Young People Deserve Reliable Birth Control Information and Access

Power to Decide, a national nonprofit dedicated to advancing sexual and reproductive wellbeing for all, has launched a new survey initiative called the Youth Reproductive Health Access Survey. It aims to collect annual data on young people’s access to sexual and reproductive health services, with emphasis on contraception and abortion. Riley Steiner, Senior Director, Research and Evaluation at Power to Decide, sits down to talk to us about the survey’s findings—including information gaps, preferences, and service provision related to young people’s access to basic contraceptive care.

 The survey’s data is collected online from approximately 1,000 young people ages 15-29, assigned female at birth. Power to Decide collected striking knowledge gaps and notable findings, including that a quarter of respondents indicated that they didn't have enough information to decide whether using birth control was the right thing for them and that a third of respondents indicated that they didn't have enough information to decide which birth control methods are right for them. Because there’s a noted lack of information and access, Power to Decide’s findings show that providers and advocates must think creatively to get young people the care they need.

Links from this episode

Power to Decide on X
Power to Decide on Facebook
Youth Reproductive Health Access Survey
Key Takeaways from the 2024 YouR HeAlth Survey
rePROs Fight Back’s resources page
Bedsider Method Explorer

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Transcript

Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

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Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

Jennie: Hey, rePROs. How's everybody doing? I'm your host Jennie Wetter, and my pronouns are she/her. So y'all, I know we're all still processing the election and what it's gonna mean for us and those we care about. I know personally, a couple of days later, I'm having less overwhelming general panic and less thoughts of just, like, quitting and starting my famous bakery bookstore that I always joke about when times are tough. I'm having more specific issue-related panic. And while I'm exhausted and y'all, I am exhausted. I'm sure you all are, too. I'm having less of that like general panic and I'm ready to keep fighting. We are gonna do a deep dive on the podcast episode soon. So, we'll talk more about what this is gonna mean for sexual and reproductive health in the upcoming weeks. But know that rePROs isn't going anywhere. I will be here with you every week to talk about what is happening and how we can all fight back. And I know things seem dark now, but there were definitely spots of hope on Election day. I am choosing to focus on some of that right now. Abortion was on the ballot in 10 states and y'all it won in seven of them. Seven. That is amazing. And honestly, it only technically lost in Florida, right? It got 57% of the vote, which would be a massive victory anywhere else. But Florida had a 60% threshold for this vote, so it did not win. But y'all abortion won in seven states where it was on the ballot. That is a glimmer of hope. For the first time ever, there will be two Black women in the Senate, which like again is one of those like, amazing that that's happening but also, like, sad that it's 2024 and that's the first time we're saying that. But I'm choosing to look at the positive of, like, this is good news. I'm also really excited to say that we had the first transgender person elected to Congress. Like, that is so exciting. So, there are spots of hope and light and I'm trying to hold onto that part right now.

Jennie: I know y'all are worried. I am too. So, let's talk about some of the resources that may be helpful to you or maybe to a friend when they need them. And it gives you some things you can think about. It's gonna be quite a few resources. So, if you want to make sure you can find all of them, we have a resources page on the rePROs Fight Back website. It's at reprosfightback.com/resources. You go there and it's got all of them. You can scroll through it and it'll give you all this information. If you need an abortion or someone you know needs an abortion and you don't know where to go, there are a couple great websites to check out; INeedAnA.com and abortionfinder.org will help you find the one closest to you that gets you in. They're constantly updated to make sure that they're reflective of whatever the current law is in your state and the states in your area. So, it will help you find where you can go for an abortion. If you have questions about legal risk or legal support or advice, check out If/When/How's Repro Legal Helpline, they're a great place to go to make sure that you are getting information about legal status. And if you need them, the Repro Legal Defense Fund also is a great place to look. They cover bail for people who are investigated, arrested, or prosecuted for self-managed abortion. So, they're a great resource if you need them. Make sure that you are protecting your digital security and a place to go for more information on that is the Digital Defense Fund. They have a guide for abortion privacy that y'all should check out to make sure that you're keeping your digital footprint clear for if you go and access an abortion, try and access information about abortion in a state where it's banned. You won't have a digital footprint that can be tracked back to you. So, Digital Defense Fund's guide to abortion privacy—definitely check it out and do what you need to do to protect yourself. Also, just a flag to be aware of some of the period tracker apps you use. Some of them save your data and track your data and that could be a problem. One of the ones that is recommended by a lot of people in repro is Euki, E-U-K-I. It's a good one. And they don't store data. If you want to rage donate, I did my share of rage donating last week. Make sure to donate to support your local abortion funds. Find ways that you can get involved in your community. And remember y'all, this is gonna be a long, long, hard marathon. It is not a sprint. We need to take care of ourselves and take care of each other. Step back when you need to step back. Step back in and fight when you are rested again. Do not burn yourselves out. And honestly, I'm saying that for myself too. I am not always good about that. I just keep going and get close to that burnout point. So, like, self-care and taking care of each other is the name of the game right now. We need to be there for each other and then in community to keep pushing forward 'cause this is going to be a long fight. So yeah, take care of yourself and step back when you can. And just thank you all for your support.

