In late February, President Donald Trump's administration announced its final rule on a revision of the Title X family planning program that could potentially divert millions of dollars from Planned Parenthood to faith-based health care organizations. Under the revision, health care providers hoping to receive Title X funding will no longer be able to “refer for abortion as a method of family planning, or to perform, promote, or support abortion as a method of family planning.”
The change is part of a larger effort by the Trump administration to push more conservative regulations surrounding abortion, and many pro-choice advocates have denounced it as a gag rule that prevents doctors from being candid with patients about their options. Overall, the Michigan Daily Editorial Board finds the rule inhibits doctors from doing their jobs, prevents patients from receiving the full-range of family planning services available and indicates the Trump administration prioritizes the evangelical agenda over the health and economic outcomes of its citizens.
The Title X revision, first and foremost, poses an ethical problem for medical professionals. Dr. Leana Wen, the president of Planned Parenthood, expressed in an interview with NPR that “it's unconscionable and unethical for politicians to restrict doctors like me from speaking honestly to our patients.” The doctor-patient relationship is supposed to be built on trust and communication, but how can this be achieved if doctors feel compelled to withhold their honest advice? Women seeking advice about their options in the event of an unwanted pregnancy deserve to know about all available courses of action.
Though the gag rule specifically targets abortion referrals, it impacts more than just abortion services. The policy defunds every kind of health care these centers provide, including STI testing, cancer screenings and forms of contraception. For the women who rely on these other services, the loss of federal funds can be devastating. This new rule penalizes all who use this care, regardless of if they actually went for an abortion.
As this policy strips federal funding from medical facilities like Planned Parenthood, it would help finance faith-based women’s health centers. Associated with the church and often referred to as crisis pregnancy centers, these clinics provide inadequate health care by misleading women into making poor health decisions. While Planned Parenthood typically informs its patients of every option available, including abortions, CPCs do not mention the possibility of a pregnancy termination. When it comes to future family planning, normal clinics will provide various forms of contraception, while CPCs preach abstinence. Furthermore, these CPCs are often modeled to look like actual health centers, which confuses women into thinking they are in a medical clinic, rather than a religious facility. The policy’s endorsement of these faith-based health centers is a step back in women’s reproductive health and medical care.
The Trump administration’s support of these abstinence-only centers over organizations like Planned Parenthood also ignores extensive empirical research on the improved socioeconomic outcomes associated with increased access to family planning. In 2013, the Guttmacher Institute conducted a review of 66 studies exploring the social and economic benefits of women’s access to contraception. The review found in states where women were given early, legal access to contraception, they were more likely to achieve post-secondary education and higher employment rates. Women also earned higher salaries, had greater purchasing power and narrowed the gender pay gap when they had more control over their reproductive health. In the realm of mental health, a growing number of studies point to a link between unplanned childbirth and depression.
As problematic as this new policy may be, there are ways for both health clinics and patients to work around it. First, institutions like Planned Parenthood can set up specific locations where they would perform abortions. However, those individual facilities would not be eligible for federal funds, nor would regular health clinics be able to refer patients to those other sites. On the other hand, patients can still ask about abortions and doctors would be able to answer their questions. This means women who are educated about their options will still have their questions answered, but women who are not as aware of their options can no longer rely on doctors to be transparent with them.
The overarching impact of this gag rule is detrimental toward any woman or man who relies on these centers’ services, not just those who need abortions. We hope for the sake of these citizens this initiative will be blocked in court. In the event it is not, one such way to mitigate these detrimental effects will be to promote education of women’s health and the clinics that actually and effectively promote women’s health.