Contraceptive Use and Risk of Unintended Pregnancy Among Females in the United States: Trends and Characteristics Between 2019 and 2022

Background: Little is known about women’s contraceptive use in the United States during the novel coronavirus (“COVID-19”) pandemic and the risk of unintended pregnancy. Methods: We compared the weighted response rates on contraception use for female respondents aged 18–44 from the Behavioral Risk Factor Surveillance System (BRFSS) between 2019 and 2022. Results: Our study reveals a significant increase of 16.1% (CI = 0.145, 0.177) in the proportion of women using contraception in 2022 as compared to 2019. The largest increase in the use of non-reversible contraception was seen in the proportion of female sterilization, at 3.0% (CI = 0.017, 0.043), mostly attributed to non-Hispanic Black individuals with a 12% increase (CI = 0.046, 0.198). The largest decrease was seen in the use of condoms, at 7.4% (CI = −0.094, −0.055). This was driven by both non-Hispanic Black and multiracial groups, each experiencing a 19% decrease (CI = −0.251, −0.127; CI = −0.304, −0.068, respectively). The proportion of women at risk of unintended pregnancy increased by 3.7% (CI = 0.010, 0.063). These increases were observed among those with an income of less than USD 15k, showing a 14.9% increase (CI = 0.037, 0.262). Older females and those with Medicaid insurance were more likely to use female sterilization. Hispanics, college graduates, and those with Medicaid insurance were more likely to use condoms. Non-White females and those without annual checkups were more at risk of unintended pregnancy. Conclusions: Contraceptive methods shifted among females with slightly increased sterilization in the years 2019 to 2022.