Jennie: If you wanna support the podcast, tell your friends about the podcast so that you can help them stay informed. You can always donate to rePROs Fight Back, but again, right now I'm really pushing people to donate to abortion funds. But if you wanna donate to us, that would be wonderful. We still have the giveaways where you can get free stickers done by Liberal Jane for $25. And the stickers in the bag that I love that says "abortion is a human right, not a dirty word" for $50. So, feel free to support us as well, but just know that I am so proud to be in this fight with you all and I know it will be a long four years, but we are in this together and we will help each other through this. So, I guess with that, I'm just gonna pause and take a second before we move on to this week's interview. We don't really talk about the election in this week's interview. We just focus on some great new data that Power to Decide had on young people and access to birth control. So, again, with the election, what is that going to mean for young people's access is something we don't necessarily grapple with in this episode, but it is something that weighs heavily on my mind. But I'm very excited to share this episode. I had a great conversation with Riley Steiner at Power to Decide to talk all about this new data about young people and access to birth control. So with that, let's go to my interview with Riley.

Jennie: Hi Riley, thank you so much for being here.

Riley: I'm so glad to be here to chat with you today.

Jennie: Before we get started, would you like to take a second and introduce yourself and include your pronouns?

Riley: Sure. I'm Riley Steiner. I use she/her pronouns. I'm the Senior Director of Research and Evaluation at Power to Decide. We're a national nonprofit aiming to advance sexual and reproductive wellbeing for all with a particular focus on underserved communities and populations, including adolescents and young adults. I'm a public health behavioral scientist by training and before coming to Power to Decide, I spent more than a decade at the Centers for Disease Control and Prevention where I worked on adolescent, sexual and reproductive healthcare access.

Jennie: Great. I am so excited to talk to you about this youth survey. Before we get into specific areas that we're gonna focus on, do you maybe wanna do a quick overview of what the survey is?

Riley: Yeah, happy to. So, Power to Decide has launched this new survey initiative called the Youth Reproductive Health Access Survey or YouR Health Survey. And this is intended to be an annual data collection effort that's really aiming to understand young people's knowledge, attitudes and experiences related to sexual and reproductive health, information, and services, with a particular emphasis on contraception and abortion. So, the survey is fielded using an online panel and we aim to collect data from about a thousand young people ages 15 to 29 years assigned female at birth. This past summer we launched the inaugural survey and so we have findings out from this 2024 data collection. And I'm excited to share those with you today.

Jennie: I'm so excited to talk about it. Sorry, y'all, I have a cat who decided that they want to sit on my notes, so we are just gonna have to relocate her. Okay.

Riley: Yeah. [laughs]

Jennie: Oh, just another day. My cat's taking over everything.

Riley: Yep, yep.

Jennie: Okay. So, I figured the best way to talk about it was to kind of maybe group some of your big findings into buckets. So, the first bucket that I saw was information-related concerns that came up. Can you tell us about some of those concerns you saw?

