Winter tourism in New Hampshire: a ‘small but mighty’ economic driver

There are plenty of fun things to do in New Hampshire all year long. And when you do them, you not only entertain yourself and your friends and family, but also help the New Hampshire economy. Tourism is one of the biggest economic drivers in New Hampshire, with an estimated $1.5 billion impact on the New Hampshire economy every winter. Here to discuss that is Commissioner Taylor Caswell, who heads the Department of Business and Economic Affairs. 

By Rosemary Ford and Caitlin Agnew

This article has been edited for length and clarity.

Melanie Plenda:

How busy is the winter season for tourism in New Hampshire? How does it stack up to the other seasons in the state?

Taylor Caswell:

It's always pretty busy. We sort of have a legacy of winter tourism here in New Hampshire — it definitely has a strong following in terms of how it compares in numbers to summer and fall.

I would say of the three, it's probably the smallest in terms of the amount of dollars that we see in the amount of visits. But, it's really relevant to the fact that at that time of year, the season is a little bit shorter. Particularly as we see changes in the climate, the fall season is fast and furious. We have about four to six weeks of really vivid colors that people all over the world have on their bucket list to come see. So that's a quick one, but summer really is a long season, and in fact, it's a season that may be feeling a little bit longer. We all know that September is starting to feel like the fourth summer month. But winter is small but mighty, and it is very much, as I said, part of the legacy of New Hampshire tourism.

Melanie Plenda:

Where do most of these tourists come from?

Taylor Caswell:

Typically, within New England, we have obviously a very strong market out of the Boston and eastern Massachusetts region. But we also get into Hartford and down into New York for winter. We also see a lot of people from Maine and Canada and Vermont also checking out their fellow ski areas or their communities nearby. So we don't have a huge fly-in market. People don't generally come from Colorado to New Hampshire, but as far as the East Coast, we really, really see that as our major market.

Melanie Plenda:

Do you have any sense of why they pick New Hampshire as a destination?

Taylor Caswell:

Well, because we're so awesome, obviously. But beyond that, I think the Boston market has very easy access into New Hampshire. Obviously, we have I-93 that comes right up into the heart of our ski country, and, particularly in winter, there's a lot of family traditions and people that have been coming here for a long time.

Since COVID, we've definitely seen an increase in the number of people who have second homes, and then there's that whole Airbnb issue that exists out there. That activity, I think, has increased the number of people who are returning visitors to New Hampshire. But for the most part, I think our geography is a big reason why we see a lot of that activity from southern New England.

Melanie Plenda:

What are some of the most popular activities here in winter, and how does the state promote them? 

Taylor Caswell:

The number one activity in terms of numbers for us, pretty much every season, is snowmobiling. But, of course, that is highly dependent on the weather. Last year was not a good snowmobiling season. Skiing is right in there behind them. Skiing has the added advantage of being able to make snow, so as long as it's generally cold, they can provide a product, and people will certainly take advantage of that. Winter hiking is becoming really, really popular, and a lot of people like to do that.

I think there's a good deal of effort to try to diversify the type of activities that people have. And of course, you’ve always got the shopping and the people going into our cool downtowns, like up in Littleton and North Conway to spend an afternoon, maybe getting something to eat, a couple of good craft beers, and picking up something nice at a small Main Street store.

Melanie Plenda:

As you mentioned, skiing is one of the most popular winter activities in the state. What’s being done to grow tourism in that sector?

Taylor Caswell:

We work closely with the ski areas, particularly with Ski NH, which is their main organization. We partner with them for big events in Boston, and we support the work that they do through marketing and through joint advertising.

One of the things that we really harp on as doing quickly and very nimbly is, as you know, if it’s raining on any sort of random day in Boston, but it’s snowing in the mountains, we have to convince everybody that there’s snow up here and what they’re seeing in their backyard isn’t necessarily the reality in the ski areas. So we have done a lot of advertising, even showing live shots of snowmaking being done so people in our key markets can see that there is snow and there is winter activity happening just a few hours north.

Melanie Plenda:

As you mentioned, weather can play a role in the failure and success of so many activities. Though you can’t control Mother Nature, what can be done to foster adaptability for activities that are weather dependent?

