Up until Iowa’s six-week abortion ban was signed into law on July 14, 2024, University of Iowa student Julia Moody viewed birth control as a reliable option.

She began taking the pill in seventh grade for health reasons and was on the medication until this past fall. But when Iowa’s abortion ban kicked into place, Moody no longer felt she could depend on access to birth control pills.

When Iowa’s near-total abortion ban was enacted in July, Moody felt scared and uncertain, so she sought a long-term option for birth control. She went to her doctor for an intrauterine device, or IUD, a long-acting reversible form of contraception.

“I just felt that an IUD would be a good, preventable option, especially because of its longevity,” the UI second-year student said.

Moody experienced painful cramps for weeks after getting the IUD — which is common — and said the procedure was agonizing, but she decided to go through with it for fear of no longer having access to birth control.

“The [IUD] I have is good for eight years, meaning it will outlast the Trump administration, and it is very effective.”

Roughly six months later, when President Donald Trump’s second term in the Oval Office was confirmed, these feelings of uncertainty resurfaced for Moody.

She stocked up on Plan B, an emergency contraceptive, also known as the morning-after pill. Worrying she would no longer have access to the medication, she grabbed several pills when they were offered for free to students in the lobby of her residence hall.

“I thought, ‘Why not?’” Moody said. “Because who knows if it’s going to be legal to even buy Plan Bs in the future.”

Moody’s actions follow a national trend caused by the overturning of Roe v. Wade and Trump’s second term, stirring up worries regarding access. Thousands sought long-term birth control options and stockpiled emergency contraception.

Planned Parenthood North Central States, or PPNCS, reported a spike in long-acting reversible contraception appointments, such as IUDs, following Trump’s 2024 election. The organization experienced a 150 percent increase in such appointments in November 2024, according to a Nov. 21 news release.

PPNCS provided more than 1,000 IUDs and implants — also known as Nexaplon — between January and March 2017, following Trump’s first inauguration.

These trends are similar to surges seen under Trump’s first administration, and now, Iowans must also navigate obtaining reproductive health care, including birth control and emergency contraception, such as Plan B, under the state’s abortion ban.

Project 2025, a blueprint for more conservative policies penned by the right-leaning Heritage Foundation — which Trump has implemented several policy proposals — calls to remove Ella, a prescription emergency contraception pill, from most health care plans. The plan would rescind no-cost coverage of some forms of emergency contraception and would override the Affordable Care Act, which requires most private health insurance plans to provide no-cost coverage of multiple birth control options.

The Trump administration paused $27.5 million in funding for organizations that provide family planning, contraception, and other reproductive health services, such as cancer screenings, on March 31.

The National Family Planning and Reproductive Health Association reported 16 organizations received notice on March 31 that funding is on hold, according to The Associated Press, including at least 11 Planned Parenthood Federation of America regional affiliates and all recipients of federal family planning grants in seven states.

The funding will reportedly continue to be withheld while the federal government investigates whether the organizations comply with the law.

States with restrictive abortion bans, such as Iowa, have experienced sharp declines in prescriptions for birth control and barriers to accessing emergency contraception.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022, Iowa and three other states have experienced a decline in access to contraceptives, according to a 2024 study by the Guttmacher Institute.

The study found that the percentage of Iowans who reported delays or trouble accessing their preferred contraceptive method increased from 7 percent to 10 percent after the Roe v. Wade decision.

Many women stockpiled emergency contraception in fear of limited access or an outright ban under the Trump administration. Sales for emergency contraception spiked by 1,000 percent on Nov. 6 — the day after Trump was elected for a second term — on Wisp, a nationwide online pharmacy focused on sexual and reproductive health, according to the company’s CEO, Monica Cepak.

The Family Planning Council of Iowa, a nonprofit dedicated to providing family planning and contraceptive resources, has distributed roughly 8,400 reproductive health care kits, called Keeping Iowans Sexually Savvy, or KISS, kits.

Tara Shochet, director of programs and grants for the nonprofit, said political developments usually cause increases in demand for the items in these kits because people are worried about accessing care.

Before Iowa’s abortion ban, the nonprofit averaged 45 orders for the kits per month, which nearly doubled to 80 a month after the ban went into effect. In the 48 hours after the results of the 2024 election, about 100 orders for kits were put in, and there has been an average of 100 orders a month ever since.

Schochet said the emergency contraception provided by the nonprofit is donated, and the organization has noticed some of the national organizations providing these donations are restricting how much they can provide because of such high demand across the country.

She said while Iowa’s abortion ban does not include emergency contraception, she is concerned it may still impact Iowans’ access to the contraception of their choice.

