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New Title X Priorities Emphasize Less Effective Birth Control Methods That Few Women Want

The new requirements are socially irresponsible. 

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With the overwhelming support of Congress, President Richard Nixon signed Title X into law in 1970. The program sought to ensure that women — regardless of their economic circumstances — had access to the type of birth control they wanted. For nearly 50 years, Title X funds have made the full range of highly effective methods of contraception accessible to millions of teens and low-income Americans, thereby reducing rates of unplanned pregnancy and abortion.

The Trump administration recently set new priorities for the program, including emphasizing natural family planning at the expense of more effective methods such as the pill, IUD and implant. Natural family planning methods, such as the rhythm method, require period tracking, temperature taking, and more. They also require women to abstain from sex or use condoms for a week per month during their fertile window.

In a break with long-standing precedent, there is now no requirement for Title X providers to offer the full range of birth control methods. The new guidelines do, however, require providers to offer counseling on natural family planning. This administration’s ideologically driven emphasis on natural family planning undermines Title X’s goal of supporting women of all economic backgrounds in having the number of children they want when they want them.

The new requirements are socially irresponsible and completely out of step with the contraceptive desires of the vast majority of women.

Our research group recently completed a study of the contraceptive preferences of low-income Texas women. Among the 1,469 women we interviewed three months after delivering a baby, less than 1 percent said that they wanted to be using natural family planning methods by the time their baby was 6 months old.

Nearly all the other women in the study wanted to use more effective birth control. For example, 41 percent of women wanted to use an implant or IUD, birth control methods that are more than 99 percent effective. But the high costs of these methods put them out of reach for many women. This is particularly true in more conservative states, where a legacy of ideologically motivated cuts to family planning funds has made it difficult for women to access these methods, even with the assistance of Title X.

In contrast, when women are given access to resources, they choose to use effective methods and prevent unintended pregnancy. The Colorado Family Planning Initiative used a mix of Title X and private funds to offer the full range of birth control methods, including free implants and IUDs, to women of reproductive age. By removing cost as a barrier, the number of women using these methods skyrocketed, which in turn substantially reduced the rates of unplanned pregnancy and abortion among teens and young women.

To be sure, a small minority of women prefer natural family planning methods and can effectively use them to prevent pregnancy — and their preferences should be supported by their providers. In fact, Title X providers are already doing a great job of providing counseling and support for women who want to use natural family planning, with 93 percent doing so. Clinics that specialize in reproductive health, such as Planned Parenthood, also do better supporting natural family planning than primary care clinics that offer family planning (91 percent versus 75 percent). Yet again, the Trump administration proposes a solution in search of a problem.

This new, singular focus on natural family planning methods is the result of conservative voices that seek to restrict women’s access to the entire range of birth control methods. This move is in step with other ideologically driven Trump administration efforts to allow employers to refuse to cover birth control methods they find objectionable, such as the IUD. Despite clear scientific evidence that the IUD works by preventing sperm from fertilizing an egg, some continue to falsely claim that IUDs can cause an abortion.

The Trump administration’s emphasis on natural family planning methods guts the core mission of Title X — to help women (and men) plan their families by providing the full range of birth control methods. Title X funds should not be used to further religious or ideological objections to certain types of birth control, but instead should be used to help all women get the effective methods of birth control that they want.

Katherine Strandberg is a research associate with the Texas Policy Evaluation Project at The University of Texas at Austin. 

Kristine Hopkins is a research assistant professor of sociology and a researcher with the Texas Policy Evaluation Project at The University of Texas at Austin.

A version of this op-ed appeared in USA Today.

To view more op-eds from Texas Perspectives, click here.

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