“Repeal and replace”: increased demand for intrauterine devices following the 2016 presidential election

Abstract

Objective: To evaluate public's interest in contraceptive options following heightened focus on a repeal of the Affordable Care Act (ACA) since the 2016 United States presidential election.

Study design: We monitored the fraction of Google searches emerging from the United States for the three most popular reversible contraceptive methods - oral contraceptives, intrauterine devices (IUDs) and condoms - from January 1, 2004, through October 31, 2017 (1 year after the presidential election).

Results: IUD searches were cumulatively 15% (95% CI: 10 to 20) higher than expected the year following the 2016 election, reflecting 10 to 21 million excess searches. IUD searches were statistically significantly higher in all states, except NV, and were consistent across states won by Trump or Clinton (Welch t test=0.60, p=.548). Conversely, searches for oral contraceptives and condoms remained stable (0%; 95% CI: -2 to 1) or declined (-4%; 95% CI: -5 to -2), respectively, following the election.

Conclusions: The etiology of increased searches for IUDs is likely multifaceted. However, it may largely be because IUDs will confer continued protection even after an ACA repeal, thereby providing a medical hedge against a possible repeal. Regardless, these data suggest the heightened focus on an ACA repeal is a concern to the record number of Americans seeking out information about IUDs.

Keywords: Health policy; behavioral medicine; computational epidemiology; population health.