Taylor Caswell:

Adaptation is really the name of the game — being able to provide different types of activities, being able to understand the value and the technology of snowmaking equipment, and we've seen almost all of our ski areas in New Hampshire have made some pretty big investments in that, and they're getting quite good at using it. So as long as it stays somewhere around 35 degrees and below, they can make that snow, and they're quite good at that. That provides a really, really quality product. 

Melanie Plenda:

What sort of an impact does tourism have on the New Hampshire economy, as a whole? And what are some of the key drivers of that impact?

Taylor Caswell:

Tourism is huge. I refer to it all the time as sort of the tip of the spear for economic development in New Hampshire, and it's kind of been in that role for a long time. It's our second largest industry by the number of employees and the amount of income that's generated for participants in that economy. But it also is our best advertisement.

I mean, we talk a lot about New Hampshire, generally about access to the workforce, having enough people to fill the jobs that employers have in New Hampshire. We talk a lot about being able to recruit businesses into New Hampshire to make investments and take advantage of, obviously, our business climate here. In almost all of those cases, what we are hearing and what we see and what we know is successful is the experience that people have as a tourist at one point or another here in New Hampshire, and the great quality product that our tourism industry puts forward. 

Melanie Plenda:

As you noted, when we talk about the economy, we tend to think of it as separate sectors, but in truth, so many areas are related to each other. For example, affordable housing can have an impact on the job market and, therefore, tourism. What’s being done to address some of those connected issues like affordable housing or preserving natural resources? 

Taylor Caswell:

That's a really, really important point, and it really speaks to the whole reason why this department exists. We were established in 2017 with the goal of doing exactly what you're describing — a holistic approach to our economy in New Hampshire that takes advantage of all the things that I was talking about, with tourism leading the way for a lot of the recruitment we do of not just tourists, but workforce and businesses and even students to our universities.

But the housing piece is another issue that we deal with here at the department, and the interconnectedness that that has even to tourism. You talk about people that like to come out here and work as a seasonal employee in some of our high tourist areas —those are also some of our highest-cost areas as far as housing goes. How do we address that?

I mentioned earlier the Airbnb issue. That's a significant issue in a lot of our sort of tourism economy communities up in the Mount Washington Valley, for example.  That's an issue that they've really been struggling with — a lot of people in in more urban areas find it quite affordable to buy a nice little home in North Conway and then maybe just Airbnb that when they're not there — perfectly legitimate business, but at the same time, that takes away a housing unit that might typically be used for someone who's working at one of those ski areas during the winter. So it is an ongoing challenge. It's one of those things where you squeeze the balloon in one place and it pops up on another, but we continue to use the sort of resources we have here at the Department of Business and Economic Affairs to understand how those pieces go together and try to help do something about it for our communities. 

Melanie Plenda:

What else is being done to grow tourism in New Hampshire? What are the challenges there and what are the opportunities? 

Taylor Caswell:

Challenges are always obviously the broader economy, and how much disposable income people have for travel — cost of gas is something that always comes up in that in that consideration, inflation, all the general costs that go into planning a trip. We are, in some respects, slaves to those types of economics. A couple of years ago during COVID and the border to Canada was closed, we definitely saw a decrease in the numbers, particularly obviously coming out of Canada, but our overall numbers were affected by that.

When we look into the crystal ball here of what's going to happen over the next couple of years, those are the types of things that we really need to be paying attention to and trying to accommodate. Those costs, again, are something that the state government is not going to necessarily have control over, but we can work with our industry to make sure that they're pricing themselves in a way that's highly competitive for the market that we're in.

Melanie Plenda:

What’s your prediction for the outlook for tourism in New Hampshire this winter? How do you think things will go?

Taylor Caswell:

We see each year the ability for our tourism industry to take advantage of a very close market, still with some disposable income to come up and really experience the state. The only thing that really holds us back, ultimately, is the weather. But I always try to be very optimistic — particularly when I’m in a format like this.

Melanie Plenda:

Business and Economic Affairs Commissioner Taylor Caswell — thank you for joining us today. 

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communications. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. For more information, visit collaborativenh.org. These articles are being shared by partners in the Granite State News Collaborative.

