Title X funding: Cutting our nose off to spite our face

I’ve worked as a nurse in labor and delivery for more than 30 years. I have always felt a joyous connection between my work and faith.

Welcoming new life. Teaching families about how to care for their babies. Empowering women to trust themselves and the process of delivery. Feeding and nurturing a precious child of God.

My work as a nurse has been a spiritual gift that I welcome and feel honored to use.

I believe my experience and work qualify me as pro-life. But the political — and sometimes religious — implications of that label often put me in conflict with the general perception of what that means to many people.

I think abortion should be legal because it has been proven to be dangerous and even fatal for women when it is criminalized. I also believe life is created by God and is sacred. We, as people of faith, should do everything in our power to honor life by empowering women to plan their pregnancies and reduce abortions.

Education and empowering women and girls to understand and take charge of their health and family planning lowers abortion rates. Not only that, it also improves the standard of living for women, their families and their entire communities.

And yet in our political and policy realities today, we seem to be — as my Granny would say — “cutting off your nose to spite your face.”

In the name of a political anti-abortion philosophy, all funding and health care policy decisions are increasingly focused on regulating access to comprehensive reproductive health care for women. Currently, the federal government has announced changes to a long-standing law, Title X.

The Title X Family Planning Program was created in 1970 as part of the Public Health Service Act. It is the only federal grant program dedicated to providing comprehensive family planning and related preventive health services. It is legally designed to prioritize the needs of low-income families or uninsured people (including those who are not eligible for Medicaid) who might not otherwise have access to these health care services. Its overall purpose is to promote positive birth outcomes and healthy families by allowing individuals to decide the number and spacing of their children.

The professional medical community has overwhelmingly expressed concern about the changes in funding. Recent statements from two organizations exemplify some of these concerns: American College of Obstetricians and Gynecologists and the American Nurses Association.

Texas is an example of a conservative state with a large population of voters and politicians who self-identify as pro-life. Despite this focus on life, a recent report from the Texas Medical Association makes it plain: some Texan women lack access to comprehensive reproductive health care and that is one of several factors that killing them. Texas has the highest maternal mortality rate in the country, and the U.S. has the highest maternal mortality rate in the industrialized world.

The report says:

Many assume Texas Medicaid covers all low-income and poor women. In reality, to qualify for Medicaid, a woman must have limited income and qualify based on pregnancy, disability, or extremely limited resources. Working-age, healthy adult women who earn more than $250 per month do not qualify. Pregnancy-related Medicaid coverage ends 60 days postpartum regardless of post-delivery complications. As a result, low-income Texas women must maneuver through federal, state, and locally funded health programs.

There is a connection between the access to medical care — before and after pregnancy — of the average low-income woman in Texas (and many other states) and Title X funding. The National Family Planning and Reproductive Health Care Association states:

— Title X funding has been proven effective while simultaneously saving millions in taxpayer funds.
— In 2015 publicly funded health centers services helped prevent 1.9 million unintended pregnancies, which would have resulted in 876,100 unplanned births and 628,600 abortions. Services provided by Title X centers helped women avert 43% (822,300) of these unintended pregnancies, which would have resulted in 387,200 unplanned births and 277,800 abortions.

Maybe we could all read that point again: nearly one million abortions can be prevented with continued funding for access to comprehensive reproductive care.

Some call the administration’s proposed changes to Title X funding a “gag rule.” In an effort to prevent any medical discussion of abortion, the administration has prioritized so-called family health providers, not clinics that specialize in reproductive medicine.

These family health providers promote a limited — and often inaccurate — view of sex, contraception and reproductive health care. It also sets up a caste system. Women with private insurance can afford to go to real clinics get good care. And women with low incomes who rely on public health care go to family health providers and get substandard care.

That’s why every major medical professional organization has come out against the new funding scheme for Title X.

In an effort to prevent abortions, the cuts to Title X will increase the number of abortions and increase the number of women who die due to complications related to pregnancy.

We have cut off our nose to spite our face.

Editor’s note: an earlier version of this article appeared to suggest the Texas Medical Association’s report concludes the lack of reproductive health care is the only factor leading to the state’s highest-in-the-country maternal mortality rate. That is not accurate. The article has been updated to more clearly reflect the report’s conclusion: the lack of access to reproductive health care is among several factors leading to maternal deaths. This error is ours, and we apologize.