How Does Title X Affect Reproductive Health?

Birth Control
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Title X, pronounced "Title 10", is a federal law that is designed to fund family planning programs and related preventative health programs for low-income individuals. Title X provides free or low-cost reproductive health services to people who are low-income and/or uninsured.

What Is Title X?

First established in 1970, under the Nixon administration, Title X funds reproductive health services including:

Title X funds these services by providing grants to both public and private organizations, including local health clinics.

Is Title X Planned Parenthood?

Although some people equate Title X clinics and Planned Parenthood, the comparison is not accurate.

According to the Guttmacher Institute, Planned Parenthod only represents 13 percent of Title X clinics. Other types of clinics funded by Title X include public health department clinics, federally qualified health clinics, hospital outpatient clinics, and independent clinics. That said, the services provided by Planned Parenthood are critical. In 2015, Planned Parenthood served 41 percent of all contraceptive clients visiting Title X clinics.

Does Title X Fund Abortion?

Title X explicitly prohibits using its money to fund abortion as a method of family planning. Title X does not fund abortion, and clinics receiving Title X funding are not allowed to use that money to provide abortions. Title X does fund contraception, which reduces the number of unintended pregnancies and as such the number of abortions.

Impact on Reproductive Health

Researchers estimate that publicly funded contraceptive services helped prevent 1.9 million unintended pregnancies in 2015 alone. That means that access to contraception likely prevented over 600,000 abortions.

Not all of those services were provided by Title X clinics, but many were. In 2015, over 800,000 unintended pregnancies and 250,000 abortions were prevented by Title X services. Furthermore, estimates suggest that without Title X services the teen pregnancy rate would have been 44 percent higher and the overall unintended pregnancy rate would have increased by a third.

In addition, research suggests that Title X clinics provide better access to a range of contraceptive measures than non-Title X clinics. For example, Title X clinics are more likely to provide services including intrauterine contraceptives, contraceptive implants. These long-acting contraceptive measures can enable women to protect themselves from pregnancy for years at a time. Title X clinics are also more likely to provide permanent birth control options, such as vasectomies.

Vasectomies aren't the only service that Title X clinics provide to men. From 2003 to 2014, 3.8 million men visited Title X clinics, and the proportion of service users who were men increased steadily over time. By 2014, more than 8 percent of visits to Title X clinics were for men. Men sought a wide range of care at these clinics including preconception care, infertility treatment, contraception, and STD care.

Changes Over Time

Title X was initially put in place because scientists and politicians recognized that unintended childbearing caused numerous social problems. These problems included an increase in poverty and decreased participation in education and the workforce. Title X was designed to reduce unintended childbearing as well as to improve maternal and child health outcomes by giving women the ability to choose how and when they wanted to have children.

Title X has not remained static since it was first passed into law in 1970. Since then, almost 300 federal bills have been proposed to change Title X between 1970 and 2011. Only twenty of those were passed into laws.

Most changes involved restricting access to reproductive healthcare. In particular, changes that have gone into place have placed numerous restrictions on the provision of abortion services. These have gone beyond restricting the use of funds for abortion. There have also been bills that have encouraged the promotion of scientifically unsupported abstinence-only education and preventing providers from discussing abortion (even though they were already not allowed to provide it).

A Word From Verywell

Support for Title X should not depend on whether people are pro-choice or pro-life. The funds it provides are not used for abortion. Instead, funds are used to improve and save lives. They enhance individuals' reproductive health and help them have children only when and how they want. They also improve overall health by providing preventative health care including cancer screening and blood pressure measurement. In fact, many people primarily access healthcare through Title X.

Research has consistently shown that the Title X program has had enormous, positive impacts on the health of low-income and uninsured men and women. Title X funding has not just reduced unintended pregnancies and helped people prevent STDs. It has also improved the overall health of many young men and women,  reduced the number of preterm and low birth weight babies, and helped families have children they would not otherwise have been able to conceive.

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  • Thiel de Bocanegra H, Cross Riedel J, Menz M, Darney PD, Brindis CD. Onsite provision of specialized contraceptive services: does Title X funding enhance access? J Womens Health (Larchmt). 2014 May;23(5):428-33. doi: 10.1089/jwh.2013.4511
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