Last month, voters in Ireland voted by a nearly 2-1 margin to make abortion legal, but the right to an abortion in the United States is under growing siege.
The implementation of Iowa’s recently passed “heartbeat law,” which bans most abortions and is one of the most restrictive state abortion laws in the country, was temporarily stayed by a judge this month, though less onerous restrictions in other states are forcing the closure of dozens of abortion clinics. In several states today only one abortion clinic remains open. Abortion access in the U.S. can no longer be taken for granted.
But it’s not just abortion rights that are under siege; access to contraception is also imperiled. The Trump administration’s recently unveiled “domestic gag rule,” as its popularly known, while technically aimed at curbing abortion, imperils the future of hundreds of Title X-supported family planning clinics providing contraceptive services to low-income households.
The proposed rule would deny Title X funding to Planned Parenthood and other family planning providers if they have any affiliates offering abortion services. What’s at stake here is the future viability of a family planning program that, over the past half century, has helped tens of millions of women gain access to contraception and other preventive health care services. At present, Title X supports over 4,000 clinics serving more than 3 million women a year.
The propose rule would also prohibit Title X family planning clinics from referring patients to any medical care provider offering abortion services, unless the patient specifically requests abortion services.
Even more ominously, the Trump administration wants to shift Title X funding away from traditional family planning clinics to “crisis pregnancy centers” that offer neither abortion services nor modern methods of contraception. Such a shift in funding and focus would undermine the whole rationale behind the creation of Title X, effectively denying low-income women access to family planning services and information.
Every woman should have access to contraceptive services and counseling information from a health care provider she trusts, whether it is Planned Parenthood or another provider. When women are denied that access, the rate of unintended pregnancy goes up, and that leads to more abortions, not fewer. At the same time, denying access to reproductive health care providers will accelerate an already alarming rise in the number of sexually transmitted diseases.
Last year, by executive action, Mr. Trump re-imposed and expanded the “global gag rule” that was first imposed by Ronald Reagan in 1984. Mr. Trump’s action requires foreign health care providers receiving U.S. funding in developing countries to certify that they do not advocate for, or refer patients to, abortion services. The practical effect of that rule is reduced access to the family planning services that can help women in developing countries prevent unplanned pregnancies — not fewer abortions.
Also last year, the Trump administration terminated all funding for the United Nation’s Population Fund, a major supplier of contraceptive services to women in the developing world, and it sought, unsuccessfully, to eliminate all bilateral funding for family planning programs serving women in developing countries.
This year, in United Nations deliberations, Trump administration appointees from the State Department and Health and Human Services sought to delete all references to contraception and sex education in a U.N. declaration on the rights of women.
As a practical matter, this administration is doing everything in its power to reduce or eliminate support for contraception, at home and abroad. Having failed to in its attempt to repeal the Affordable Care Act, which has significantly expanded contraceptive coverage, the administration has tried to undermine the so-called “contraceptive mandate” by giving employers and insurers the power, for any moral or religious reason, to drop contraceptive coverage from their insurance plans. In December of last year, a federal court in California temporarily blocked that proposed regulatory change, but the legal battle over the contraceptive mandate is far from over.
These myriad attacks on contraception do not reflect the will of Congress, which continues to appropriate funds for Title X, or the views of the American public, as a recent opinion poll indicates that 73 percent of Americans oppose a policy that would make it illegal for health care providers that receive federal funding to refer or counsel women about the option of abortion. What they do reflect is an administration more interested in pleasing its narrow political base than serving the reproductive health care needs of women.
This op-ed by Population Institute President Robert Walker originally ran on June 21, 2018 in The Baltimore Sun