Federal policy on women’s health shifts under Trump
Critics worry changes could lead to more unintended pregnancies and abortions
WASHINGTON — Step by methodical step, the Trump administration is remaking government policy on reproductive health — moving to limit access to birth control and abortion and bolstering abstinence-only sex education.
Social and religious conservatives praise the administration for promoting “a culture of life.” But women’s-rights activists and some medical experts view the multipronged changes as a dangerous ideological shift that could increase unintended pregnancies and abortions.
“When I ran for office, I pledged to stand for life,” President Donald Trump
said in a recent speech to the Susan B. Anthony List, which backs political candidates who oppose abortion. “And as president, that’s exactly what I’ve done. And I have kept my promise, and I think everybody here understands that fully.”
Most of the changes involve rules and regulations under the administration’s direct control, such as a proposal to forbid federally funded family planning clinics from referring women for abortions and separately allowing more employers who cite moral or religious reasons to opt out of no-cost birth control for female workers.
Trump also is appointing numerous new federal judges endorsed by antiabortion groups.
Justice Neil Gorsuch, the president’s only appointment to the Supreme Court so far, has a sparse record on abortion, but has drawn praise from anti-abortion groups and criticism from abortion rights supporters. Unlike regulatory changes, judicial appointments cannot be reversed by a future president.
Democrats say Trump is changing policy in ways that could disrupt access to family planning for some people.
A recently proposed rule would make major changes to Title X, the familyplanning program, including banning clinics from sharing physical space and financial resources with abortion providers. Providers like Planned Parenthood could be forced out.
“It’s across the spectrum of women’s health services,” said Rep. Diana DeGette, D-Colo. “They’re proposing abstinence-only sex education — which study after study has shown doesn’t work — restrictions to family planning, and more and more restrictions to abortion.”
Title X serves about 4 million lowincome people, mainly women. Disruptions could affect women’s access to long-acting contraceptives, such as implants and IUDs. Those are more effective than daily pills that can be forgotten but also much more expensive up-front.
Speaking at a recent rally organized by women’s health advocates in Phoenix, Karina Romero recalled how she had no health insurance and about $20 in her bank account when she sought birth control at a Planned Parenthood clinic in the city’s suburbs.
The federal program enabled her to get a long-lasting contraceptive implant.
“They have allowed me to pursue a higher education without having to worry about how I’m going to pay for my birth control, or how I’m going to pay for just a regular check up every year,” said Romero, who studies online at Northern Arizona University.
The administration says it supports family planning and isn’t cutting funding — merely drawing a “bright line” between birth control and abortion. Officials say the doctor-patient relationship is protected because if a woman asks for an abortion referral, Title X doctors could offer a list of pregnancy services providers, including some who perform abortions.
Trump’s changes come at a time when U.S. rates of births overall, births to teens, and abortions are low.
In addition to the proposed Title X changes, other actions include:
Proposing a shift in the Teen Pregnancy Prevention Program to emphasize an abstinence-only approach.
Proposing new criteria for federal family-planning grants that would favor applicants who promote “natural family planning” and abstinence.
Expanding a ban on U.S. funding to foreign organizations that promote or provide abortions.