Advertise free contraception
Just as we read that abortion continues to decline in the United States (“Self-managed abortions on the rise,” Sept. 21), family-planning clinics are contending with onerous changes to Title X, the federal program that funds free and low-cost birth control for the uninsured and underinsured.
Medical clinics are scrambling to figure out how to offer Title X reproductive health services following implementation of the Trump administration’s gag rule. The rule prohibits clinics from referring pregnant women in the Title X program for abortions, even when a woman requests one. Clinics risk Title X funding for all Title X patients if they direct women who want an abortion to a clinic that provides them safely.
The primary recipients of Title X services are teens who want confidential services and uninsured women including undocumented girls and women.
Some Title X clinics have opted out of the federal program altogether. Patients who would otherwise qualify now have to pay out of pocket for a pregnancy test — and counseling if they are pregnant — STD testing and reproductive health care. The end result will almost certainly be more unplanned pregnancies and potentially more abortions as well.
In New Mexico, the abortion rate remained flat between 2014 and 2017 at 11.7 abortions per 1,000 women, according to a new report by the Guttmacher Institute. The rate nationally in 2017 was 13.5 abortions per 1,000 women, a 7 percent decline from 2014. The decline is
attributed to a decrease in pregnancies, due in part to improved contraceptive use.
The abortion rate is directly tied to unintended pregnancy: pregnancies that are mistimed or unwanted. At the national level, about 45 percent of pregnancies are unintended but disproportionately higher at 75 percent for teenagers and 60 percent among girls and women living below poverty. They are due to lack of contraception during intercourse or contraception misuse or failure.
I believe, and my doctoral research supports, that many sexually active girls and women fail to avail themselves of contraception because they are unaware of exactly where they can obtain it confidentially and/ or for free in their community. The black box of health care costs and insurance creates ignorance and further avoidance of an already delicate matter.
My solution? I believe Title X providers should advertise that they offer free or low-cost contraceptives. So should medical providers that accept Medicaid. When I say advertise, I mean clinic names, addresses and phone numbers on billboards, posters, radio and newspaper advertisements, and social media.
Unintended pregnancy is as much a public health issue as the flu, so why are free flu shots advertised but not free contraceptives?
This inconsistency may be due in part to how contraception is viewed primarily as a political issue, not a health issue. A review of national television news coverage of contraception for four-plus years found that less than a third of the stories featured medical content. The most frequent sources of information were politicians at 40 percent, and Catholic Church leaders provided information more often than medical professionals (16 percent vs. 11 percent).
To continue the decline in abortion and unintended pregnancy, we need to support ongoing access to the full range of reproductive services. Moreover, health professionals need to take the lead in promoting the availability of free and low-cost contraceptives in order to get more girls and women on birth control, continue the drop in unintended pregnancies and abortions, and help to get the politics out of reproductive health.