Online, that mistrust has bloomed. In two separate papers, published in 2021 and 2024, Dr. Bartz analyzed the tone of birth control-related posts on Twitter. In the first study, researchers found that almost a third of posts about the pill from 2006 to 2019 were negative. In the second study, the team found that one of the major focus points of posts about the pill was its side effects. Another analysis from 2023 found that 74 percent of a sample of YouTube videos posted between 2019 and 2021 discussed discontinuing hormonal birth control methods because of side effects.
But the side effects of the pill don’t override its utility for many women. It is often seen as an easy point of entry for people newly considering continuous birth control because it can be started and stopped at any point, rather than requiring a painful procedure, said Dr. Cherise Felix, an obstetrician and gynecologist at Planned Parenthood’s south, east and north Florida chapters.
It is also more than 90 percent effective at preventing pregnancies, and can be used to help manage a range of health conditions, like endometriosis and polycystic ovarian syndrome.
What the analysis from Trilliant also underscores is that perhaps women are not so easily swayed by what they see online, said Dr. Felix, who reviewed the findings but was not involved in the analysis. If anything, they end up discussing it with their doctors to make more informed decisions. “I have not once had a patient start a conversation with ‘I stopped using my birth control because I saw this on TikTok,’” Dr. Felix said. “But I can tell you that just over the course of my career, I am having better-quality discussions with my patients.”
Nine states with some of the most restrictive abortion laws had bigger-than-average growth in pill prescriptions.
Source: Trilliant Health
Several experts also pointed to increasingly restrictive abortion laws as a reason for the pill’s staying power. Trilliant’s analysis found that nine states with some of the most restrictive abortion laws saw bigger-than-average growth in prescriptions. For example, in Alabama, where abortion is completely banned with few exceptions, and South Carolina, which restricts abortions after six weeks, prescriptions increased by almost 5 percentage points between 2018 and 2023, compared with a national increase of 3 percentage points in that same time frame.
Women began stocking up on the birth control pill after the June 2022 Supreme Court ruling that ended the constitutional right to abortion, said Julia Strasser, director of the Jacobs Institute of Women’s Health at George Washington University and co-author of a recent study looking at contraception use. In 2019, roughly 32 percent of initial prescriptions were for more than one month; by 2022, more than half of initial prescriptions were for a greater supply of “two months, three months, six months and sometimes even 12,” Dr. Strasser said.
So if more women are relying on the pill, why does social media seem to tell a different story? One explanation, Dr. Bartz said, is what’s known as a negativity bias. Consumers are “much more inclined to complain and say ‘oh my gosh, let me tell you about all this bleeding that I’m having on my pill’ or ‘let me tell you about my weight gain,’ ” she said, and far less likely to post positive reviews.
She’s seen something very different in her clinical practice: Patients valuing their birth control options more than ever. “Post-Dobbs,” Dr. Bartz said, “there has been a heightened recognition of the need to be very proactive in preventing pregnancy.”