Riley: Yeah, so it was really striking what we found regarding knowledge gaps in the 2024 data collection. So, we asked young people to report sort of their own perceptions about whether they had enough information to make decisions about birth control. And a quarter of respondents indicated that they didn't have enough information to decide whether using birth control right now is the right thing for them. And then about a third indicated that they didn't have enough information to decide which methods, birth control methods are right for them. And then we also asked sort of an objective knowledge assessment, which really aligned with those self-perceptions and sort of highlighted some of these information gaps. So this assessment included 11 true or false statements and respondents could either choose true, false, or I don't know. And on average the participants only answered five out of the 11 correctly. And there were a few where there were around 20 to 30% who got it incorrect. So a couple of those statements, things like thinking that menstrual tracking is a highly effective method of preventing pregnancy. Also thinking that it's important to take- to quote unquote "take a break" from birth control pills for health reasons after several years. You know, I don't think that's super surprising given what we know about some of the myths and disinformation that's on social media. I know you chatted with our CEO Dr. Raegan about that recently, but it's really concerning. And we also saw sort of looking at age differences; so our sample is 15 to 29 and sort of looking at age differences, the younger adolescents, the minor respondents are sort of more likely to have these information gaps.

Jennie: Man, I'm thinking about myself at that age and the information I did not have was so much. I've talked about it on the podcast before, but I went to Catholic school K through eight. So, I had sex ed from a nun. So, you can only imagine the gaps in my knowledge around birth control through so much of my life because I never really had that opportunity to get that education. And then when you're a young person starting seeing a doctor, like I wasn't getting that full range of information from them.

Riley: Yeah, and that's something, so that's a really another important finding that's coming out of the survey is just how much young people want to get this birth control information from a healthcare provider. So, we ask about sort of preferred information sources and overwhelmingly across age as well as race, race, ethnicity, we see that young people want to get information from a healthcare provider—about 80%.

Jennie: Man. And I just, again, thinking, like, I didn't grow up in- I had no information and maybe some of that misinformation you get from like your friend group, but I grew up before like TikTok and all of those things where you're seeing this real pervasive atmosphere of misinformation around sexual and reproductive health.

Riley: Yeah, I mean I think it's a whole, it's sort of a whole new frontier 'cause, you know, the gaps in sort of our provision of quality school-based sex education, those are longstanding. But now, we're sort of seeing some of those gaps be "filled"—and I say that sort of in air quotes—by this some of this mis- and disinformation.

Jennie: And I think another one that I see is kind of related sometimes is concerns around side effects. I know, like-

Riley: Yes.

Jennie: -definitely when I was younger it was the like mis- and disinformation of, like, your friend group of what they were saying. So, there are real side effect concerns, but I think there's also, like, the mis- and disinformation side effect concerns. So, what did the survey show?

Riley: So, we included some questions related to concerns about hormonal contraception that are actually kind of drawn on a new measure that's been put forward by some researchers from UCSF. And we do see those concerns and those worries about side effects. So, about half of the sample overall worry that birth control has dangerous side effects and also notable about a third are concerned that using hormonal contraception will make it harder for them to have a baby later in life so that it will impact future fertility when we know that no method except for sterilization impacts future fertility once you stop using it. So those are concerning findings that I think really underscore that we need to be providing information really about the full range of methods, about potential side effects. Providers need to be listening to patients when they do have concerns about side effects and really helping them find the method that's best for them 'cause like you said, I mean there are, I mean, we know birth control has that effect. That's absolutely true. But the idea that it's not safe, you know, that's I think what's concerning and really does need to be addressed.

Jennie: Yeah. And it's, it's so hard to, I mean we know this from so many areas, right? It's so hard to combat that misinformation, 'cause once it gets out there, it's really hard to be like, no, but actually this is what the data shows. Like, it is perfectly safe. So, it's really hard to kind of fight back against those things once people start to get exposed and, like, really take it in.

Riley: Yeah. Yeah. It's a challenge and it's something, you know, we at Power to Decide as we're trying to increase access to high quality information that is trusted, that is resonant, that's medically accurate, we’re thinking a lot about: what are the best strategies for doing that? And how do we sort of leverage our digital platforms like Bedsider to really kind of democratize access to this high quality information and kind of break through the mis- and disinformation that is circulating?

Jennie: So, the last big bucket I saw around concerns was around access. What were some of the access concerns you were seeing? Because access is like such a small word that covers such a huge range of issues.

Riley: Yes. So, I mean I would also just, I would note that, you know, I think these information gaps and the sort of misconceptions around safety, like, to me those are actually really important findings about access.

Jennie: Yep.

