“I didn’t need to suffer”: The Impact of the Covid-19 Pandemic on the Contraceptive Decision-Making of College-Aged Women

Abstract

Since March of 2021, the Covid-19 pandemic has caused interruptions in contraceptive access and sexual and reproductive health care across the United States. For college students, the pandemic has also meant drastic changes in social connectivity, sexual activity, and privacy that have the potential to affect the way they navigate their reproductive choices. The Covid-19 pandemic thus poses a unique set of circumstances under which to examine the contraceptive decision-making of college-aged women. How do women in their final two years of university think about their contraceptive decisions during the Covid-19 pandemic? What do these considerations tell us about how they think about their contraceptive realities more generally?

Through the quantitative analysis of survey data and thematic analysis of in-depth interviews, this thesis found that while college-aged women typically make harm minimization calculations that center pregnancy aversion, the Covid-19 context reframed these considerations. In the absence of consistent sexual activity, contraceptive affordability emerged as a primary concern. While some respondents reevaluated their toleration of dissatisfaction for the sake of pregnancy prevention, others held to ideals of hormone and menstrual regulation. Contraceptive choices were further determined by dismissive providers and coercive sexual partners, from whom respondents encountered fierce condom resistance among other autonomy violations. Respondents underestimated STI risk and echoed mainstream feminist parley on birth control and freedom, which came into conflict with their shared experiences. In the face of future social disruption, improvements in financial access are sorely needed, and in the pursuit of sexual and reproductive health care that revolves around patient preferences and satisfaction rather than a preoccupation with unintended pregnancy, a reorienting of contraceptive research, care, and policy is required.