Report: Opposition to Contraception & IVF

“Conservative attacks on birth control could threaten access.”

The Washington Post, June 2024

The Supreme Court’s Dobbs decision pushed long-simmering opposition to contraception to the forefront. The “personhood” movement, long considered fringe and an electoral liability, has now moved closer to the heart of the anti-abortion movement and is threatening IVF and contraception.

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

1. Alter the definition of pregnancy used by the government 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.

Some groups oppose all contraceptive methods with the potential to prevent implantation in the uterus; some have aligned only on two methods, emergency contraception and the IUD. In Dec. 2022, the FDA changed the labeling of Plan B One-Step, a common emergency contraceptive, to clarify that “evidence does not support that the drug affects implantation or maintenance of a pregnancy after implantation, therefore it does not terminate a pregnancy.” Nevertheless, no anti-abortion group changed their position on emergency contraception as a result of that clarification.

Conflating when “life” begins and when pregnancy begins

Messaging regarding contraception 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 “when human development begins.” These terms are not necessarily synonymous with when pregnancy begins. 

Some anti-abortion leaders describe the anti-abortion distinction between contraception and abortion as “hinging on whether one considers abortion to be ending a pregnancy or ending a life.” This approach aims to replace policy that relies on established medical science about pregnancy with policy that reflects a particular religious interpretation of “life.”

Opposing contraceptive methods by reclassifying them as abortion

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 are instead for 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 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.”  

The chart below describes the range of anti-contraception positions and actions of leading groups.  All of these groups align on the effort to redefine contraception.

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 SCOTUS decision that is not about 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.”

Many anti-abortion leaders are unwilling to support pro-contraception legislation or are working against common forms of contraception by reclassifying them as potential abortifacients.

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.

In 2024, nearly the entire Republican 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 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 made similar arguments in a Senate floor debate on the legislation in 2022:

 “The so-called Right to Contraception Act…defines contraceptive in such a broad way that it includes drugs that induce an abortion weeks or months into a pregnancy.”

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

As President, Donald Trump rolled back insurance coverage of contraception and attacked the network of family planning clinics across the country. Now as a presidential candidate, he first announced potential restrictions to contraception and then reversed course. 

The Heritage Foundation’s Project 2025, a blueprint for a possible second Trump administration, recommends eliminating coverage of emergency contraception under the ACA’s women’s preventive health coverage requirement, calling it a “potential abortifacient.” Considering that most anti-abortion Republicans avoid appearing to oppose birth control by redefining birth control in a way that classifies some forms as abortion, it is clear that a potential second Trump presidency will pose a grave threat to contraception.

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

In a media landscape permeated with misinformation and disinformation about reproductive health, it is critical to clearly define and consistently use accurate medical terms when discussing pregnancy. 

Also see ACOG’s dictionary here.

Abortifacient ⚠️ (medical term; often mis-used)

Any substance used to terminate a pregnancy.

“Abortifacient contraception” ⚠️ (non-medical term; not neutral)

A disinformation term coined by anti-abortion leaders to falsely claim that some contraceptives end an existing pregnancy. This term has no medical meaning and should not be used.

Abortion 

Abortion means ending a pregnancy. There are two main options: an abortion procedure (also called in-clinic abortion) and the abortion pill (also called medication abortion). Both are safe and effective.

Conception ⚠️ (not neutral)

Medically, conception occurs at implantation, which is the start of pregnancy. However, the term “conception” is understood differently among various groups — some organizations, such as the Catholic Church, use the term to indicate fertilization. Even among trusted medical sites, conception can be defined differently. 

Groups that oppose abortion and contraception have embraced this term as a synonym for “fertilization,” and its use can be a dog whistle for an anti-contraception agenda.

Avoid this term due to public confusion about its meaning and its partisan signaling; if used, it should be clearly defined and sourced in the copy to reduce confusion. 

Contraception ✅ (medically accurate term; neutral term)

Birth control and contraception are synonymous, though contraception can often be used for a purpose other than preventing pregnancy, such as treating menstrual pain, acne or other conditions. These terms refer to devices, medicines or procedures used to prevent pregnancies, with the beginning of pregnancy defined as implantation. Pregnancy cannot be detected until after implantation, when the body begins to produce pregnancy hormones. While contraception prevents pregnancy, it cannot end a pregnancy.

