This study estimates the effect of climate change on contraceptive use in a global context. We link women’s monthly contraceptive calendar data from the Demographic and Health Surveys in 44 low- and middle-income countries with high resolution daily temperature data, exploiting the random component of local temperature deviations to causally estimate this effect. We find that high temperatures impact contraceptive use, driven by changes in short-acting reversible contraception. However, these impacts are region-specific: while temperature shocks reduce contraceptive use in sub-Saharan Africa and Latin America, they increase in South and Southeast Asia. We find clear heterogeneities by education, age, parity, and urban/rural status. Our estimates imply that temperature-related climate change in sub-Saharan Africa – the most impacted region – will reduce contraceptive use by 2.4-4.3 percent by 2100. We conclude that the disproportionate worsening of climatic conditions in low- and middle-income countries will exacerbate already-existing global disparities in contraceptive access and use.