VARIATION IN CONTRACEPTIVE INTEREST ACROSS THE UNITED STATES IN RELATION TO STATE-LEVEL ABORTION POLICY RESTRICTIVENESS

Objective This study aims to evaluate the relationship between online contraceptive interest and abortion restriction in the United States. Design Retrospective Ecological Study Materials & Methods Google Trends data from January to December 2025 was collected for contraceptive methods including: tubal ligation, vasectomy, intrauterine device, condoms, oral contraceptive pill, contraceptive patch, birth control shot, coitus interruptus, and emergency contraception. Relative search volume was used as a proxy for population-level interest. Data on abortion policy was gathered from Guttmacher Institute. States that made changes to gestational age limits for abortion during the study period were excluded. Spearman rank analysis was performed to identify associations between contraceptive interest and abortion restriction. Results A total of 49 regions, comprising 48 states and the District of Columbia, were included. There were 10 states with no gestational age restrictions on abortion, 17 states with restrictions at 24-26 weeks, 4 states with restrictions at 18-23 weeks, no states with restrictions at 12-18 weeks, 2 states with restrictions at 12 weeks, 4 states with restrictions at 6 weeks and 12 states with a total abortion ban. Higher levels of abortion restriction were associated with increased interest in high efficacy contraceptive methods including tubal ligation (rs(47) = 0.75, p < 0.01), vasectomy (rs(47) = 0.41, p < 0.01), and the birth control shot (rs(47) = 0.63, p < 0.01). Among low efficacy methods, interest in condoms (rs(47) = 0.37, p < 0.01) and coitus interruptus (rs(47) = 0.38, p < 0.01) was significantly associated with higher levels of abortion restriction. There was also a significant association between abortion restriction and interest in emergency contraception (rs(47) = 0.48, p < 0.01). Conclusions In states with higher levels of abortion restriction, interest in highly effective contraceptive methods may reflect increased desire for definitive contraception, while interest in lower efficacy methods may be due to accessibility. While these findings are limited to relative search behavior, they provide a foundation for future studies examining if search trends correspond to actual contraceptive utilization and whether states with more restrictive abortion policies have sufficient clinical resources to meet patient demand.