“In theory, the ban is not about contraceptives and shouldn’t be about contraceptives, but I think there are a variety of ways in which it can and will impact access, certainly,” she said.

She said although there is not yet a ban on contraception, a potential limit to access discussed in political spheres can and will impact what type of contraception is available, how it is available, and how comfortable certain providers are carrying it.

“The real impact, the real fallout that we’re going to see, is yet to be determined,” Shochet said.

Iowa City activists and UI campus leaders have worked to create partnerships to ensure students and residents still have access to emergency contraception.

IC orgs partner to provide access

The UI’s Women’s Resource and Action Center, or WRAC, partnered with the Family Planning Council of Iowa roughly three years ago to provide free reproductive health care kits.

The council provides the kits free of charge, and WRAC makes them available to students at their location on campus.

Tucked into a purple plastic bag, the kit contains an informational booklet about sexual health, condoms, a pregnancy test, and two doses of an emergency contraception pill.

The partnership began roughly three years ago, and WRAC Director Linda Kroon said almost 2,000 kits have gone out the door over the past two years.

Kroon said demand has increased at least 50 percent this year.

This bump has moved upward this school year, Kroon said, and may have been sparked initially by the abortion ban and students returning to campus, then continued through Trump’s win into his second presidency.

Kroon said the kits reduce barriers so students can make their own decisions. Sometimes, students grab two or three kits in one go, Kroon said.

“We let it be known that there are free products available here, and if people want to take advantage of them, they can,” Kroon said. “I think that’s a great way for a public university to operate.”

The Domestic Violence Intervention Program, or DVIP, which absorbed the Rape Victim Advocacy Program in October 2024, is another resource for individuals seeking access to contraceptive care.

Alta Medea, DVIP’s director of community engagement, said the organization provides support for those who experience reproductive abuse, which involves acts such as damaging or corrupting contraceptives, withholding contraceptives from a partner, or impregnating a partner quickly after they have given birth.

Medea said DVIP’s advocates can help individuals leave these situations and assist them with access to new prescriptions.

She added birth control is a necessary tool for women to establish autonomy and freedom.

“Individuals, whether they’re victims or not, having access to scientifically proven reproductive care is part of their ability to make decisions for themselves, have economic security, and autonomy,” she said. “When we limit access, we limit an individual’s ability to make decisions that fit their lives.”

DVIP also has advocates available to victims of sexual assault who choose to get a Sexual Assault Nurse Examination at the hospital. Part of the advocate’s role is to help educate the victim about medication options during the exam, which may include an emergency contraceptive.

“Allowing medical professionals and the individual to make the most appropriate choice for the victim is really what’s important,” Medea said. “It’s not our place to make a determination, or anyone else. It’s really a decision between a medical provider caring for their patient and getting them the resources they need.”

The UI Undergraduate Student Government, or USG, has also launched an initiative to provide access to contraceptives for university students and Iowa City residents.

Through a partnership with the Emma Goldman Clinic — a
nonprofit women’s health care clinic that provides abortion and gynecology services, safe sex promotion, and education — USG is distributing free Plan B. Normally, Plan B costs around $50 out of pocket in pharmacies.

USG President Addison Eckard said the company Plan B One-Step donated 365 pills for distribution on campus, and most of the pills are still available for pickup at the Emma Goldman Clinic on 227 N. Dubuque St.

The pills come in a discreet, brown paper bag, and anyone can just walk in and grab one within minutes, Eckard said.

Brenda Ramirez, USG’s vice president, said the organization initially wanted to distribute the pills in the wellness vending machine it opened in the Iowa Memorial Union this fall, but providing medication proved too much of a liability for the university.

However, despite the pills being distributed off-campus, Eckard emphasized the importance of birth control access for college students.

“Anything that’s able to help students be in a mindset where they can stay in school and be healthy is super important to us as individuals and to student government,” she said. “We advocate for students, so if you’re not a student, we can’t do much to help you. I think especially Iowa, with the reproductive piece [abortion ban], students need to be educated on their rights and resources, and that’s maybe where that bridge to student government can come in.”

Students face access barriers

Accessing reproductive health care may be more difficult for college students specifically, Kroon said, considering they are likely navigating being on their own for the first time, being away from their primary care provider, and potentially experiencing financial strain.

A motivator behind offering the reproductive health kits, Kroon said, was reducing the economic barrier for students.

The cost of Plan B One-Step, a popular over-the-counter, single-dose emergency contraceptive pill, ranges from $40 to $50. Generic brands like Take Action or My Way can still cost up to $40, according to Planned Parenthood.

“We get students from all different kinds of places in society, some of whom have less means than others,” Kroon said. “Some folks are depending on scholarships and loans and jobs — plural — and adding any place that we can relieve any of that burden, I think, is a good thing.”

