Using a Reproductive Justice Lens to Explore Contraceptive Barriers for Abortion Fund Applicants in the Rocky Mountain West

Background: Access to contraception and abortion are two tools for individuals to decide if and when they want to parent children, and are essential components of reproductive justice. Despite how crucial contraception and abortion are to exercising full control over one’s life, many barriers to meaningful access exist. This study focuses on the contraceptive experiences of abortion fund applicants to draw attention to various elements that restrict the realization of reproductive justice in the Rocky Mountain Region.

Methods: This study uses qualitative data from 830 applications to an abortion fund submitted between 2013 and 2022. The abortion fund shared de-identified participant information, including their qualitative responses to the intake questionnaire. Participant qualitative responses involved short text descriptions of why they were seeking assistance from the abortion fund, and ranged in length from one sentence to longer paragraphs. All data was coded in NVivo by a team of six researchers and analyzed using a thematic content approach.

Results: Our analysis of intake applications revealed four central themes regarding the contraceptive experiences of abortion fund clients: (1) contraceptive failure; (2) negative side effects of contraceptives; (3) lack of access to contraceptives; and (4) reproductive coercion and relationship factors. These themes highlight the individual, interpersonal, and structural factors that shaped their access to contraception. First, many applicants described intrapersonal challenges with contraception, from inefficacy and contraceptive failure to debilitating mental and physical health side effects. Second, participants identified interpersonal and relationship factors that resulted in reproductive coercion and lack of bodily autonomy. Third, applicants’ contraceptive experiences were also widely impacted by macro factors, including accessibility and affordability of contraceptives.

Implications and Conclusion: This study deepens the growing literature of the contraceptive experiences of abortion clients by calling attention to the various factors that shape and limit the realization of reproductive justice for women and pregnant people in the Rocky Mountain Region. The findings of this study suggest the need for several intervention strategies—from expanded access to over-the-counter contraception to the implementation of comprehensive sexuality education—that may reduce barriers to achieving reproductive autonomy at various levels. Expanding access to contraception and abortion care is even more critical now as federal and state government actors continue to restrict reproductive rights.