The ski industry’s continued impact on New Hampshire’s economy

For most of us, the snow isn’t here yet. However, the skiing season has begun. As one of the largest economic drivers in the state, the ski industry affects every New Hampshire resident. Every year about 2.8 million people visit the ski areas of New Hampshire — and most of those people come from out of state. They spend an estimated $384 million, generating thousands of jobs and hundreds of millions more in economic impact. That’s why the winter season is an important one for the state, especially for the northern and western areas. On this episode of “The State We’re In,” host Melanie Plenda talks with Jessyca Keeler, president of Ski New Hampshire about the outlook for the season and what’s new in New Hampshire ski areas.

By Rosemary Ford and Caitlin Agnew

This article has been edited for length and clarity. 

Melanie Plenda:

Please tell our audience more about Ski New Hampshire. As an organization, what do you do and whom do you serve? 

Jessyca Keeler:

We are a nonprofit 501(c)(6) trade association that represents ski areas from around the state of New Hampshire. We currently have over 30 members. We also work with a host of associate members that are kind of adjacent to the ski industry.

We have three or four different buckets, if you will, of activities. One of those is advocacy and government relations work. We also do a lot of educational programming and planning for our members and offer networking opportunities as well. Then we do some marketing and PR and communications work.

Melanie Plenda:

In a general sense, what is the outlook for the 2024-2025 ski season this year? How does the weather look? How many people are expected? 

Jessyca Keeler:

We're always an optimistic bunch in the ski industry. While I'm not a meteorologist, one thing I will note is that this is apparently a La Nina year in terms of global climate phenomena or patterns. What that means, at least what we've read or been told that that means, is that we could be looking at a colder winter than average. Precipitation could be higher, could be lower. We could be seeing more storms. But honestly, time will tell.
We’re excited about the pattern that we're currently in. It's gotten colder in the last week or so. We've had a couple snow events. So we're excited about that. In terms of how many people are expected to come, I mean that really depends a lot on the weather. As much as ski areas do a lot of work to prepare for the winter and make sure that we have a great skiing surface and experience for people, the weather really can dictate how many people come in any given season. But, over the last 10 years, we've been averaging approximately 2.3 million skiers, which would be Alpine, cross-country and tubing visitors, over the course of each winter. So hopefully, we'll be in that range. 

Melanie Plenda:

For our audience, tell us more about the direct and perhaps indirect impact that skiing has on the New Hampshire economy. What businesses and industries are affected? What kind of revenue does it generate? 

Jessyca Keeler:

The last economic impact study we did was about six years ago, and what we were looking at was about $384 million in direct and indirect spending by skiers. That's spending at ski areas but also spending at places like restaurants and lodging properties and grocery stores and gas stations. But then you look at the induced effect, which really brings that number up to about a 500-plus-million-dollar economic impact to the state of New Hampshire. So that means that you're taking the employees who work in those businesses, whether it's the ski areas or the lodging properties or the restaurants, and they are then spending their funds, their income, if you will, on rentals or homes. They're paying taxes, going to the same grocery stores and gas stations that guests are going to, and they're just generally contributing back to the economy. So overall, we're looking at about a half a billion dollars a year. That number may have grown or changed since the study was completed in early 2019, but that's roughly the economic impact.

Overall, we're looking at communities in generally rural and mountainous parts of the state that rely heavily on tourism. So that's, you know, a lot of those communities, the ski area is kind of the big attraction — the big driver, the big economic driver for those areas. So without those ski areas, a lot of those other businesses might not do so well. It's an important economic driver for a lot of parts of the state.

Melanie Plenda:

It looks like many ski areas upgraded facilities over the summer, especially in terms of snow-producing equipment. Can you tell us more about that? 

Jessyca Keeler:

Ski areas are constantly investing in snowmaking. This is something that's been going on for decades, really. When the ski industry started back in the 1930s in the state, it was pretty evident right away that we might need some help along the way, because Mother Nature can be kind of fickle in the winters here in New England and in New Hampshire. 

It's really just important and vital for ski areas to invest in that technology so that we can guarantee a great product for skiers and riders who are coming up here to ensure that our winter tourism industry is healthy. So it's something that we do on a regular basis. I think this year alone, at least eight ski areas that I've counted that I know of invested — some small investments, some really big investments — in snowmaking this year, and I expect that to continue in the years to come.