The center is meant to help students succeed, Kroon said, and having access to the items in the kits allows students to reach their ideas of success.

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“As part of the university here, we’re really trying to help students succeed, and success is defined by that student,” Kroon said. “In my mind, if someone is like, ‘OK, I’m pregnant, I’m going to become a parent, and that’s what I want to do,’ and they get to do that, then that’s success for that student. However, most people come to college intending to complete a degree, and so we want people to be able to do that because that’s what [they] want to do.”

Lyz Lenz, chair of the board of directors of the Iowa Abortion Access Fund, said she worries her 14-year-old daughter may not have access to reproductive health care when she goes to college.

Lenz said she was sexually assaulted in college and was able to get emergency contraception from a Planned Parenthood clinic, and she questions whether her daughter will have the same resource.

“I think about sending my own daughter to school, and will she be in a place where she can get that?” Lenz said.

Lenz said she worries reproductive health clinics will close due to abortion bans, which happened in the Hawkeye state.

Iowa once had six clinics that would provide abortion care, Lenz said; now, the state only has two brick-and-mortar clinics: Emma Goldman in Iowa City and a Planned Parenthood clinic in Ames. Lenz said as a parent to a young woman in Iowa, she has stockpiled the morning-after pill.

“That’s insane to me that we now live in a state where you can’t just trust that you can go to the doctor to get care, that you have to stockpile medicine and do all these things,” she said.

Lenz worries for her daughter’s access to care in the future when she is on a college campus.

“It’s not just about like is my daughter going to be able to get an abortion, but is she going to go to school in a state where, if something happens, she can get the care she needs?” Lenz said. “Is she going to be able to have a clinic next to her university? I mean, these are the things that people now have to think about. In addition to what are you going to major in, are you going to go to a school and not be able to go to the doctor or get birth control or get emergency contraception after perhaps one of the worst things that may ever happen to you?”

Out-of-state strain

Iowa’s abortion ban not only impacts the state but also strains the resources of bordering states helping those who cross state lines to receive care.

Iowans are traveling to border states where abortion laws are far less strict.

Abortion is not restricted based on gestational duration in Minnesota, according to data by the Guttmacher Institute.

Abortion is legal in Illinois until fetal viability, generally 24-26 weeks into a pregnancy. The state has a shield law to protect abortion providers from investigations by other states and a state law that protects privacy for patients. The data shows that abortion is banned at 22 weeks in Kansas and 20 weeks in Wisconsin.

The number of Iowans who need support to cover the cost of abortion care and out-of-state travel has surged.

According to a Feb. 27 news release from the Chicago Abortion Fund and the Iowa Abortion Access Fund, 625 Iowans received abortion funding and practical support from abortion funds outside of the state in 2024, compared to 194 in 2023.

This is a 222 percent increase in just one year.

Six months after the Iowa ban in July 2024, nearly 370 Iowans traveled to a neighboring state for abortion services, according to the news release from the Chicago Abortion Fund.

These surges in numbers impact the region, significantly straining abortion funds and increasing appointment wait times in some states.

Nebraska and Wisconsin clinics are experiencing three to five-week wait times.

Minnesota and Kansas clinics have two to three-week wait times, which delays care for both locals and out-of-state travelers, according to the news release.

Alicia Hurtado, communications and advocacy director of the Chicago Abortion Fund, said the data is the most recent, and the increase with need is coupled with hurdles and barriers people seeking abortion care face when needing to travel out of their state.

The Iowa Abortion Access Fund and the Chicago Abortion Fund partnered before Iowa’s near-total abortion ban, drawing on lessons learned from other states where bans took effect sooner. The Iowa organization is still operating, but now all calls are directed to the Chicago Abortion Fund.

Hurtado said the fund has seen a 185 percent increase in call volume after the implementation of Iowa’s six-week ban. The fund provides one-on-one case management for people seeking abortion care, and, as Hurtado said, they have hired more support coordinators to help with the influx of need.

Hurtado said the trend of increasing call volume is influential in day-to-day operations, as they are fielding hundreds of calls a week and working to provide personalized and individualized support.

“It’s been really an exercise of flexing the resources that we do have, being creative, and forming partnerships with folks like the Iowa Abortion Access Fund to ensure that we’re kind of all working together to make sure that there’s no interruption in health care, especially for folks in our space that have a time-sensitive health care need that they can’t necessarily wait around for or wait for a better time,” she said.

Iowa’s abortion ban and potential barriers to access birth control and emergency contraception will only have negative outcomes, Moody said.

Access to birth control and contraception is important for Iowans, she said.

“It is a woman’s right to have an abortion,” Moody said. “Her reproductive health should be between her and her doctor and nobody else.”