Family planning services are vital to the health and well-being of poor and low-income women in general, and marginalized populations in particular, according to three new articles in the Guttmacher Policy Review. These services constitute

• a gateway into the U.S. health care system for women who would otherwise only have a tenuous connection to medical care, or none at all;
• a source of urgently needed contraceptive services and other sexual health care for young women in foster care, who are at high risk of unintended pregnancy; and
• a highly successful public health program that boosts maternal and newborn health, saves billions in taxpayer dollars, and averts significant numbers of unintended pregnancies, unplanned births and abortions.

Family planning centers are a significant entry point to the U.S. health care system

Six in 10 women who obtain care at a family planning center describe it as their usual source of medical care, and in many cases, it may be their exclusive source. The nationwide network of more than 8,000 publicly subsidized family planning centers provides contraceptive and related services to more than seven million women a year. According to "The Role of Family Planning Centers as Gateways to Health Coverage and Care," by Rachel Benson Gold, these centers are increasingly leveraging their long-standing role as trusted safety net providers to connect clients not only to insurance coverage but also to needed health care beyond what the centers provide directly.

"Because of the trust they have built with their clients, family planning centers have become a crucial entry point into the health care system and, increasingly, a hub for referrals to other medical services," says Gold. "That’s a compelling argument for policymakers to continue supporting these centers, even as they increase resources for comprehensive service providers, such as community health centers. It also gives health plans a reason to bring family planning centers into their networks, and comprehensive providers a clear rationale to collaborate with family planning providers."

High unintended pregnancy rate among young women in foster care must be addressed

Nearly 160,000 adolescents live in foster care or with relatives other than their parents. Young women in foster care are more than twice as likely as their peers to become pregnant by age 19, with many experiencing a repeat pregnancy by that age. Children and youth in foster care are, by definition, eligible for Medicaid, which pays for contraceptive care and other preventive services. But there may be a particular lack of awareness and information about teen pregnancy among foster youth, according to "Teen Pregnancy Among Young Women in Foster Care: A Primer," by Heather D. Boonstra.

"The basic policy framework for reducing teen pregnancy among foster youth is already in place at the federal level," says Boonstra. "This includes the health care plans that child welfare agencies are required to develop for each child, as well as federal teen pregnancy prevention initiatives. Moving forward, child welfare agencies and program planners should be thinking about ways to maximize these levers to address the sexual and reproductive health needs of foster youth. However, budget cuts at the federal and state levels, both for child welfare programs and for publicly subsidized contraceptive services, could jeopardize any potential progress."

Title X is the lynchpin of the national family planning effort

The federal Title X family planning program not only subsidizes contraceptive services directly, but also provides essential support to create and sustain the network of health centers where women go to obtain these services. The impact is significant: The services provided at these sites enable women to avoid 973,000 unplanned pregnancies each year, averting 433,000 unplanned births and 406,000 abortions. These services further save (conservatively estimated) the federal government and the states $3.4 billion in Medicaid costs for prenatal, delivery and infant care—amounting to $3.74 saved for every $1 spent on contraceptive care, according to "The Numbers Tell the Story: The Reach and Impact of Title X," by Susan A. Cohen.

"It’s completely irresponsible and illogical that the House of Representatives voted to defund Title X," says Cohen. "Some lawmakers may have doubts about the value of Title X, but women do not. The program’s tremendous achievements are apparent in the numbers—measured in services provided, negative health outcomes averted and dollars saved. Title X is precisely the kind of government program that should be strengthened, not gutted. "

Read all three articles in the Spring 2011 issue of the Guttmacher Policy Review:

"The Role of Family Planning Centers as Gateways to Health Coverage and Care," by Rachel Benson Gold

"Teen Pregnancy Among Young Women in Foster Care: A Primer," by Heather D. Boonstra

"The Numbers Tell the Story: The Reach and Impact of Title X," by Susan A. Cohen