inc., which held that religious protections allow employers to deny contraceptive access to employees, laid the groundwork for legally reclassifying common forms of contraception as abortion. The opinion states that the four contraceptive methods challenged by the owners of Hobby Lobby “may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus.” In a related footnote, Alito suggests that the plaintiffs' personal opinion deserves equal weight as established medical science: “The owners of the companies involved in these cases and others who believe that life begins at conception regard these four methods as causing abortions, but federal regulations, which define pregnancy as beginning at implantation…do not so classify them.”

• In his concurring opinion in the Dobbs case that overturned federal protection for access to abortion, Justice Thomas wrote that SCOTUS “should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell,” and characterized these cases as “demonstrably erroneous.”

• In June 2023, Justice Thomas referenced the Griswold decision in a concurring opinion in a decision unrelated to reproductive health issues. Thomas wrote that the Griswold decision was among a group of decisions that represented a drift away from “the limited judicial station envisioned by the Constitution.”

It is unclear how the Trump administration will approach contraceptive policy. 

In February 2025, President Trump issued an executive order in support of expanded funding for IVF treatment. Importantly, the executive order did not address the desire of some anti-abortion leaders to curb some existing IVF treatment practices. While campaigning for office in May 2024, Trump wrote, “I have never and will never advocate imposing restrictions on birth control,” a statement designed to curb speculation after he suggested earlier that states may take various positions on the issue. During his first term, his administration issued new rules that expanded the ability for employers to opt out of covering no-cost contraceptive services via their employee insurance plans. 
Various members of the Trump administration oppose aspects of contraceptive access, however, the regulatory and policy landscape regarding contraception in the new administration remains unclear. 

Congressional votes on legislation that guarantees or advances contraceptive access has largely received party-line votes, with most Republicans voting in opposition. 

In 2024, nearly the entire Republican House congressional caucus rejected the Right to Contraception Act, with many falsely claiming that guaranteeing access to contraception equates to abortion access. During the Senate floor debate on this vote, Sen. Bill Cassidy (R-LA) promoted disinformation about the definition of contraception, making false connections between the bill language and the impact: 

“The bill defines contraception so broadly that it likely also includes the right to a chemical abortion pill. It eviscerates conscious protections for health care providers outlined in RFRA. And it prioritizes abortion provider Planned Parenthood, preventing the government from funding life-affirming organizations.” 

Sen. Joni Ernst (R-IA) made similar arguments in a Senate floor debate on the legislation in 2024, saying that the bill:

“goes ‘far beyond the scope of providing access to contraception,’ creating a precedent to ‘mandate access to abortion drugs for women and girls of all ages.’”

Some Republican-sponsored legislation described as advancing contraceptive access also includes language that would reduce access. For example, the proposed Orally Taken Contraception Act of 2023 advances an anti-contraception effort to redefine contraception and exclude methods that impact the process of becoming pregnant “after fertilization.” According to leading conservative groups, this would exclude emergency contraception and the IUD — and for some conservative groups, the birth control pill.

Large numbers of Republican elected officials are on record opposing or spreading misinformation about common forms of contraception, including these medically inaccurate statements: 

House Speaker Mike Johnson, at the 2023 Louisiana Right to Life Forum: “Everybody asks us all the time: ‘Why do you guys care so much? The HHS mandate it’s just about contraception, sterilization…What’s the big deal?’ Well, those are abortifacients. The morning-after pill, as we know, is an abortifacient.”

U.S. Rep. Marjorie Taylor Greene (R-Ga.), in Scientific American: “The Plan B pill kills a baby in the womb once a woman is already pregnant.”

Former presidential candidate Nikki Haley sided with the Alabama court in conferring personhood rights to a frozen embryo:

“Embryos to me are babies…when you are talking about an embryo, you are talking about a life.” — Nikki Haley commenting on personhood for embryos

Policymakers in blue states are preparing for state-level attacks on reproductive health care and contraceptive access:  

“What we’re watching is this interplay between protective states and the Trump-Vance administration, and what impact that administration will have on state laws and access to sexual and reproductive health care.” — Candace Gibson, director of state policy at the Guttmacher Institute (Stateline)

Alliance Defending Freedom (ADF)

“We are on a winning trajectory. It may be that the day will come when people say the birth-control pill was a mistake.” —Alan Sears, ADF founder/former CEO, the New Yorker, Oct. 2023

Catholic Medical Association (CMA)

“...we assert that the use of contraceptives for family planning is unhealthy and unethical. We believe that fertility is a gift, and that a normal fertility system should not be “fixed” via contraception.” —CMA Affirms Truth of Teaching on Contraception, Dec. 2016

Heritage Foundation

“Conservatives have to lead the way in restoring sex to its true purpose, & ending recreational sex & senseless use of birth control pills.” —Heritage Foundation 2023 LinkedIn post

National Right to Life

“National Right to Life does not take a stance on anything that prevents fertilization. However, National Right to Life does oppose any device or drug that would destroy a life already created at fertilization.” —as quoted in The Washington Post, May 2022

NRL’s model legislation defines pregnancy as beginning at fertilization and prohibits anything that stops this “pregnancy.” State chapters specifically oppose emergency contraception and IUDs. 

Susan B. Anthony Pro-Life America

“Maybe your caucus gets to a point next year, two years from now, three years from now, where you do want to talk about IVF, and how to regulate it in a more ethical way, or deal with some of those contraceptive issues,” said Billy. “But I don’t think that that’s the conversation that you need to have now.” —SBA Pro-Life America Vice President of State Affairs answering a question about local activist opposition to emergency contraception and IUDs, 2022

“...And the most dangerous ones are emergency contraception pills. These are commonly mistaken as  “birth control,” but their abortive consequences are well-known…Around 10% of U.S. women use emergency contraception, abortive agents.”  —SBA List, 2011

“Conservatives should oppose the FDA’s approval of Opill and ask future Republican presidential administrations to revoke the FDA approval for Opill and other over-the-counter contraceptives.” —Michael J. New, assistant professor at Catholic University of America and senior associate scholar at the Charlotte Lozier Institute (SBA Education Fund) writing in National Review

“The complete clinical pharmacology of Plan B demands that the drug product be duly recognized as an abortifacient – or potential abortifacient – and not merely described as “emergency contraception.”  —Susan B. Anthony Education Fund (dba Charlotte Lozier Institute), Plan B: Abortifacient and Other Risks

Students for Life of America (SFLA)

“Making it easy for abusers to cover up their sexual abuse and statutory rape crimes with Online, No Test Chemical Abortion Pills or over-the-counter birth control sales is negligent public policy.”
—Students for Life of America 2023 press release and webpage on contraception

“FYI, birth control can cause abortions and your doctor probably won't tell you that,”  —X (Twitter) post, Kristan Hawkins, President of Students for Life of America