In the days following Donald Trump’s victory in the 2024 election, Americans stocked up on their birth control and pregnancy management options amid the looming threat to access by the president-elect’s association to conservative playbook Project 2025. According to ABC News, Google searches for “birth control” and “Plan B” spiked the day after the election, with the surge starting as early as Nov. 2. Winx Health, an online sexual health retailer, reported a 966% jump in sales for their morning-after pill in the 72 hours after the election was called.

“One of the things that’s most interesting here, I think, is that we’re not seeing people buy single doses of this product. Women are buying the value pack. They’re buying in bulk,” Winx founder Cynthia Plotch told West Palm Beach, Florida’s WPTV in November.

Sara Neill, a physician-researcher in the department of obstetrics and gynecology at Beth Israel Deaconess Medical Center and Harvard Medical School shared concerns from a patient replacing her IUD years before medically required in a Dec. 19 TikTok video.

“She was actually worried that because of the next Donald Trump presidency that she wouldn’t be able to get her IUD exchanged when it was actually needed so she was actually coming in preemptively to see if she could get an IUD exchange before he became president again,” she said. “It’s hard because I really can’t give her a for-sure answer. The sad thing is that things that we already thought would never happen, have happened.”

As Inauguration Day approaches, concern for the future of products like birth control pills revs up. A vast number of Americans rely on contraception to address hormonal health needs and prevent unwanted pregnancies, which has become an increased concern given the additional barriers to accessing abortion since Roe v. Wade was overturned. According to KFF, 90% of women between 18 and 64 have used contraception at some point of their lives and 76% have used more than one method.

In November, Dr. Brittany Cline, an OB-GYN at Northwestern Medicine in Chicago, spoke about her office’s uptick in demand for birth control counseling and long term options.

“On Monday, I used all of our intrauterine devices that the clinic had, and I think that this is going to continue over the next few months and even years down the line, as people try to take some control over their bodies,” Cline told ABC News.

Is birth control threatened under a second Trump term?

Project 2025, an almost 900-page presidential playbook outlined by conservative think tank the Heritage Fund, may not call for a full-out ban on contraception but does propose limiting how people can access it. Under the Affordable Care Act’s federal contraceptive coverage guarantee, most private insurance plans are required to cover contraception without charging copays or deductibles. Guttmacher Institute, a sexual and reproductive health research organization, reports that after the policy took effect in 2012 it eliminated costs for many privately insured women, with 67% of those using birth control pills paying no out-of-pocket fees, up from just 15% who didn’t pay before. According to the National Women’s Law Center, this saved Americans $1.4 billion in birth control pills in 2013 alone.

Free or low cost coverage is vital as cost is a major barrier for people accessing care. A 2022 KFF report revealed that 3% of privately insured women cited cost as a barrier for continuing use, while one-in-five uninsured women of reproductive age stopped using contraceptives because they couldn’t afford it. Trump’s first presidency may foreshadow rollbacks the president-elect could make in his second term. In 2020, the Supreme Court ruled in favor of his administration’s allowing employers to opt-out of the no-cost contraceptive guarantee if they had a religious or moral objection, which resulted in an estimated 126,000 women losing birth control coverage from their employers.

On the campaign trail, Trump was not explicit in his approach to contraceptives. In May, he didn’t directly answer whether he opposed a person’s right to contraception, instead stating that he had a policy coming soon.

“Things really do have a lot to do with the states and some states are going to have different policy than others,” he told KDKA-TV in Pittsburgh.

Though he has yet to reveal a policy, Trump took to social media after the interview to clarify that he did not want to ban birth control, although his campaign later stated that he was speaking on abortion medication not birth control.

“I HAVE NEVER, AND WILL NEVER ADVOCATE IMPOSING RESTRICTIONS ON BIRTH CONTROL, or other contraceptives. This is a Democrat fabricated lie,… I DO NOT SUPPORT A BAN ON BIRTH CONTROL, AND NEITHER WILL THE REPUBLICAN PARTY!,” Trump posted on May 21.

Contraception is a vital piece of overall healthcare access as it is not only used in pregnancy prevention but many people use it to regulate period cycles, treat migraines, premenstrual syndrome, endometriosis, and more.

As the demand for contraception increases, policy changes and telehealth have made it easier than ever to access care.

According to KFF, about 77% of women access their birth control from a doctor’s office and prefer to do so despite a growing number of options. Contraception can be ordered through online pharmacies like Wisp and in recent years have become available without consulting a physician.

The FDA approved the first non-prescription daily birth control pill, Opill, in July 2023, which hit pharmacy shelves in late March 2024. Birth control pills are now available without a prescription at retailers like Target and Costco. In October, the Biden Administration proposed further expanding the ACA to include this over-the-counter birth control option and emergency contraception, although the rule has not been finalized.