America is dying: Title X, another battle in the war of reproductive access

As President Trump addressed the nation in the State of the Union, a sea of women wearing white flooded the benches of the United States Capitol. The color white is symbolic of the trailblazers who paved the way for women’s suffrage. This display of solidarity was inspiring, and the diversity of these congresswomen created a sense of hope. It makes me, as an onlooker, believe that — maybe, just maybe — female health concerns might move up on the government’s to-do list.

As of now, prospects are grim. Title X of the Public Health Act went into effect last month; this legislation further hinders women’s access to family planning and contraception. Title X is a grant program controlled by the federal government that expands access to reproductive healthcare. According to the CDC, family planning was one of the “ten great public health achievements” nearly 20 years ago. So severely curtailing access to family planning seems counterintuitive.

Unfortunately, that is exactly what is happening.

The proposed regulation shifts funding away from organizations such as Planned Parenthood, which offer a wide range of reproductive services including but not limited to: sexually transmitted infection (STI) tests, contraception, cancer screening and much more. Under the new provision, funds would go towards faith-based programs that promote fertility awareness (measuring the days until ovulation) and abstinence-only education, which has actually increased the prevalence of STIs and teen pregnancy.

Additionally, the legislation would eliminate nondirective counseling, meaning conversations regarding abortion may not be offered upon a clinic visit. This rule forces women to continue with pregnancy, stating that all women who test positive for pregnancy must be referred to prenatal care regardless of their ability to move forward with motherhood. Previously, Title X protected minors with confidentiality when they sought out contraception; however, a new clause now requires parental documentation from all adolescents seeking birth control. In the case of Planned Parenthood of Southeastern Pennsylvania v. Casey, the Supreme Court acknowledged the importance of access to proper reproductive services: “The ability of women to participate equally in the economic and social life of the nation has been facilitated by their ability to control their reproductive lives.” New Title X legislation directly undermines this personal liberty.

The accessibility of family planning directly affects health outcomes. Take Kerala, India for example. This southwestern coastal state of 35 million has health outcomes that are on par with high-income countries. These positive health indicators come despite Kerala’s slow economic growth and lower state per capita income. What has been coined as “The Kerala Model” has caught the eyes of many public health professionals and can be boiled down to one simple principle: female empowerment and free family planning services. These services are all-encompassing and teach women about everything from breast feeding and nutrition to immunization. Consequently, Kerala has been defined as a nation that has attained high levels of health before reaching economic prosperity. Clearly, making child and maternal health a governmental priority benefits everyone. Hey, America — take note.