Adequate Information Can Help Unlock Youth Birth Control Access

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Adequate Information Can Help Unlock Youth Birth Control Access

November 27, 2024
An illustration of a school locker created by rewire.com.

This was originally posted on rewire.com on November 18. 2024.

In the wake of the election, we must continue the important work of defending and expanding access to birth control across the United States now more than ever. Many barriers to access, such as too few clinics, parental consent requirements, and not having a trusted provider, impact how birth control is provided in this country. But other barriers to care, like limited awareness of the full spectrum of birth control methods and concerns about using these methods, influence whether and how individuals seek out and use birth control.

As Power to Decide marks its 12th Thanks, Birth Control campaign, we reflect on findings from our new Youth Reproductive Health Access Survey (YouR HeAlth) Survey that point to sizable gaps in what young people know about birth control. Birth control information gaps need to be addressed with medically accurate, trustworthy resources to support young people’s access to sexual and reproductive health care.

Power to Decide’s YouR HeAlth Survey aims to understand young people’s knowledge, attitudes, and experiences with sexual and reproductive health information and services. The 2024 YouR HeAlth Survey was fielded this past summer via Ipsos KnowledgePanel, the largest online probability-based panel in the U.S. About 1,200 people aged 15 to 29 years old who were assigned female at birth completed the 2024 survey.

About one-quarter of young people indicated that they do not have enough information to make a decision about whether using birth control now is right for them, and nearly one-third said that they do not have the information they need to decide what method is right for them. Notably, even more 15 to 17-year-olds reported these information gaps. Prior research suggests that people can better access the right birth control method for them if they have enough information about birth control.

The YouR HeAlth Survey also included 11 true-or-false statements to measure knowledge. For example:

  • Nearly 1 in 5 incorrectly think that people should “take a break” from birth control pills every couple of years for health reasons.
  • About 1 in 4 incorrectly think that menstrual cycle tracking apps are highly effective at preventing pregnancy.
  • About 30 percent incorrectly think that teenagers cannot access over-the-counter birth control pills.

Findings from this assessment align with self-perceptions of knowledge gaps. On average, participants answered less than half of the statements correctly, and many participants selected “I don’t know” to each statement. We found that a higher proportion of 15 to 17-year-old participants answered incorrectly or indicated they did not know.

When asked about their concerns about birth control, about one-third of respondents said they worry birth control could affect their ability to have a baby later in life. This concern is unfounded; no method of birth control, other than sterilization, affects someone’s ability to become pregnant once they stop using it.

It is striking that these findings are similar to knowledge gaps identified by Power to Decide more than a decade ago. There are many potential explanations for why we have not made more progress (for example, inadequate school-based sex education and growing mis- and disinformation online), but one that has not been widely discussed is how our public health approach has changed. We have made a welcome and long-overdue shift away from narrowly focusing on (and to varying degrees, stigmatizing) individual knowledge, attitudes, and behaviors. Now, the emphasis is rightly on systems and structures, such as clinical care and the policy environment.

As a public health behavioral scientist trained to examine individual behavior within this larger context, I couldn’t agree with this shift more. It is critical for acknowledging and addressing the racism, sexism, classism, and other systems of oppression that have driven disparities in access to quality sexual and reproductive health care. The importance of improving systems to provide birth control in a person-centered manner that meets individuals’ values, needs, and preferences cannot be understated.

However, in widening our lens beyond the individual, we cannot forget about individuals’ knowledge and attitudes. We need to consider how larger systems and structures influence what young people know and think about birth control. We need to shape the larger systems to ensure that young people get trustworthy, resonant, and medically-accurate information that empowers them to navigate our complex health-care system and make informed decisions that support their sexual and reproductive well-being. This information is especially essential for young people who are learning to seek out and obtain health care independently.

So, let’s give young people the information they deserve, while prioritizing people-centered principles. Doing so means respecting people regardless of their level of knowledge, and it means recognizing and addressing misconceptions about birth control rather than dismissing them.