Donald Trump will be sworn in as the 47th president of the United States on Monday. He’s promised a lot will happen on the first day of his second term — like closing the border and settling the Russia-Ukraine war. But for some, Jan. 20 has a more personal meaning: it’s their deadline for reproductive health care, even sterilization, because they’re worried Trump could limit access to abortion and birth control.
For Meagan, a North Carolina attorney and mother of two, Trump’s win in November meant her reproductive healthcare options could narrow. She felt she needed to do something to protect herself before he took office.
“We’ve seen him appoint justices who are responsible for overturning Roe, and now he’s coming back into office,” Meagan said.
Meagan asked that we use only her first name to protect her privacy. She knows North Carolina law currently allows abortion up to 12 weeks. She knows Trump has said he won’t back a federal abortion ban, but Meagan worries Trump will limit access to abortion in other ways.
Many conservatives want Trump to invoke the Comstock Act — an 1873 law that could stop providers from mailing women the most common abortion drug, mifepristone. She also worries he’ll rescind FDA approval of such drugs.
“I expect him to immediately stop shipping abortion supplies, medical equipment and medication, through the Comstock Act,” she said. “I expect him to use the FDA approval of mifepristone and even mifepristone. I expect that to be a form of attack.”
Meagan and her husband don’t want more children. And after complications with both her pregnancies, she’s worried about becoming pregnant again. She wonders: What would happen to her if she needed an abortion and couldn't get one?
So, after Trump’s win, Meagan decided to get sterilized. But she struggled to book an appointment before the inauguration, and eventually decided to instead get a long-lasting IUD. It was a hard decision. Meagan had an IUD years earlier and, she says, the procedure was painful.
“I never wanted to get another IUD,” Meagan said. “But I wanted the security of eight years of having that.”
More requests for sterilization, long-lasting contraception
The inauguration is a deadline for many women, said Meagan’s doctor, Clayton Alphonso. He estimates the number of women who contacted his Chapel Hill practice for sterilizations increased fivefold after the election. And there was a much larger increase in the number who switched to long-term, reversible contraception.
“All of the women that reached out to me really wanted to have it done before the inauguration,” Alphonso said. “I think there’s just a fear of the unknown, of not knowing what this next Trump presidency is going to have on the ability of them to make their own reproductive choices.”
The impending inauguration has had an impact across the region, said Dr. Katherine Farris. She’s the Chief Medical Officer of Planned Parenthood South Atlantic, which operates clinics in Virginia, West Virginia, and South Carolina as well as North Carolina. Its 14 clinics don’t perform sterilizations for female patients, but they do a small number of vasectomies for men. Farris says there was an immediate and significant increase in the number of men requesting them.
“Patients are telling us that they want to do something permanent so they don't have to worry about their partner having access to birth control that’s not permanent,” Farris said.
And the number of women requesting long-term contraception at Planned Parenthood South Atlantic clinics skyrocketed by 54% after election day, Farris said.
“I don’t think people know what to expect in the next coming months,” she said. “What they do know is that they’re afraid that they will not have options if they have an unintended pregnancy in the next Administration. Even in states where abortion is currently legal, they are not confident that will still be the case in one or two years.”
'What if it's really worse in 10 years?'
Farris said many women were troubled by some of the rhetoric during the campaign. Like comments by Trump’s running mate, J.D Vance, and others about women’s roles and fertility.
And there was the election night post from Trump supporter, Nick Fuentes, “your body, my choice.” That went viral.
“We had a lot of patients and staff talking about that,” Farris said. “And the scary thing about that type of language is it not only implies if you’re pregnant, I can control what you do about it, but it further implies I can choose whether or not I make you pregnant without your consent.”
But sterilization is a big step, Alphonso says. Most women don’t regret their decision, but younger women are more likely to express remorse. Alphonso tries to counsel them before they make up their minds.
“I just always have to talk about the data around like we don’t know what the world is going to be. And you know life can be so different in 10 years,” Alphonso said. ”But then one patient looked at me and said, well, what if it's really worse in 10 years?”
Alphonso said the number of sterilization requests declined before the holidays. But he expects it will increase if and when the politics of reproductive health heats up again.