Melanie Plenda:

How is climate change affecting the industry?

Jessyca Keeler:

It's definitely something that we've been grappling with over the years. We are seeing warming winters. Winters seem to start a little bit later. It takes a while for the weather to get cold enough to make snow, or for us to start seeing snowfall, or the ground freezing. This time of year, ski areas are sometimes opening later than they planned, maybe by a week or so. We're seeing that on the other end as well, in the spring. So we might be having warmer springs happening earlier than we expect, and that has caused some ski areas to close earlier than planned.

Likewise, with the extreme weather events that we're seeing. Last year, in December, we had this big rain and flooding event that kind of caused us to lose a lot of the snowmaking gains that we had right before the holidays. That really had an impact on us. Then in the spring, we saw some crazy storms where a lot of heavy snow fell, and in some places it was so heavy that it was either more icy or it was so heavy that it brought down trees, which caused power outages. Then ski areas can't over operate in those regions.

So it's definitely having an impact on our industry, but we're pretty resilient, and we have been taking strides and making efforts over the years to try and deal with what comes our way.

Melanie Plenda:

What’s being done to mitigate that impact? 

Jessyca Keeler:

Investments in snowmaking are a really important part of that adaptation for us as an industry, and ski areas are constantly reinvesting in that. Other investments include grooming technology as well — better groomers. There's a lot of work done on the slopes during the summer months to prepare for a season so that you can have less snow on the trails, for example. There’s a lot of different things that ski areas are doing to adapt.

Melanie Plenda:

Your organization also gathers skiing deals. Can you tell us more about those? Are there still discounts, and how regularly is that updated? And when’s the best time to get a deal?

Jessyca Keeler:

So it really depends on what kind of deal you're looking for. If you're a season pass holder — if you know you're going to ski more than, say, five times in a winter and you know you want to go to either the same mountain or different mountains — we do provide information about different season passes. I find that the best time to buy those is usually in the spring, when season one is still going. So if you're skiing in March, you might start to see ski areas advertising to you for the best rates for next season. If you're pretty sure that you're going to ski next season, I would recommend that you get your passes in the spring. It's usually like April, May, maybe into June, it varies by ski area, but those are the best times to get a pass. 

Melanie Plenda:

What does the future look like for skiing in New Hampshire?

Jessyca Keeler:

Like I said, we're optimists, and I would say I fall into that category as well. The ski areas, based on the investments that they've been making at their properties — we're not just talking about snowmaking, we're talking about new lodges, new trails, new mountains, even added to some of the existing ski resorts. We’re just seeing a lot of investment, and I think that points to a healthy industry. The future is bright. With those snowmaking and snow grooming investments that we've made, I think that we're prepared to deal with whatever comes our way. 

Melanie Plenda:

Well, good luck with the season. Jessyca Keeler, president of Ski New Hampshire, thank you for joining us today. 

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communications. It is shared with partners in the Granite State News Collaborative, of which both organizations are members.These articles are being shared by partners in the Granite State News Collaborative. For more information, visitcollaborativenh.org

New Hampshire’s growing hunger problem and ways to relieve it

For many, Thanksgiving is an epic feast, featuring a table full of food. But for some, full tables aren’t always a reality. Feeding America, a nationwide network of food banks, food pantries and local meal programs, released its “Map the Meal Gap 2024” report earlier this year, and it noted that more than 135,200 New Hampshire residents are food-insecure — a year-over-year increase of more than 41,000 people. In total, about 10 percent of New Hampshire residents — and more than 13 percent of children — are food insecure, meaning they don’t know where their next meal is coming from. Several organizations in the state are doing what they can to address hunger locally. On this episode of “The State We’re In,” Jenn Morton, of End 68 Hours of Hunger-Nashua and Anne Hayes of Gather talk with host Melanie Plenda on the problems and solutions. 

By Rosemary Ford and Caitlin Agnew

This article has been lightly edited for length and clarity.

Melanie Plenda:

First, Jenn and Anne, please tell our audience about your organizations and how they are addressing food insecurity and hunger in New Hampshire.

