Pregnancy Prevention Method Use Among US College Women Before and After Dobbs

Objective: To describe pregnancy prevention methods (PPMs) used among US college women before and after the Dobbs Supreme Court decision. Participants: Students assigned female at birth, aged 18-25, attending four-year US institutions who reported vaginal intercourse in the past year. Methods: Repeated cross-sectional analyses used ACHA-NCHA-III Spring 2021/2022 and IIIb Spring 2024/2025 data to compare PPM use at last vaginal intercourse (LVI), emergency contraception (EC) use, and unintended pregnancy (UIP). Logistic regression assessed post-Dobbs hormonal method use. Results: Hormonal method use declined from 54.1% to 45.8%, primarily due to reduced birth control pill use (49.5% to 40.9%). Condoms, fertility awareness, method nonuse, and EC use increased; LARC use declined slightly; UIP remained stable. Conclusions: College women shifted away from birth control pills and toward condoms, EC, fertility awareness, and no method use. These descriptive findings support monitoring method nonuse, ensuring timely access to EC, and providing confidential, evidence-based contraceptive counseling.