Confronting New Obstacles to Family Planning

Little is known about how legislation reducing access to family planning services affects the women who rely on these services. A 2015 article in Perspectives examined the experiences of low-income women and teenagers in nine Texas metropolitan areas in 2012, a year after state legislation reduced access to publicly funded services. The upshot of this qualitative study: Obtaining reproductive health care had become more expensive and was forcing women to make agonizing decisions.   

As a result of the legislation, some women had to pay, or pay more, for previously free or low-cost services, or had to consider going without care. One woman said the $50–75 it cost for a family planning visit was “hard when you’re a single parent and you have kids.” That cost, another woman said, could force her to choose between a family planning visit and necessities such as gas or diapers. Notably, other women reported that because of cost, they were not using the highly effective contraceptives they preferred. One said that because the implant would cost her more than $1,000, she was relying on the much cheaper, but less effective, vaginal contraceptive film.

Women in Texas had faced some obstacles even before the new legislation. Many adult participants said they had not known about a previous program that provided reimbursements for contraceptives. For their part, teens mentioned several long-standing requirements that they had to meet in order to avoid obtaining parental consent for family planning services.

The authors offered several proposals that had been voiced by study participants, such as lifting the parental consent requirement, expanding women’s access to free or low-cost reproductive services, and ensuring that family planning services are provided after pregnancy-related care ends. The experiences of low-income women and teens, the authors wrote, should inform future policy changes.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine