Publicly funded family planning providers are struggling to meet a growing need for subsidized contraceptive care, which is being driven by more women wanting to postpone childbearing during tough economic times. This surge in demand is straining already-limited resources, and is exacerbated by rising unemployment that has resulted in more women losing employer-based insurance coverage, according to "A Real-Time Look at the Impact of the Recession on Publicly Funded Family Planning Centers," based on a new survey by the Guttmacher Institute.

Two-thirds of the responding centers reported an increase in the number of clients seeking contraceptive services between the first quarter of 2008 and the first quarter of 2009, and more than four in five reported an increase in the number of clients who are poor or low-income and therefore eligible for free or reduced-fee care. In addition, nearly two-thirds reported a decline in the number of clients who are able to pay the full fee for services.

"The recession has put many women in an untenable situation. They want to avoid unintended pregnancies more than ever, but are having trouble affording the contraceptive services they need to do so," says Dr. Sharon Camp, Guttmacher president and CEO. "The very providers these women turn to in times of crisis are themselves struggling to make ends meet. It is time to bolster the nation’s family planning system to help women avoid unintended pregnancies and the unplanned births and abortions that would result."

The nation’s publicly funded family planning centers provide contraceptive services and related health screenings to women across a broad socioeconomic spectrum, and these centers are the primary safety-net providers of these services to economically disadvantaged women. Compared with Americans overall, women of reproductive age are more likely to lack health insurance, and lower income and younger women (those 29 and younger)—who are already at the greatest risk for unintended pregnancy—are even less likely to be insured.

According to the new report, some family planning centers have been able to expand their hours of operation to meet the growing need. Unfortunately, many more centers have been forced to cut back on services due to budgetary constraints. More than half of responding centers reported one or more service delivery challenges related to staffing or cutbacks in services.

• Nearly half reported staff layoffs or a hiring freeze.
• One-third reported cutbacks in the number of contraceptive methods offered, typically the long-acting and more effective methods like the IUD and implant (which have high up-front costs) and some brands of birth control pills.
• A quarter reported longer wait times for clients seeking care.

"These findings underscore the critical importance of publicly funded family planning centers as safety-net providers—now and in the future," says Camp. "Policymakers should focus on practical steps to strengthen this safety net by increasing the number of Americans with health insurance that includes contraceptive coverage, expanding Medicaid family planning coverage, ensuring that family planning centers are integrated into health plans as in-network service providers and ensuring that reimbursements to providers are adequate to cover the cost of their services and supplies."

About this study

"A Real-Time Look at the Impact of the Recession on Publicly Funded Family Planning Centers" is based on new data from a survey of 60 family planning centers located around the nation that receive some funding through the Title X program and are representative of the range of provider types comprising the family planning center network, as well as on the most recent data available from the Current Population Survey on the number and percentage of women who were uninsured in 2008.

An earlier study published in September, "A Real-Time Look at the Impact of the Recession on Women’s Family Planning and Pregnancy Decisions," surveyed women to determine how the current economy has affected them and their families, their views of contraceptive use, their ability to access contraceptives and their decisions on whether or when to have a child.