Alexandra Hill has known for years that she doesn’t want to have children. The 35-year-old, who lives with her boyfriend in Connecticut, told me she’s tried different forms of birth control in the past, including condoms and birth-control pills. Earlier this year, she started taking the over-the-counter contraceptive pill, Opill, which she likes because of its minimal side effects.
Then Donald Trump was reelected. “Now I’m concerned, even though I’m in a blue state,” Hill told me. “My first thought was, I should stock up on as much as I can. But I’m also trying to think ahead — what if that is not possible?” Rather than risk uncertain availability of the pill in the years ahead, Hill found a Connecticut surgeon who accepts her insurance and scheduled a January 16 consultation for a bilateral salpingectomy — a sterilization procedure in which the Fallopian tubes are removed. “I also requested to be put on a cancellation list in the hope of getting an earlier appointment,” she told me.
In the days since Trump won, some people are moving quickly to protect future access to health care with a now-uncertain future, like birth control or gender-affirming care. Trump’s messaging on issues related to the pill, emergency contraceptives, and abortion has been at times contradictory: He’s said, on the one hand, that decisions on these issues should be up to the states — where some ballot measures protecting abortion rights were successful — but has, on the other, taken credit for appointing Supreme Court justices who were instrumental in overturning Roe v. Wade. And Robert F. Kennedy Jr., Trump’s choice to lead the Department of Health and Human Services, has been clear in his skepticism of certain vaccines and his opposition to gender-affirming care for minors.
Many aren’t waiting around to find out what, exactly, will unfold. Mothers told me they were ordering extra packages of the morning-after pill to have on hand for their young-adult daughters; Winx Health, which offers the emergency-contraceptive pill Restart, said bulk orders went up by 9,600 percent in the week after the election. Other women told me they were moving up their appointments for hormonal-contraceptive implants. Planned Parenthood said in a statement that nationwide appointments for IUDs increased by 760 percent the day following the election, and appointments for birth-control implants rose 350 percent.
This isn’t the first time an election has sent women to the gynecologist’s office. In the 30 days after Trump’s 2016 victory, the daily rate of insertions of “long-acting reversible contraceptives” such as IUDs rose more than 21 percent compared with the 30 days before, according to a 2019 study in JAMA Internal Medicine. In 2022, after Roe v. Wade was overturned, women stockpiled emergency contraceptives like Plan B, which lasts around four years, and more had sterilization procedures.
I feel as if my back is kind of against the wall, and I need to make a decision for the long term.
Now, with fewer checks on Trump’s agenda, many are preparing for the long haul. Caroline Doss, a 30-year-old based in Washington, D.C., told me she’s used a long-term hormonal contraceptive, the Nexplanon rod, since her early 20s. Lately, she said, she’d become curious as to whether it was exacerbating her anxiety, and wondered how she might feel without it once the protection from her current implant wears off in the spring.
Trump’s reelection changed her thinking. Doss, who is a flight attendant, said her job takes her around the country, making it difficult to predict what sort of emergency contraceptive might be available nearby if she needs it. “I don’t even want to know what could happen,” she told me. “Right now, I’m in no position to have a child at all.” She’s now planning to get a new Nexplanon rod implanted in the coming weeks, which her doctor told her will last three years.
“People are looking for either IUDs or permanent sterilization before the inauguration at a rate higher than that I usually see,” Dr. Clayton Alfonso, assistant professor of obstetrics and gynecology at Duke University School of Medicine in North Carolina, told me. In a typical week, he might get one message from a patient interested in getting an IUD. The week after the election, he got around ten requests for an IUD or sterilization procedure, he said.
Women for whom birth control isn’t currently a personal concern told me they are worried about those around them. Sarah Hill, who has a large blended family in Michigan, told me she was buying a few extra packages of Plan B with her two older daughters, 21 and 15, in mind.
“I want to be able to make sure that my children are taken care of, that my daughters have the ability to have access to what they want for their own bodies,” she told me. Hill, who is 39, told me she was a teen mom, and part of her thinking was driven by a hope to help her children avoid pregnancy before they were ready. She ordered six packages of the pills from Amazon on Wednesday morning, she said. When some of her children arrived home from school that afternoon, they said that some high-school boys had begun taunting students by chanting, “Your body, my choice.” “As a parent, that makes me worried,” she told me.
In Georgia, Ellen, a 34-year-old who asked to be identified only by her first name, told me that her small stash of medical-abortion pills, which she keeps on hand in case someone else might need them, was nearing expiration. Ellen, who got an IUD in April, said she first ordered the pills — which contain mifepristone and misoprostol, and are distinct from the morning-after pill — last year from the nonprofit Aid Access, which supplies them through the mail, including to people who may want them for potential future use. The organization said it received 10,000 requests for abortion pills in the 24 hours following the election, which is 17 times its typical orders.
Earlier this year, someone close to Ellen had a miscarriage, and had trouble getting the medical care she needed, which included the pills, in a deep-red state. “She had to move mountains to get medication from the pharmacy, and they allowed her to go way too long,” Ellen told me. The woman languished for several days until she was hospitalized and finally treated, Ellen said. The experience reinvigorated her desire to maintain a personal supply of abortion pills for others.
Given the uncertainty, trans people also told me they plan to stock up on hormones and other medications in case they become difficult to access. A 22-year-old in New Jersey who asked to be identified as Wren said she began her transition about three months ago. Beginning treatment with testosterone blockers and estradiol has been “life-saving,” she told me. She spent election night wondering, “Am I going to lose this medication?” In the days since, she said she’s ordered nine months’ worth of the drugs, which lasts a year before expiring.
The situation might be even more complicated for trans men taking testosterone, which, unlike estrogen, is a controlled substance. FOLX Health, a telehealth platform that provides services including gender-affirming treatments like hormones, said its clinical-visit bookings were up 69 percent in the past week.
And some people want to get their vaccines taken care of right away. Amanda Powell, a 31-year-old in Atlanta, has an autoimmune condition, which can leave her immunocompromised. She told me she plans to take her 11-year-old son to CVS this weekend, where they will both get the latest COVID booster and flu shot. While she typically does this earlier in the fall, a new job and health-insurance plan pushed things back. Now she’s eager to catch up; the errand is part of a checklist she created to prepare for Trump’s second term, which includes other steps like getting hard copies of important family documents and renewing her son’s passport. When it comes to vaccines, it’s not that she’s concerned they will immediately become unavailable in January, she said, but rather — if changes affecting vaccinations are announced early in Trump’s term, “I might as well just get ahead of it and then have some level of peace in this crazy time.”
The upcoming inauguration has also accelerated the timeline of some decisions that otherwise might have played out more gradually. A 35-year-old in Portland, Oregon, told me she uses condoms in her dating life, and that she’s certain she doesn’t want children. But before this election, she said, she’d never considered a sterilization procedure.
Now, she told me, “the prospect of not being able to take advantage of abortion if it ever came up that I needed it is just terrifying to me.” Hormonal contraceptives aren’t something she’s interested in, she said. “How do I set myself up so that I’m never at risk?”
She made an appointment to discuss tubal ligation with her local gynecologist in early January. Although she feels the decision is the right one for her, a small part of her wonders if the finality of the procedure could deter a partner who would otherwise be an ideal match. “That’s kind of in the back of my mind,” she told me. Still, she said, “I feel as if my back is kind of against the wall, and I need to make a decision for the long term.”
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