States of Uncertainty: Contraceptive Decision-Making in U.S. College Health Centers after Dobbs and the 2024 Election

Abstract

In 2022 the United States Supreme Court eliminated the federal protection for abortion access in the landmark decision Dobbs v. Jackson Women’s Health Organization. In the three years since, states have passed protective and restrictive abortion legislation, creating a patchwork of laws across the country. The recent 2024 election and the beginning of Donald Trump’s second presidential term have created new political influences in healthcare, which are ongoing. This study aimed to understand how these political flashpoints have affected contraceptive decision-making and counseling. I interviewed medical professionals working in college health centers to gain valuable insight into how patients in the early stages of their reproductive lives are making contraceptive decisions and how providers are helping to navigate these uncertainties and anxiety-laden decisions. Legislation and politics affect healthcare decisions on the individual level, prompting providers to counsel with such considerations in mind—attempting to balance their patients’ concerns, best healthcare practices, state laws, and uncertainties about the future.