What Policy Change Means for Women’s Health
The Reproductive Health Impact Study (RHIS) is a multiyear comprehensive research initiative that analyzes the effects of federal and state policy changes on publicly funded family planning care in the United States. The study, which focuses on Arizona, Iowa, New Jersey and Wisconsin, documents the impact of these policies over the period 2017−2022 on family planning service delivery and on patients who rely on this care. For the study, the Guttmacher Institute is working with research and policy partners in each state.
The RHIS was conceived in the aftermath of the 2016 election, in anticipation of federal and state efforts to change funding streams and service delivery for publicly funded family planning. As the study progressed, the RHIS team adapted ongoing study activities to document several relevant events—notably, the 2019 changes to the federal Title X regulations (the Trump-Pence administration’s “domestic gag rule”) and the COVID-19 pandemic.
The study uses original in-depth research and a wide range of secondary data sources to create a robust set of scientifically innovative, policy-relevant findings. The project’s objective is to illuminate the effects of policy change from a number of different angles:
- Family planning landscape: Identify how delivery networks are changing in composition and capacity as funding streams and programmatic guidance shift
- Clinics: Quantify changes to the number and types of safety-net health centers available to women, and to the number of women who visit these sites for contraceptive services
- Clinic staff: Describe the perspectives and experiences of clinic staff as they navigate the changing policy landscape while providing high-quality services to patients in their communities
- Patients: Describe the perspectives and experiences of family planning patients as they navigate access and barriers to access within a changing family planning service delivery system
- Reproductive health indicators: Monitor shifts in key reproductive health indicators and expenditures at the state level
These objectives will be achieved through the activities outlined below: