Minnesotans are seeking long-term contraception and worried about abortion access after Trump’s victory

When Alicia Kotz and her husband were ready to have children, she had difficulty getting pregnant. She had a miscarriage before her first child was born. Then she had health problems again and lost another pregnancy before finally having her second child.

Recently, her doctor told her that if she became pregnant again, it would be too hard on her body and she could die. Although she has no plans to become pregnant, she is not yet in menopause either. She has painful periods, often resembling labor pains, as well as uterine cysts.

While she spent the last six months debating what to do, one major event influenced her choice – the re-election of Donald Trump as president.

“I thought no, I have to make a permanent decision now. I have to get it removed, I can’t risk getting pregnant again,” Kotz, of Shakopee, Minnesota, said of the decision to have a hysterectomy. “I rushed the decision because I’m very afraid of getting pregnant again.”

Kotz isn’t the only one worried about how Trump could impact abortion access, despite living in one of the most accessible states in the country.

Planned Parenthood North Central States recently reported that since Trump’s victory, the number of patients making appointments for long-acting contraceptives such as implants and intrauterine devices (IUDs) has increased by 150 percent.

Other health systems in Minnesota such as Mayo Clinic, HealthPartners, Allina Health and others said it is too early to say whether their systems are seeing the same increase.

WE Health, a reproductive clinic in Duluth that also offers abortions, said there hasn’t been an influx of requests for long-term contraception yet, but has received more calls about pre-med care, which is when medications for abortion are provided before pregnancy.

Minnesota passed the PRO Act last year, protecting abortion access nationwide. However, although Trump has stated that he will not sign a federal abortion ban, he has not explicitly stated that he would veto nationwide abortion restrictions.

Dr. Sarah Traxler, the chief medical officer at Planned Parenthood North Central States, said the surge in appointments was on par with 2016, when Trump was elected to his first term, and 2022, when Roe v. Wade was overthrown.

“People are worried. There is still a lot of uncertainty about what will happen to access to sexual and reproductive health care across the country,” she said. “I think Minnesota has some really significant protections in place, but it remains to be seen what the Trump-Vance administration will do when they take office in January.”

Planned Parenthood reports an increase in vasectomy appointments

Traxler noted another increase: vasectomy appointments. In Minnesota, a significant number of people have made appointments for vasectomies, which Planned Parenthood only performs at three of its Minnesota locations: St. Cloud, Duluth and Little Canada.

The dates are fully booked until January.

“I think that in the vast majority of cases, contraception is the responsibility of the partner who has a uterus. But I think there are people out there with penises who are really taking responsibility,” Traxler said.

“They understand that if their partner has no way to prevent pregnancy, it is a threat to them as a partner and as a father – it also threatens their autonomy and freedom.”

Others seek long-term contraception as gender-equitable health care

The need for long-term contraception may extend beyond pregnancy prevention. It can be used for medical reasons including gender-affirming care.

James Hirsch, a transgender man, moved from Iowa to Minnesota for better access to health care. In 2023, Minnesota passed the “Trans Refuge” law, protecting people in the state seeking gender-affirming care.

An important part of Hirsch’s gender-inclusive healthcare is stopping his periods, which he achieves through hormone replacement therapy (HRT). But he fears losing HRT as Trump attacks gender-affirming care for transgender people. To stop his period, Hirsch also received a hormonal coil.

“It’s unfortunate because I just moved here to a more progressive state, but the president was able to stop that. They could almost ruin this decision,” he said.

At a campaign rally in August, Trump said on the first day of his presidency that he would “sign an executive order directing every federal agency to stop promoting sex or gender reassignment at any age.” It’s unclear what that might actually mean.

Rae Rowe, a gender non-binary person in Minneapolis, also wears an IUD, partly to stop periods for gender reasons and partly for medical reasons. They received their first IUD after surviving a bilateral massive pulmonary embolism and a deep vein thrombosis. Doctors then warned that excessive periods could lead to bleeding.

Rowe has had an abortion in the past and knows firsthand that even in places where abortion is protected, the cost of abortion can be prohibitive. But their fears go beyond that.

“I think there will be a kind of domino effect the next time it is administered, where more forms of contraception will be seen as failed attempts, which will make access to them very, very difficult,” they said.

Minnesotan living in Texas complains about access

Isabella Peterson, who lives in Dallas but is originally from Minnesota, has an IUD that expires at the end of December. She said she couldn’t find any in-network gynecologists there who would accept new patients.

“I’m out of options at the moment. “It’s a lot different here than in Minnesota,” she said. “It’s stressful and scary. If it gets to the point where I can no longer make an appointment in my network and it’s mid-December, I just have to move forward. And they’re not cheap: They cost $1,000.”

Texas passed a strict abortion ban in 2021, banning almost all abortions and imposing penalties on doctors who perform them, including loss of their medical license and prison time.

A Manatt Health report released in October found that 44 percent of gynecologists surveyed in Texas said they have considered or have already changed how and/or where they practice. The report found “historic and worsening bottlenecks” in access in the state.

Although the Peterson IUD is not immediately ineffective, it loses effectiveness over time. She says that regardless of the future Trump presidency, she plans to return to Minnesota soon for better access to health care.