When I was twenty-two, I was diagnosed with Polycystic Ovary Syndrome (PCOS). Although I experienced symptoms for years, it wasn’t until I went a full year without getting a period that I realized I needed to book a doctor’s appointment. Luckily, I had an OB-GYN at the time who listened to my concerns and went through the process of diagnosing me. PCOS is a common hormonal imbalance that can result in irregular or absent menstrual cycles, excess hair growth, acne, weight gain, and infertility. Treatment varies and will often depend on if you want to become pregnant or not. My doctor and I ultimately decided on a hormonal IUD to manage my PCOS, since it also aligned with my preferred method of birth control.
I’ve come to rely on this form of birth control to manage my PCOS symptoms and exercise reproductive autonomy. However, increasing attacks on contraception threaten both my own and millions of others’ access to reproductive healthcare and freedom.
The Heritage Foundation came out with a report earlier this year entitled “Saving America by Saving the Family: A Foundation for the Next 250 Years.” The report builds off the conservative think tank’s Project 2025 and calls for a “whole-of-government approach,” under which every action and proposal at the federal government level should be considered through the lens of whether it encourages married couples to have more children. The report denounces IVF and same-sex marriage and threatens everything from social welfare services to no-fault divorce. Laced throughout is a call for policies and cultural shifts focused on promoting traditional, conservative family units as a way to boost the fertility rate.
Growing up, I never questioned whether I would be able to access contraception. This view came from a place of privilege, considering access to contraception has always been tenuous for people due to cost, access to healthcare, or other societal factors. This inaccessibility still persists and will be exacerbated by the policy goals lined out in the Heritage Foundation’s recent report. The vision the Heritage Foundation has for the United States’ next 250 years adds to an ongoing campaign against contraception, a campaign that has intentionally been flying under the radar.
While the express policy recommendations found in the report are troubling enough, the authors also point to the increased availability of contraception as one of the leading contributors to what they view as the “fall of family units” and declining fertility rates. Abortion and women entering the workforce were also cited as main factors for lower fertility rates.
The devastating effects of abortion bans have been felt across the country, with increased maternal and infant mortality, increased intimate partner violence, and barriers to reproductive freedom. Abortion is only the starting place, though. This report affirms that conservatives view contraception as a problem that must be removed in order to “save America.”
Anti-abortion activists have continuously conflated contraception with abortion, with the Trump administration following suit. The Trump administration threatened to incinerate nearly $10 million worth of contraception, describing it as “abortifacient birth control.” Attacks on birth control have been happening at the national and state level, with cuts to Title X funding, and state parental consent laws cutting off access to contraception for young people.
At the same time as these coordinated attacks are playing out in the policy space, fears around various forms of contraception have been spreading online. It has become common to see posts on social media about how contraception causes a whole range of health concerns such as reduced fertility, depression, or even increased chances of contracting sexually transmitted diseases. Trump’s current nominee for surgeon general, Casey Means, has echoed similar sentiments, calling contraception a “disrespect for life” and alluding to “horrifying health risks” of hormonal birth control.
Frustrations with a healthcare system that understudies and underfunds women’s health, combined with an increasing reliance on social media as a news source means that more people are relying on unvetted claims about the alleged dangers of birth control. Peer-reviewed studies show time and time again the safety and efficacy of birth control. Medical providers such as Dr. Jennifer Lincoln, MD, and Nikki Vinck, PA, as well as researchers like Emily Pfender, PHD have been using their own social media platforms to educate people about birth control and reproductive healthcare more broadly.
Yet online, legitimate questions or concerns about the side effects of contraception are often met with calls to forgo it altogether. Conservative activists reinforce these ideas and are able to capitalize on them. Disinformation and increased fear around birth control makes it easier to push through policies restricting contraception in the name of protecting women’s health.
As someone who relies on contraception to manage my PCOS, it is all too clear that attacks on birth control are not about supporting reproductive health. Millions of Americans are impacted by reproductive health conditions such as PCOS and endometriosis and rely on various forms of contraception to manage symptoms that range from irregular menstrual cycles to debilitating pain. Accessible and varied forms of contraception also give people the ability to exercise reproductive autonomy by choosing science backed methods to prevent pregnancy.
Reproductive health and reproductive freedom go hand in hand. Whether someone is using contraception to treat a chronic illness, to not get pregnant, or both, they should have the ability to make informed decisions and access the care they deserve.
About the Author: Gwynn Marotta is a Manne Legal Fellow with the Texas Civil Rights Project. She focuses on reproductive justice issues at the intersection of immigration, voting rights, and criminal injustice.