Jenn Morton:

End 68 Hours of Hunger focuses on feeding children who face food insecurity at home. There are End 68 Hours of Hunger programs throughout the state. Ours in Nashua distributes food bags to about 17 schools and community centers locally, and we are currently feeding approximately 480 children a week. 

Anne Hayes:

We're a broad spectrum organization. Our mission is to offer innovative programs that build food security in welcoming and dignified ways, and it ranges from a bricks-and-mortar food pantry here in Portsmouth to mobile markets. We run about 40 mobile markets every month going out on the seacoast from all the way down to Seabrook and all the way  up to Somersworth and Farmington.

We also do a lot of food repurposing. We take food that would otherwise go to waste and turn it into meals and distribute about 80,000 of those meals every year, and another 1.7 million pounds of food every year to about 10,000-plus New Hampshire residents and York County, Maine, residents every month.

Melanie Plenda:

Anne, what does food insecurity and hunger look like in New Hampshire? 

Anne Hayes:

If I were to go out this morning in front of our food pantry, there would be about 30 people waiting in line, and it's all ages. It's people who are unhoused. It's seniors on fixed incomes that have felt the pinch of increases in food prices and housing prices. It's families with small children. There was a man in our pantry today with his little two-year-old in the cart. It's a huge range of people, from individuals all the way up to families with eight people in them. It's hard to say what it looks like, because you'd be really surprised at what it looks like.

Melanie Plenda:

Jenn, how big of a problem is this? 

Jenn Morton:

I think food insecurity is kind of a hidden problem in New Hampshire and across the nation. It's something that people don't always want to admit to or talk about.

We often get children that were identified at schools for behavioral reasons. It's not that they come in saying that they're hungry, but they'll come in really tired, and when the teacher asks about how their night was, they will admit to not sleeping so well. And when they ask more about why they didn't sleep so well, it turns out they didn't have dinner the night before, so they went to bed hungry. Food insecurity and hunger doesn't always present as someone saying, “I need food.” It can be an invisible problem that especially children aren't really tuned in to. We have children who are worried or nervous about going home on Fridays because they don't know where their next meal is coming from, and that's where our bags come in. They go home with the children for the weekend so that they know that they can have a source of food while they're at home.

Melanie Plenda:

There was a rise in the number of food-insecure people in New Hampshire last year. What’s fueling that? 

Anne Hayes:

Back in 2020, when the pandemic hit, things went up a lot. We all thought that it would come back down when the pandemic ended, but I think what's happened is, with food prices going up, with housing prices going up, with the end of pandemic era benefits, people are really finding themselves super squeezed. They may have been able to set aside a little bit of money earlier on when those benefits ended, but now that money is gone, and they are forced to come and access a food pantry, which we think is actually a really good idea for people. We love to see people come here first before they end up not being able to pay their rent, not being able to keep their car on the road so they can go to work, those kinds of things. But what we're really seeing is that people are just really being squeezed by the cost of living.

Jenn Morton:

Unfortunately, pay scales have not kept up with the cost of living, especially in New Hampshire. Minimum wage jobs or jobs that are barely making a living wage, maybe $12, $14, $15 an hour is not going to pay rent for a family of four. So there aren’t as many agencies that can help with rent or utility bills, but there are lots of agencies that can help with food. We’re always glad when families are able to reach out and say, “I’m really just struggling this month.” We see it throughout the school year. Our numbers increase in September, October. People just hear about our program, they're like, “No, I'm OK. I can get through this right now.” But when we really see a spike in our bag numbers is January, February, March, when people are deciding whether to pay their utility bills for heat and hot water through the winter, or whether they're deciding to put food on their table. That is especially when our bag numbers get really high, and we're glad that they have a resource to reach out to fill that gap.

Melanie Plenda:

As a community, in your opinion, are we doing enough to ensure everyone has enough to eat? 

Anne Hayes:

I think the community is very supportive of Gather’s work and of the work of other organizations like us. I feel like we have a very, very generous community, both in terms of people who donate money and in terms of people who give their time to help.

I think on the state level, there's more that we could be doing. There's more we could be doing to make sure that people who are eligible are on SNAP. There's more we could be doing by providing breakfast before the bell for students in schools, making it easier to sign up for free and reduced price lunch at schools for children, making it easier for seniors. We did get some legislation passed this year that made it easier for seniors to sign up for SNAP [the Supplemental Nutrition Assistance Program], and that was great, but there's more to be done. 

