By Patricia West
As a Pennsylvania social worker specializing in family dynamics, I’ve spent most of my 40 year career analyzing and trying out various ways to keep women healthy and safe. This month [June 7] we celebrate the anniversary of a breakthrough in that process: the 1965 Griswold v. Connecticut Supreme Court decision that legalized contraceptive use for married couples—and more importantly, recognized an individual’s right to privacy in family planning matters.
The Centers for Disease Control and Prevention recently recognized family planning as one of the ten great public health advances of the 20th century. At clinics and centers that provide family planning, the complications of pregnancy that are a woman’s most common source of ill health can be prevented or treated. And our national family planning program – Title X of the Public Health Service Act of 1970 – made family planning available to low-income people as well as the rich. As a result, some 98 percent of us have used birth control at some point in our lives, and we mostly take it for granted.
We shouldn’t. The House voted recently to defund Title X completely for fiscal 2011. The Senate saved the program, but another attempt to kill it is certain this year. The attackers are using innuendo and misinformation to entangle family planning in their anti-abortion war, claiming to cut spending but ignoring the truth: Title X, the only dedicated source of federal funding for family planning services, saves the government some $3.4 billion every year by preventing unintended pregnancies, nearly half of which would likely end in abortion.
In Pennsylvania, for example, the state’s 234 Title X centers served 287,200 clients in 2008, providing not just contraceptives but also essential preventive care: pelvic exams and Pap tests; pregnancy testing; screening for high blood pressure, anemia, diabetes and cervical and breast cancer, and for sexually transmitted infections including HIV; basic infertility services; health education; and referrals for other health and social services. This care helped
Pennsylvania women avoid 59,700 unintended pregnancies, which likely would have resulted in 26,500 births and 24.900 abortions. That saved the state $183.5 million in Medicaid spending, according to the Guttmacher Institute.
At the moment, unintended pregnancy costs U.S. taxpayers about $11 billion a year, according to new Guttmacher research. Without publicly funded family planning services, these costs would be 60 percent higher. Nationwide, Title X funds 89 nonprofit grantees who operate more than 4,500 sites. Most are county and local health departments; the rest are hospitals, family planning councils and other private nonprofit agencies.
Seventeen million people need some assistance to get the kind of care these centers provide, but today Title X is funded to cover just over five million of those in need. Some 70 percent of them have incomes at or below the federal poverty level of $10,830 per year. They live paycheck to paycheck, and the Pennsylvania women I have worked with know what that is like. Six in ten women who get care from Title X
consider it their usual source of health care, and for many it is their only source.
Every dollar invested in publicly funded family planning averts nearly $4 in Medicaid costs. It only makes sense that the Obama administration should include contraceptives in the women’s health preventive services benefits under the Affordable Care Act.
Title X, in short, is essential to preventing unintended pregnancies and improving public health while saving taxpayers billions of dollars every year. Family planning gives a woman options for her life beyond childbearing. If she wants two children – as most American women do – she will be able to pick the five years she will be pregnant and bearing her children, confident that contraceptives are available to her for the 30 years she will spend avoiding pregnancy.
This is a life-changing freedom. In the coming Pennsylvania and national spending battles, Title X must be recognized for what it has always been: a fundamental part of American life that can and must be preserved.
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West lives in Philadelphia and is a member of the Women Donors Network. She is a public health social worker and user of “the pill” from 1959 through 1970.
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Copyright (C) 2011 by American Forum. 6/11
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