21 million women live in U.S. counties with limited birth control access

A nurse displays a set of birth control pills at Pima County Health Department's Northwest Clinic, which offers free reproductive health services for all ages through federal funding from Title X, in Tucson, Ariz., on Thursday, Sept. 3, 2026. Anna Watts for NPR hide caption

There are 21.4 million women in the U.S. who need subsidized birth control living in a county somewhere with limited access. That's the major takeaway from a new analysis of contraception access from two reproductive policy organizations, Power to Decide and the Guttmacher Institute , shared exclusively with NPR. Both organizations are nonprofit and nonpartisan, and both support access to reproductive and sexual health services, including abortion.

The analysis produced two interactive, county-level maps . It's an updated version of a map of contraception deserts that Power to Decide first made in 2017. "We did the best we could with the limited data we had right then," says Rachel Fey , who runs state and federal policy work at Power to Decide, formerly known as The National Campaign to Prevent Teen Pregnancy. "[We] used that as a way to talk to policymakers, the press, the average person about what it really looked like for some people — particularly people on the lower end of the income scale, or in rural areas, or who were disproportionately Black and brown — when it comes to contraceptive access."

An interactive map from Power to Decide shows to what degree publicly-funded contraceptive services meet local needs. Counties in red have the highest access, according to this analysis, and the lightest yellow counties have the lowest. In the counties in gray, no publicly-funded clinics offer contraceptive services. Power to Decide / Screenshot by NPR hide caption

These new maps draw on research expertise at Guttmacher to develop a different methodology, "that I think is more accurate and it's a truer picture of the barriers that people face," Fey says.

In Maricopa County, Ariz., the new analysis shows there are 29 clinics that receive public funding for family planning, and almost 300,000 women in need of subsidized birth control. Researchers estimate that only 8% of the need is being met, which is what they call an "extreme access gap."

That doesn't surprise Wendy Redford, chief clinical officer of Wesley Community & Health Center in Phoenix. "I think that largely reflects that certain groups' needs are not being met," she says. Even in a big city with a lot of options, "if you don't have high resources — namely insurance and even Medicaid — if you don't have those things, accessing care is incredibly difficult because doors are shut on you."

The interactive maps from Power to Decide show state- and county-level details about the available clinics and the population in need of subsidized birth control. With only 8% of the need being met in Maricopa County, researchers consider it to have an "extreme" birth control access gap. Power to Decide / Screenshot by NPR hide caption