United States of America

United States of America

OVERVIEW

Contraception: Over-the-Counter	condoms, spermicide & contraceptive gel, sponge
Contraception: Prescription required)	pills, injectable, implant, patch, vaginal ring, IUD
Emergency Contraception	no prescription required
STIs	testing available; no travel restrictions
Menstrual Products	pads, tampons, cups
Abortion Law	law determined by state; legal in some states & illegal or highly restricted in other states
LGBTQ Laws	homosexuality legal
Related Pages	see Gynopedia Index for full list of state and city pages

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here. It is recommended that you consult with a health practitioner to determine the best contraceptive choice for you. If you want to find which hormonal contraceptives are available by brand, manufacturer or country, click here.

Laws & Social Stigmas

Contraceptives (hormonal and non-hormonal) are available in the United States of America, but many forms require a prescription. Generally, condoms, spermicide, and the birth control sponge are available over-the-counter at drug stores and pharmacies without a prescription. However, for contraceptive pills, injectables, implants, or IUDs a prescription is usually required. Pills can usually be attained in a drug store or pharmacy after receiving a prescription. IUDs, injectables, or implants usually require that the person comes into a clinic or medical facility to receive the contraception.

What to Get & Where to Get It

No prescription required

• Condoms (external and internal) are available over-the-counter at drug stores and pharmacies (i.e., no prescription is required). External condoms are about 85% effective at preventing pregnancy, if used correctly. Internal condoms (also called "female condoms") are about 79% effective at preventing pregnancy.
• Spermicide or contraceptive gel are available over-the-counter at drug stores and pharmacies (i.e., no prescription is required). Depending on the brand, they are about 72% effective at preventing pregnancy. They need to be used with diaphragms and cervical caps in order to work effectively. There is also a contraceptive gel called Phexxi that is about 86% effective at preventing pregnancy.
• The birth control sponge is available over-the-counter at drug stores and pharmacies (i.e., no prescription is required). It is about 76-88% effective at prevent pregnancy, if it is used properly. It needs to be inserted before sex. It can be used by itself or with a condom. The main brand for brith control sponge that is sold in the United States is Today Sponge.

Prescription required

• Birth control pills (combination pills and progestin-only pills) are available, but they require a prescription from a medical professional before you can attain them. This means that you need to visit a medical facility, such as a clinic or doctor's office, and you may need to have a general check-up before you get the prescription. Birth control pills are about 91% effective in preventing pregnancy.
• Birth control rings (also known as the "vaginal ring') are available, but they require a prescription from a medical professional before you can attain them. This means that you need to visit a medical facility, such as a clinic or doctor's office, and you may need to have a general check-up before you get the prescription. The two main brands available in the US are NuvaRing (which lasts for 5 weeks) and Annovera (which lasts for 1 year, or about 13 cycles). Birth control rings are 91% effective at preventing pregnancy.
• Birth control patches (also known as the "transdermal contraceptive patch') are available, but they require a prescription from a medical professional before you can attain them. This means that you need to visit a medical facility, such as a clinic or doctor's office, and you may need to have a general check-up before you get the prescription. The two main brands available in the US are Xulane patch and the Twirla patch. People typically wear the patch on their belly, butt, or back. Birth control patches are about 91% effective at preventing pregnancy.
• IUDS (intra-uterine devices) are available, but they require a prescription from a medical professional before you can attain them. This means that you need to visit a medical facility, such as a clinic or doctor's office, and you may need to have a general check-up before you get the prescription. You will also need to have the insertion performed by a medical professional. Both hormonal and non-hormonal brands are available in the US. The hormonal brands available are Mirena, Kyleena, Liletta, and Skyla. The non-hormonal (copper) brand available is Paragard. Depending on the brand, IUDs work for about 3-12 years. IUDs are 99% effective at preventing pregnancy.

Costs

• Condoms cost about $2 per condom in the United States, as of 2022. You can also find nonprofits and organizations that provide free condoms. If you buy condoms by the box, it may be cheaper than buying them individually.
• The birth control sponge costs about $15 for a 3-pack, as of 2022.
• Spermicide costs between 60 cents to $3 per dose, or $8-15 per kit. If you buy the Phexxi contraceptive gel, it's more expensive at $267.50 per a 12-box of applicators (if you have no insurance). If you do have health insurance coverage, the price should be much cheaper.
• Birth control pills can range considerably in cost, depending on the pill brand and your insurance coverage (if any). The average price for a 1-month supply of pills is around $50, but you can also sometimes get pills for free. In terms of the price range, you can expect to pay between $22-$84, roughly speaking. Some brands, like Sprintec and Enskyce, can run under $30 per 1-month supply. The more expensive brands include Apri ($84 per month) and Drospirenone/Ethinyl Estradiol ($79 per month).
• Birth control rings vary in cost, depending on the brand and your insurance coverage (if any). For Nuvaring, the cost is about $200 per 1-month ring (without insurance coverage). For Annovera, the cost is about $2,098 per 1-year ring (without insurance coverage). If you have insurance, the prices can be considerably cheaper. You can also get birth control rings for free at some places.
• Birth control patches vary in cost, depending on the brand and your insurance coverage (if any). If you don't have insurance coverage, you can expect to pay around $55 per month, but costs can be higher. Generally, a 3-pack of the patch (which usually lasts for 1 month) ranges in price from $0-150. If you have health insurance or quality for a government health program, the patch is often free.
• IUDS (intra-uterine devices) vary in cost, depending on the brand and your insurance coverage (if any). If you don't have insurance, you can expect to pay $500-$1300 for an IUD. If you do have health insurance, the IUD should be low cost or free.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) For combined pills, you must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Medications & Vaccines

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here.

Gynecological Exams

Pregnancy

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.