Riley: I think oftentimes when we think about access to sexual and reproductive healthcare, we're sort of thinking about how it's provided, you know, how much does it cost? Is there a clinic nearby? Do you have a provider that you trust? So, kind of all of those in some, kind of, like, the supply basically of our contraceptive care. But you know, on the other side we have individuals who have, based on what they think and know, are gonna either seek out care or not. So, I do think these information gaps are really important to address, to improve access. But we do, in addition to looking kind of at that information side, we do also have questions in the survey around service provision. And I wanted to note a couple of things there. I think that one of the more striking findings to me, particularly as someone who focuses on adolescent access is missed opportunities within the primary care context. So, we ask about sort of receipt of preventive care. So that's, you know, the well visit—not going 'cause you, like, have a stomach bug or COVID, but because you're just going in for your annual checkup—and we found that most young people do have a preventive care visit. So, it's like 75% in the past year. And of those only about a third indicate that their provider talked with them about birth control at that visit. So, that's a huge missed opportunity. And then when we go back to, you know, young people's desire for information from a provider, it sort of is especially concerning 'cause they want to get this information, they're there, they're in the space seeing their provider and it's not happening. So I think, you know, it really points to the importance of giving providers, particularly primary care providers, the resources to do this within the context of: there are many competing priorities at a preventive care visit. So that's one thing. We also look a little bit at the quality of contraceptive care that's provided. Again, sort of drawing on some of the measures that are increasingly used in the field. So, we ask about person-centered contraceptive counseling. And so, among those who had healthcare related to birth control in the prior year, a little less than, it's like about 40% I think indicate that the care was excellent across sort of the measures of person-centered contraceptive counseling. So definitely opportunities to improve there. So, even when the care is provided and that counseling and information is shared, making sure that it is being, it's respectful, that it's aligning with what patients want and need to hear and not just what a provider thinks is most important.

Jennie: Yeah. Again, thinking back to my personal experience, like, I don't remember options being talked about, right? It was, like, here's the birth control pill. There were less options then than there are now, but there were still a range of options that could have been discussed but never were.

Riley: Yeah. And that's something that at Power to Decide with our tools, we're really aiming to address and sort of fill, again, fill in that gap. So, we just kind of relaunched our Bedsider method explorer, which is an amazing tool that goes through all the different methods, includes information about them, has comparison features so you can kind of look side by side. We know that some providers do actually use that tool and refer patients to that tool. And we're actually right now evaluating some printed materials that sort of align with that tool and present the various contraceptive options and sort of help patients think about what are the factors that are most important to them when selecting a method.

Jennie: So, the survey gave you a great idea of what access to care looks like for young people right now. And there are clearly so many gaps. What do we need to do to make sure that young people's needs are being met?

Riley: Yeah. And that's the million dollar question. Yeah. And I do think that we, you know, as I mentioned at Power to Decide, we are really focused on how we increase access to information. And I think that this survey just underscores and reinforces that that is so important and that we need to be creative. Some of the information gaps that we found are very similar to information gaps that Power to Decide found in a prior data collection that occurred more than a decade ago. So, we're not making the kind of progress that we need to make. And so, we really do need to think creatively about how we can get young people the best, high quality information. So, we have bedsider.org. We're also thinking about sort of innovations around social media and thinking about how we can bring the provider voice into those digital spaces. So we have our hashtag #AskDrRaegan series where our CEO Dr. Raegan, who's a practicing physician, you know, sort of provides basic health education about issues that we're seeing related to sexual and reproductive health. So, we're exploring how we can kind of build on that sort of effort. And then also thinking about how we have partnerships in communities, whether it's with healthcare providers, whether it's with colleges and universities to help connect young people in those spaces to these types of digital tools 'cause we know, right, we know that providers have limited time. And so if, you know, the provider interaction can sort of be the entree and then young people can have a resource that they can go to on their own time as they need to, as they want to follow up. We think that's really important. So, I think the need for sort of creativity in our approach to health education and recognizing that just relying on sort of school-based sex ed is not gonna cut it. And then I would say, you know, on the healthcare side, I do think providers, you know, the survey really just underscores the important role of providers. And you know, I hope that that for the provider audience is empowering. You know, they are, they are respected by young people as sources of information. And so, I think to the extent that that can, that can feel some inspiration to do this work and to incorporate in their practice, I think that gives me some hope.

