Hours after Donald Trump was elected president for the second time, Dr. Clayton Alfonso had two messages from patients seeking to replace their IUDs. Over the next few days, three women inquired about getting their tubes tied.
All of them said the election was the reason they were making these choices now.
Requests for long-term birth control and permanent sterilizations have surged across the nation since the election, doctors told The Associated Press. And companies that sell emergency contraception and abortion pills say they're seeing significant spikes in requests from people who are stockpiling the medications — one saw a 966% increase in sales of emergency contraception from the week before in the 60 hours after the election.
"I saw this bump after the Trump election in 2016" and after Roe vs. Wade was overturned in 2022, said Alfonso, an OB-GYN at Duke University in North Carolina. "But the patients seem more afraid this time."
Although anti-abortion advocates are pressing Trump for more restrictions on abortion pills, it's unclear what — if much — will be done regarding access to contraceptives of any kind during the second Trump administration. Trump told a Pittsburgh television station in May that he was open to supporting regulations on contraception. But after media reports on the interview, he wrote on his social media platform Truth Social that he "has never and will never" advocate for restricting birth control and other contraceptives.
Alfonso said his patients want to replace still-effective IUDs and "restart" the 3-to-12-year clock on them before the inauguration. He also said the women are particularly concerned about IUDs, which have been attacked by abortion opponents who believe life begins when an egg is fertilized. Experts believe the devices work mostly by blocking fertilization, but also may make it harder for a fertilized egg to implant in the womb.
A patient who requested a tubal ligation Tuesday told Alfonso she doesn't want kids and is "just absolutely terrified of either forced pregnancy or inability to access contraception."
Pittsburgh OB-GYN and abortion provider Dr. Grace Ferguson said more of her patients are scheduling IUD insertions or stockpiling emergency contraception, telling her upfront that it's "because of the upcoming administration change."
One patient, Mara Zupko, said she wants prescription emergency contraception since she's on the cusp of the weight limit for Plan B, the most well-known over-the-counter type. Her husband is getting a vasectomy.
"We always kind of teetered on whether we wanted children or not," said Zupko, 27. "But as the world has become scarier and scarier, we realized we didn't want to bring a child into that environment. And I also have several health risks."
Women are also turning to companies that sell emergency contraception online or offer abortion pills mifepristone and misoprostol through telehealth — something that's been happening even before the election, but that some companies say has accelerated.
A study earlier this year showed the abortion pill supplier Aid Access received about 48,400 requests from across the U.S. for so-called "advance provision" pills from September 2021 through April 2023 — with requests highest right after news leaked about Roe being overturned but before the formal announcement. Other research found that more women had their tubes tied post-Roe, with the biggest increases in states that ban abortion.
Mifepristone has a shelf life of about five years and misoprostol around two years, according to Plan C, an organization that provides information about medical abortions. Plan B typically has a shelf life of four years.
Telehealth company Wisp saw orders for abortion pills spike 600% between Election Day and the following day. And between Nov. 6 and 11, the company saw a 460% increase in sales of its emergency contraception and birth control offerings.
At Gen Z-focused Winx Health, which sells emergency contraception called Restart, company leaders saw a 966% increase in sales in the 60 hours following the election compared with the week before. Sales of "value packs" of Restart — four doses instead of one — were up more than 7,000% in the past week.
"Morning after pills" are legal in all states, but Winx co-founder Cynthia Plotch said many people seem confused about what emergency contraception is compared to abortion pills. In a 2023 poll by the health policy research organization KFF, a majority of responders said they know these two things aren't the same, but only 27% reported knowing emergency contraceptive pills cannot end a pregnancy.
Doctors agree confusion around morning after pills may explain some of the stockpiling. But Alfonso at Duke suspects most people are doing this for the same reason they are seeking longer-term methods of birth control: to avoid abortion by preventing pregnancy in the first place.
Alfonso predicts the birth control and abortion pill surge may level out like it did in 2016 and 2022. If the new administration "is not focused on health care right away," he said, "then I think it'll go to the back of people's minds until it picks up in the media."