Jenn Morton:

There were actually several bills in the Legislature last spring that would have expanded the free and reduced lunch program for students. Currently, there are not as many families qualifying for student free and reduced lunch as needed. It's based on the federal poverty income level, and we've definitely been able to expand other programs based on the federal poverty level, such as the Education Freedom Account program. We're giving out money for private schools, and yet we're not feeding the children who need to be there to eat.  So there's definitely ways that we need to support better at the state level.

But, as Anne said, our communities are really pitching in. No one wants to see children hungry in their communities. That has been my takeaway from my eight years volunteering here. We have a lot of volunteers that show up for any event that we plan. We do get a good amount of financial support, but at the state level and federally, there's definitely more to be done. I would love to see a statewide free breakfast and lunch program for students.

Melanie Plenda:

Along those same lines, what can we do? Is there a solution to this problem? 

Jenn Morton:

Definitely. Advocate, advocate, advocate for hunger solutions in your community. Pitch in and volunteer at your local level, but reach out to your state representatives, let them know that you care about the fact that there are hungry people in your community. We can work funding into the budget if that's something that we choose to prioritize. So I definitely encourage anyone to advocate for people, and that would be a great help. Also, local donations — both of actual food goods or monetary donations — are always appreciated to any of your local nonprofit food banks and food pantries,

Anna Hayes:

On the state level, reaching out to your state reps makes a big difference. The Hunger Free NH bill  [in the last legislative session] that we had was pretty much gutted, unfortunately, — there was a lot in there that could have really helped people. I think the more people who reach out and say something to their reps, the more likely it is that people start to recognize the problem.

Beyond that, I would say, definitely, Gather has a ton of volunteer opportunities. We work with between 40 and 50 volunteers every day to distribute the food that we distribute, and we would love to have more support in that way .And donating, because in the end in New Hampshire, more of the weight of this problem falls on nonprofits. So anything you can do to donate your time, talent or treasure is greatly appreciated. 

Melanie Plenda:

How can people help you with your work? What’s the best way to contribute?

Anne Hayes:

We can always use funding to support our work. If you go to our website, at gathernh,org,we would appreciate any contributions that people can make. Also on our website is a button that says “volunteer.” We would love to have people sign up to do that. And then just really helping by reaching out to state reps, reaching out to your neighbors, seeing if you can organize a food drive — participating in those kinds of things really makes a difference for us.

Jenn Morton:

Same here. Our website, end68hoursofhunger.org our website has your local communities listed that have End 68 Hours of Hunger programs. Most of them have buttons to give directly to your local community. Quite a few of them also have buttons to local volunteer opportunities. We also have an Amazon wish list at End 68 Hours of Hunger in Nashua. So all you have to do is visit that website, click through a wish list or a donate button, and you can really make a big difference in the life of a child in your community by helping to end their hunger situation, we really appreciate it.

Melanie Plenda:

Thank you Jenn Morton from End 68 Hours of Hunger-Nashua and Anne Hayes from Gather for discussing this really important topic today. 

“The State We’re In” is a weekly digital public affairs show produced by NH PBS and The Marlin Fitzwater Center for Communications. It is shared with partners in the Granite State News Collaborative, of which both organizations are members. These articles are shared by partners in the Granite State News Collaborative as part of our Race and Equity Initiative. For more information visit collaborativenh.org. 

Amid political anxiety, providers see uptick in requests for long-acting birth control

The demand is fueled by uncertainties about abortion access and insurance coverage for contraceptives, experts say.

By: Kelly Burch, Granite State News Collaborative

Health clinics around New Hampshire have been fielding increased demand for long-acting and permanent birth control options since the presidential election, amid fears that the new administration might curtail access to or insurance coverage of contraception.

At Planned Parenthood of Northern New England, which has clinics in Derry, Exeter, Keene and Manchester, appointment bookings for long-acting reversible contraceptives — which include the birth control implant and intrauterine devices known as IUDs — were up as much as 82 percent in the week after the election (compared to the week before), while the number of vasectomy consultations increased slightly. 