Jennie: Those suggestions are all great. It is so important that providers are getting the information to young people, that there are all these extra resources. But man, it really also just makes me think of how lacking our sex education system is and how much of a disservice we are doing to young people by not getting them that information in a medically accurate, comprehensive way that is really just failing them.

Riley: Yeah, yeah. I mean, and it's something, you know, in my prior life, I worked at the Division of Adolescent School Health at CDC, which supports school-based sex education. And it's so important that we don't also give up on that side of things. And I do think our policy team at Power to Decide is doing some important work in that space to continue to sort of push on implementation of quality standards.

Jennie: Yeah. It's one of my personal, like, I dunno, it's one that makes me especially fired up as somebody who had such terrible sex ed. I know I wouldn't have been helped by some sort of national program since I went to private school, but just knowing that there are so many people who are getting this really terrible version of sex education, it really makes me mad.

Riley: Yeah. And sadly, I think that we may see increasing attacks on our school-based sex education in the coming years. And really, again, other strategies are going to have to fill in those gaps. And so, I am grateful, I'm just so grateful for the work that Power to Decide is doing on our programmatic side to really be thoughtful about that and recognize that this is basic information that every young person deserves. There's nothing, there's really nothing controversial about it. It's just basic health information that people need to know.

Jennie: Okay. So, we always talk about ways our audience can get involved. How can my audience get involved?

Riley: Well, first thing, I would just encourage folks to take a look at our data report. One of the things we're super excited about with this survey is, you know, we collected the data over the summer and we released these initial kind of select findings in mid-October. So, they're very timely data. And the data report is available on our website at powertodecide.org/yourhealthsurvey. And for the researchers who are listening, we are interested in collaborating and sharing data for additional analyses. And so, we have contact there in terms of folks who are interested in exploring that. But just encourage people to take a look at the full report. There's so much more in there than what we've talked about today and there's gonna be more coming. So, we did kind of focus on some select findings for that data report. We didn't wanna overwhelm people, but we do have additional analysis planned including, you know, sort of deeper dives into these issues by race, ethnicity, which we know is just so important to understand. So, that's one thing. And then also, you know, just to be engaging and sharing our resources and we really have a perfect opportunity for that with our 12th annual Thanks Birth Control campaign, which is this Thursday, November 14th. So, this is really the kickoff to our kind of yearlong celebration of all that birth control makes possible. And we encourage people to participate via social media using the hashtag #ThxBirthControl, T-H-X for thanks, it's an opportunity to share our resources, share the data report, really lift up that there are these challenges and there are these opportunities to address information gaps and improve access for young people. And then we also have an opportunity coming up on November 19th, we're holding a webinar about the survey and where we'll do a deeper dive into the data. So, if folks are really interested, want to learn more, we encourage you to join us. On that survey page that I mentioned on our website, there's a link to register for the webinar on that Tuesday afternoon. So, definitely encourage folks to check that out.

Jennie: I love participating in Thanks Birth Control Day every year, seeing all the stories people are telling about why birth control is important to them and what a difference is made in their life. So y'all, I highly recommend engaging on Thanks Birth Control Day. And also they, they usually have some really fun swag that you can go buy. So, make sure to check out their store.

Riley: Yes. And we're actually having a sale on the store, so our merchandise is75% off. So, definitely take advantage of that. And then we also do have just a toolkit on our website that people can use to help engage. I'm not the most savvy on social media, but the toolkit makes it so easy. Like, there's like actual posts that I can just use and that, and that's really great. And it is, I mean I feel like right now we all need a day like this, right? We need a day where we just see in our online space our community and you know, we can just feel hopeful and celebrate all that is amazing about birth control.

Jennie: We will make sure to include the links to the report and the toolkit in our show notes. And y'all, I can't recommend the toolkit enough either 'cause there's always like fun graphics and sometimes my brain is not, doesn't wanna come up with the clever thing to say. So there's always great suggested posts. So yes, definitely check out their toolkit. Okay. Riley, thank you so much for being here. It was so much fun talking to you about the new youth survey.

Riley: Well, thank you for having me.

Jennie: Okay y'all, I hope you enjoyed my conversation with ri. Make sure you are taking care of yourselves, doing what you need to do to support yourself and your friends, and we're in this fight together. And just please, please, please be kind to yourself, take care of yourself and step back when you need to and step back in when you're able. And I will see all of you again next week. [music outro] If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprosfightback.com. Thanks all!