Pro-Life? Then You Should Be Pro-Title X
Title X of the Public Health Service Act is the only federal program exclusively focused on family planning.1 Passed in 1970 with bipartisan support, it was co-sponsored by then Congressman George H. W. Bush and signed into law by President Richard Nixon.2 In recent years, however, it has become a political football, with some Republicans threatening to attach language ending Title X to nearly every government funding bill that moves through Congress. But the truth is that pro-life Americans should support this program—and there are three big reasons why.
1. Title X is Explicitly Forbidden from Funding Abortion Care.
Title X money can’t be spent on abortions—it says so explicitly in the legislation, in the regulations that govern it, and in the administrative requirements for the program. The purpose of Title X is to provide grants to public health departments, hospitals, community health organizations, and non-profit agencies to target low-income, adolescent, and un- and underinsured communities with family planning and reproductive health services, which are dispensed at over 4,200 sites nationwide.3 But not $1 of the approximately $275 million the program received in the last funding year was spent on abortion.4
One of the five sections of the Title X statute itself is entitled “Prohibition of Abortion,” and it includes only one sentence: “None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning.”5 The Code of Federal Regulations not only repeats that language, but requires every program receiving Title X funds to offer counseling on prenatal care, delivery, infant care, foster care, and adoption.6 And once a grantee—53% of which are actually state, county, and local health departments, rather than Planned Parenthood-type clinics—receives Title X funding, how it spends that money is closely monitored by the Department of Health and Human Services.7 Providers must undergo independent financial audits, regular comprehensive program reviews, and site visits to prove they are abiding by this spending ban.8
2. Title X Reduces Abortions in this Country.
Half of all pregnancies in the U.S. each year are unintended, and 43% of those end in abortion.9 But when women have access to contraception and are taught how to use it correctly, the rate of unintended pregnancy is estimated to fall to only 5%.10 Between 2006 and 2010, 14% of all women—and 25% of all low-income women—who obtained contraceptive services did so at a Title X-funded site.11 And Title X-funded sites not only provide contraception services, but they are also more likely than clinics that don’t receive Title X funds to offer a variety of methods and have established protocols to make it easy for patients to start and continue to use birth control.12 Among those methods is the extremely effective but underutilized IUD—which is offered at 85% of all Title X-funded sites but at only 60% of non-Title X-affiliated sites.13
Thanks to these services, it is estimated that between 1980 and 2000, Title X-funded sites helped women avoid 20 million unintended pregnancies—9 million of which statistically would have likely ended in abortion.14 In 2012 alone, the contraceptive services provided at Title X-funded sites helped prevent 1.2 million unintended pregnancies—which could have led to approximately 586,000 unplanned births and 403,000 abortions (with the remainder ending in miscarriage).15 Without Title X-funded sites, rates of both unintended pregnancy and abortion would be 35% higher—and 42% higher among adolescents.16 More than 2 million births and 2 million abortions to minors were prevented by Title X-funded sites from 1981-2001.17 And since the public cost of unintended pregnancies is was $21 billion in 2010, every one prevented by Title X saves the taxpayers money while also reducing the number of abortions in this country.18
3. It’s Not Just Contraception—it’s about Healthier Moms and Babies.
Title X does so much more than just fund contraception. It’s responsible for healthier women (and men—8% of the 4.6 million patients served in 2013 were male) and healthier babies across the country.19 In addition to contraceptive services, Title X also funds screenings for breast cancer, cervical cancer, high blood pressure, anemia, and diabetes, Pap tests, STI (sexually transmitted infection) and HIV testing, infertility services, research, and continuing education programs for clinicians.20 It also serves as a clearinghouse for data and information on family planning and reproductive health.21
Sixty percent of women seeking contraceptives at a Title X-funded site consider it to be their usual source of medical (not just contraceptive) care.22 Between 2006 and 2010, 18% of all women who were tested, treated, or received counseling for an STI did so at a Title X-funded site.23 So too did 14% of all women who were tested for HIV and 10% of women who received a Pap test or pelvic exam.24 In just 2013, Title X-funded sites performed 988,000 Pap tests, 1.6 million breast exams, almost 6 million STI tests, and 1.2 million HIV tests.25 And those tests result in real public health improvements: services provided at Title X-funded sites are estimated to have averted 53,000 chlamydia infections, 8,800 gonorrhea infections, 1,900 cases of cervical cancer, and 1,100 deaths from cervical cancer in 2010 alone.26
But adults aren’t the only ones who benefit from Title X services—helping women plan their pregnancies means healthier babies too. Because women who visit Title X-funded sites are better able to space their pregnancies, their children are less likely to be born at a low birth weight, be small for their gestational age, or be premature.27 Services provided by Title X-funded sites in 2010 prevented 152,000 short interpregnancy interval births and 87,000 preterm or low-birth-weight births.28 Additionally, better family planning, like that funded by Title X, means lower rates of both maternal morbidity and infant mortality.29
Americans are conflicted about abortion—with 43% of the country identifying as both pro-choice and pro-life when given the option.30 But there is no reason why any American should be conflicted about Title X. If being pro-life means wanting to reduce abortion in this country, Title X is one of the most pro-life pieces of legislation in our nation’s history. Its funding can’t be spent on abortion, it reduces the number of abortions every year, and it provides essential health care that leads to healthier moms and healthier babies.