Other health centers — including Lovering Health Center in Greenland, Equality Health Center in Concord and Lamprey Health Care, which has locations in Nashua, Newmarket and Raymond — have also seen an increase in calls about birth control options. 

“People feel very strongly that the time is now,” said Sandi Denoncour, executive director of Lovering Health Center. “There’s so much uncertainty and anxiety about what’s to come, they’re choosing a long-acting or permanent option.”

President-elect Trump has said he will not ban birth control and would veto a national ban on abortion. However, the nonprofit Center for Reproductive Rights has reported that a second Trump presidency poses “grave threats to reproductive freedoms.” Project 2025, which has been closely associated with Trump, calls for changes that include ending mandatory insurance coverage for contraception and access to medical abortion. There’s also anxiety that certain birth control methods and abortion could be banned or strictly limited, whether at the state or federal level, Denoncour said.

The result is an urgency for people to get access to long-acting birth control options before any changes can take place, Denoncour said. 

“It’s all very acute to people,” she said. “People are very worried. The anxiety is palpable.”

Lamprey Health Center hasn’t had a substantial increase in new appointments for birth control, said CEO Sue Durbin. However, providers have noticed more calls asking about replacing long-acting birth control before it’s medically necessary. IUDs can last for three to 10 years, depending on the brand. Replacing an IUD early essentially restarts the clock on that time period, ensuring a highly effective birth control option for years to come. 

For some patients, that can provide peace of mind. 

“There really is a lot of anxiety, and a lot of uncertainties in the larger landscape,” Durbin said. 

Ultimately, whether it’s possible to replace a contraceptive early comes down to an individual’s medical history and what their insurance will cover. 

“It would be making a decision on their medical situation, rather than the political situation,” Durbin said. 

Lamprey Health Center began offering vasectomies a little over a year ago, and has seen a steady increase in demand for that permanent form of birth control, Durbin noted. Although the numbers increased this fall, it’s “hard to say whether or not that’s related to the political environment right now.” 

At Equality Health Center in Concord, there’s been “an increase in panic of our patients looking to make plans for their reproductive health,” said Executive Director Jinelle Hall. It’s something she also thinks about for her two daughters, who are 19 and 23. 

“I want to make sure they have the necessary means whether they want to become pregnant or not,” she said. “It’s not just my professional life; it’s my personal life.”

Equality Health Center also reports more worried phone calls from patients receiving gender-affirming care, a trend also seen at Lovering Health Center. There’s a limit to what the health center can do for those patients, Hall said. For example, “we can’t extend scripts” beyond what’s medically allowed. 

Instead, workers at Equality are reminding patients that they can still receive all their typical health care, at least for the time being. 

“We’re making sure our patients understand we’re here for them and we understand they’re anxious,” while also providing “some solid information and advice that it’s business as usual until anything changes,” Hall said.

‘There’s no guarantee’

Delivering that message can be tricky, Denoncour said. 

The exterior of Planned Parenthood's clinic in Keene. Appointment bookings for long-acting reversible contraceptives were up as much as 82 percent in the week after the election, while the number of vasectomy consultations increased slightly at the organization’s four facilities in the state. (Casey McDermott/NH Public Radio)

“One of the challenges of messaging over the past few years, when the [24-week] abortion ban passed in New Hampshire and Roe fell, [is telling] folks, ‘services are still available, but we should be very worried,’” she said. “Services are not protected. There’s no guarantee that these couldn’t change based on federal or state actions.”

Internally, health centers are preparing for possible changes in access to abortion and contraceptives, providers said. Hall also urges patients to channel anxieties into speaking up about the importance of reproductive health care. 

"Your voice has to be heard,” she said. “We cannot sit back. Continue to have conversations with folks who make these decisions. We vote these folks in.”

This year, Equality Health Center is celebrating 50 years of providing health care in Concord, and Hall doesn’t see that changing anytime soon. 

“We’ve gone through some tough times, and we’re about to again,” she said. “We’ll come out on the other side. It’s just going to have some challenges.”

That determination to carry on is shared by other health clinics, including Lovering Health Center. 

"The anxiety we’re hearing from patients, we absolutely feel it,” Denoncour said. "But we can’t act like we’re under threat every day. We’re stubbornly optimistic.” 

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