Embryo ✅(medically accurate term; neutral term)

The stage of development that starts at fertilization (joining of an egg and sperm).

Emergency contraception pills ⚠️ (medical term often misused)

There are two different types of emergency contraceptive pills (levonorgestrel, commonly referred to as Plan B, and Ulipristal acetate). They are both designed to prevent ovulation after unprotected sex. Their primary mechanism is to prevent or delay an egg leaving the ovary, thus preventing fertilization. In spite of the FDA’s updated labeling that clarifies it does not prevent implantation, some inaccurately claim that emergency contraception may also prevent fertilization or implantation. Note: Certain intrauterine devices (IUDs) can also be used for emergency contraception. Emergency contraception (pills and IUDs) cannot terminate a pregnancy that has already begun.

Fertilization ⚠️ (medical term often misused)

When a sperm and an egg fuse, this is called fertilization, which creates an embryo. While this is an essential step towards pregnancy, this is NOT when pregnancy medically begins. For example, an egg fertilized in a petri dish cannot become a pregnancy until that fertilized egg is successfully implanted in the uterus. In the absence of contraceptive use, only about 50% of fertilized embryos will successfully implant.

Fetus ✅ (medically accurate term; neutral term)

The stage of human development beyond eight completed weeks after fertilization. This is the stage after pregnancy has begun. Medically, the beginning of pregnancy is called implantation.

Hormonal Contraception

Hormonal contraception methods contain hormones that prevent pregnancy. These hormones prevent the body from releasing an egg each month. Methods include birth control pills, skin patches, vaginal rings, the implant and an intrauterine device (IUD). While the primary mechanism is to prevent fertilization, some hormonal methods have the potential to also prevent implantation.

Implantation ✅ (medically accurate term; neutral term)

The process wherein the fertilized egg implants in the uterine lining, and pregnancy medically begins. When a fertilized egg implants, the body begins to create pregnancy hormones to support the uterine lining. This is the hormone that is detected in a pregnancy test. Note: Prior to this phase, a pregnancy test will not work.

Life or “when life begins” ⚠️ (non-medical term; not neutral)

This term should not be used to reference when pregnancy begins. Opponents of abortion and contraception frequently use the phrase “when life begins” in a way that can add confusion to medical and legal discussions about pregnancy. This term is often used in “personhood” legislation (see “Personhood” definition, below). Given the lack of public consensus on the meaning of the term “life” or “when life begins,” this terminology can spur confusion and misinformation in media reporting or polling.

“Personhood” ⚠️ (non-medical term; not neutral)

Anti-abortion leaders use the concept of personhood to extend the legal rights of a person prior to birth. Many “personhood” proponents use the 14th Amendment as the constitutional basis for this standard.

There are two types of “personhood” proposals: “fetal personhood,” which applies to a fetus in the womb, and “embryo personhood,” which applies to the pre-pregnancy embryo stage. Personhood statutes threaten access to contraception, IVF and abortion.  

​​“Pre-implantation chemical abortion” ⚠️ (non-medical term; not neutral)

A disinformation term coined by anti-contraception advocates with no medical meaning. Any device or substance that prevents implantation is contraception. In this misdefinition, “chemical abortion” is being used as a substitute for “contraception.” This term should not be used.

Pregnancy ✅ (medically accurate term; neutral term)

The gestational stage medically begins at implantation, during which a person carries a growing fetus in their uterus. Note: Many health care providers date a pregnancy from the time that a pregnant person has had their last menstrual period, for the purpose of calculating a due date. However, this is not the same as when pregnancy has medically begun.

The Pregnancy Process ✅ (medically accurate term; neutral term)

Refers to the entire process of becoming and being pregnant. This is distinct from the specific gestational stage of when a pregnancy medically begins, detailed above.

​​“Restorative Reproductive Medicine” ⚠️ (non-medical term; not neutral).

This is a political term used in some legislative proposals that refers to non-IVF fertility approaches. It uses Catholic-affiliated fertility programs and is not a substitute for IVF.

“Unborn human being” ⚠️ (non-medical term; not neutral)

Do not use. This is not a medical phrase. This phrase is used by groups and policymakers that oppose abortion and contraception to advance “fetal personhood”-style legislation that would ban most forms of contraception and IVF.