LITTLE ROCK, Ark. - The Biden administration has taken the first steps in the regulatory process to eliminate the domestic gag rule, which forced more than 900 reproductive-health clinics nationwide to leave the Title X family-planning program and lose major amounts of funding.

Rachel Fey, vice president for policy and strategic partnerships at the contraceptive-access advocacy group Power to Decide, said the move is essential to improving access to affordable birth control in low-income and rural communities.

"Getting rid of that gag rule and increasing annual funding for Title X are two things that this administration is beginning to do, and that Congress - in terms of the funding level - can build on, that we think are critically important," she said.

In Arkansas, state lawmakers are considering House Bill 1069, which would allow pharmacists to prescribe contraceptives directly to customers. According to the National Alliance of State Pharmacy Associations, at least six states already allow pharmacists to prescribe birth control.

Fey said a significant number of Arkansas counties have only one health clinic or provider per 1,000 women offering reproductive planning options - making them so-called "contraceptive deserts."

"For example, that might mean that there is a health center in their county that offers the full range of methods," she said, "but the number of low-income women who depend on that clinic versus its capacity might not be in line."

Fey added that lack of access to birth control particularly affects Black, Brown and Indigenous women. She said she thinks more work is needed to ensure women in disadvantaged communities have the tools they need for family planning.

"A broad network of health centers that offer the full range of methods," she said, "and policies that help augment that with good coverage of the full range of methods without co-pay, no matter how much money you make, no matter where you live."

Arkansas has the nation's highest teen pregnancy rate and one of the country's highest unintended pregnancy rates among women of all ages, according to the Centers for Disease Control and Prevention.

Health clinics in New England and elsewhere are coping with a sharp uptick in requests for long-acting contraceptives in the wake of the election.

Planned Parenthood centers in New Hampshire, Maine, and Vermont report more than double their weekly average appointment inquiries for intrauterine devices - or IUD's - and the birth control implant.

Planned Parenthood of Northern New England CEO Nicole Clegg said the organization had exceeded its monthly average for vasectomy consultations by mid-November.

"There's a lot of anxiety," said Clegg, "that people have around whether or not they're going to have access to their preferred birth control choice."

Clegg said patients are also calling with concerns about the availability of gender-affirming care.

She said the increase mirrors what the organization experienced after President-elect Donald Trump's first win in 2016, and the eventual overturning of Roe v. Wade in 2022.

In New Hampshire, abortion remains accessible up to twenty-four weeks of pregnancy, but health care advocates note that state law does not expressly protect abortion rights and that anything could change under the new Republican trifecta at the statehouse.

Clegg said New Englanders are already showing a heightened interest in volunteering at health centers to ensure patients can get the care they need.

"We've had these intense fights before," said Clegg, "and time and time again the American public has stood up for Planned Parenthood and our rights. We think they'll do the same again this time."

Clegg said a loss of federal funds would reduce peoples' access to vital, preventative health care services.

The co-leaders of Trump's new Department of Government Efficiency have already vowed to cut $300 million earmarked for groups like Planned Parenthood, which they claim pursue a progressive agenda.





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A majority of South Dakotans have voted to maintain a strict abortion ban but other factors are shifting the landscape for reproductive care in the state.

Of the 10 states voting on abortion during the 2024 election, South Dakota was one of three to keep a ban in place.

Kim Floren, director of the Justice through Empowerment Network, which provides financial assistance to people seeking abortions, said the state's view on the issue is not new but concern is growing over how the federal government may affect reproductive rights.

"I'm feeling the panic from people who are in areas that maybe haven't experienced what we've experienced as far as barriers go," Floren noted. "The reality is that we as a community can figure out how to take care of one another."

The Justice through Empowerment Network provides assistance with travel and transportation, child care, lodging, interpreters, birth control and medical procedure funding. Floren pointed out the organization supports 30 to 40 people per month. The final tally for Amendment G, which would have established a right to abortion in the state's constitution, was 41% for and 59% against.

South Dakotans voted in 2006 and 2008 against near-total abortion bans but Floren stressed since then, President-elect Donald Trump's first term made people feel "emboldened to be more vocal." Still, she acknowledged his second term will begin in a different context than his first.

"Before Dobbs, we did not have all of these reliable, safe websites where you can order abortion pills from and have them sent to your house for extremely cheap," Floren observed. "In some ways, access here has gotten better."

Floren added Gov. Tim Walz of Minnesota will return to his post after running for vice president on the Democratic ticket. Walz in 2023 signed a bill protecting patients who travel to Minnesota for abortion care and their providers from legal penalties in other states.


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It is now up to Wisconsin Supreme Court justices to decide the fate of an abortion law from the mid-1800s.

A circuit court determined last year an 1849 law does not apply to "medically consented" abortions in Wisconsin. The high court heard arguments Monday about whether a 1985 state law overrides the older one, allowing abortions before the point at which a fetus could survive outside the womb.

Jenny Higgins, professor of obstetrics and gynecology at the University of Wisconsin-Madison, said while the impact of this case is critically important, even if the 1849 law is determined to be unenforceable, returning to the status quo would mean a dire landscape for abortion access.

"Even though abortion is technically available at clinics in Wisconsin right now, it's heavily restricted," Higgins explained. "Because of insurance and Medicaid prohibitions, people have to pay out-of-pocket for a service that should be covered by insurance."

The 1849 law, which was brought to light after Roe v. Wade was overturned by the U.S. Supreme Court, prompted a statewide freeze on abortion services for more than a year. Higgins noted if Wisconsin's high court rules the law still applies today, the state would be looking at another abortion freeze.

Abortion access disproportionately affects those who are already the most marginalized, Higgins pointed out. She noted while people from all walks of life may find themselves needing abortion care, factors like poverty and racism make it much harder for some to achieve reproductive autonomy, compared to those with more economic and social resources.

"Those effects make it much harder for folks to be able to access contraceptive care, be in relationships that are stable and healthy and communicative, to be able to see past the end of the day into one's future if you are, again, mostly focused on your own economic scarcity or figuring out how to feed your kids, or figuring out how not to get evicted," Higgins outlined.

The 1976 Hyde Amendment, established three years after Roe v. Wade, prohibits the use of federal funds for abortion. Higgins hopes federal lawmakers will focus more on this amendment when considering the barriers to abortion care.


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