The number of abortions in the United States has risen in recent years, and one hypothesis circulating among researchers is that a cultural backlash against hormonal birth control is producing more unintended pregnancies. Whether that is true has not been established, and the researchers closest to the data disagree.
The question surfaced in NPR reporting published this week, which laid out the competing explanations without resolving them. The disagreement is instructive, because it shows what the available evidence can and cannot answer.
For readers making their own contraception decisions, the practical takeaway sits underneath the epidemiological dispute: the research on whether hormonal contraception is safe and effective is not the part that is uncertain.
The Competing Explanations for the Trend
Cynthia Harper, a contraception researcher at the University of California, San Francisco, considers the birth control hypothesis worth testing. "There is definitely a social media phenomenon of wellness influencers with non-evidence-based personal experiences that are just ricocheting through the stratosphere," she said, describing it as overlapping with an ideology holding that women should be at home having children young. "These two things have come together, and contraception has never been so maligned," she said.
Harper also pointed to access. Federal funding has been cut for reproductive health providers across the country and for the health system more broadly. "Everything I see points to lower access to contraception," she said.
Testing the hypothesis would require specific research. Harper said you would have to survey people accessing abortion care and ask whether restricted access to contraception was the reason for the pregnancy.
Brittni Frederiksen, a women's health policy researcher at KFF, offers a different explanation. "I actually think the number of abortions going up is likely just due to increased abortion accessibility, particularly with telehealth medication abortions," she said. In that method, patients obtain abortion pills from a pharmacy or in the mail after a telehealth visit, and its use has grown dramatically since becoming available during the pandemic.
Frederiksen points to survey data that does not show the contraception decline the hypothesis requires. In KFF's biennial women's health survey, 82% of sexually active reproductive-age women were using contraception in 2024, and 6% were not, with the remainder pregnant, trying to conceive, or unable to conceive. Reviewing preliminary 2026 data, she said the shares using contraception look pretty similar.
The Gap Between Attitudes and Behavior
Both researchers may be describing real things. Cultural attitudes toward contraception can shift while aggregate use stays flat, particularly if changes are concentrated in specific groups or in which method people choose rather than whether they use one.
Caitlin Bernard, an OB-GYN in Indianapolis who helps lead a statewide free birth control program, described what she observes in practice. Her patients are not talking much about the state abortion ban that has been in place for years. "This is just the normal status quo now," she said, adding that other considerations are more top of mind.
What patients are weighing, she said, is whether they would rather take a pill or have an IUD, and whether insurance would cover both options. She also sees patients worried about finances generally and avoiding doctor visits to steer clear of unexpected medical bills.
Bernard did identify one factor she believes is affecting decisions: social media, and the rise of Make America Healthy Again and trad wife influencers, both delivering messages about hormonal birth control being bad for women.
Frederiksen noted that funding cuts affecting access are occurring in ways that may not be visible in the data yet, which is a reminder that survey snapshots lag behind changes on the ground.
The Separate Question of Whether the Pill Is Safe
The contested question is whether contraception trends explain abortion trends. The underlying claim circulating on social media, that hormonal birth control is dangerous, is a separate matter with a clearer evidentiary picture.
Research indicates hormonal contraceptive options are safe and effective at preventing pregnancy. Analyses of social media content have found that many videos exaggerate potential side effects while minimizing the downsides of non-hormonal alternatives, and that most such videos are posted by people who are not medical professionals.
That does not mean hormonal contraception is free of side effects or right for everyone. Different formulations affect people differently; some people experience mood or bleeding changes that make a method unsuitable, and certain conditions, including a history of blood clots, some migraines with aura, and uncontrolled hypertension, affect which options are appropriate. Those are conversations for a clinician, not a comment section.
After the Supreme Court overturned Roe v. Wade in 2022, documented shifts did occur. Research confirmed a real increase in IUD and implant use and a spike in vasectomies and tubal ligations, indicating people were moving toward longer-acting and permanent methods rather than away from contraception.
The Questions That Remain Open
No study has yet tested whether restricted contraception access is driving individual decisions to seek abortion care, which is the specific research Harper identified as necessary.
Several other things remain unresolved. Whether the preliminary 2026 survey data holds after full analysis. Whether funding reductions affecting reproductive health providers will show up in later measurement periods. And whether a high-profile legal case originating in Louisiana, which aims to remove telehealth medication abortion as an option nationally, will alter the accessibility factor Frederiksen identifies as the likely driver.
For individuals, none of this changes the practical guidance. Anyone choosing or reconsidering a contraceptive method should base the decision on their own medical history and preferences in consultation with a clinician rather than on social media claims. Most insurance plans cover contraception without cost sharing, and federally qualified health centers and Title X clinics provide services on a sliding scale. Anyone experiencing side effects they find unacceptable should ask about switching methods rather than stopping without a replacement. MedicalDaily has covered other shifts in preventive women's health services and the narrowing of rural obstetric access.
Key Questions Answered
What is the question researchers are examining? Whether a cultural and online backlash against hormonal birth control is reducing contraception use and therefore contributing to the recent rise in abortion numbers in the United States.
Has that link been established? No. One researcher calls it an intriguing hypothesis that would require surveying people accessing abortion care to test. Another attributes the rise primarily to increased accessibility of telehealth medication abortion.
What do the survey data show? KFF found 82% of sexually active reproductive-age women using contraception in 2024, with 6% not using it. A preliminary look at 2026 data suggests similar shares.
Is hormonal birth control safe? Research indicates hormonal options are safe and effective at preventing pregnancy. Analyses of social media content have found many videos exaggerate side effects, and most are posted by people without medical expertise.
Does that mean it suits everyone? No. Side effects vary, and conditions including a history of blood clots, certain migraines with aura, and uncontrolled hypertension affect which methods are appropriate. Those decisions belong with a clinician.
Did contraception use change after 2022? Yes. Research documented real increases in IUD and implant use and a spike in vasectomies and tubal ligations, indicating a shift toward longer-acting and permanent methods.
Where can someone get affordable contraception? Most insurance plans cover it without cost sharing. Federally qualified health centers and Title X clinics provide services on a sliding scale regardless of insurance status.
