Proposed Title X Regulatory Changes: Silencing Health Care Providers and Undermining Quality of Care

The impact of policy changes from the perspective of providers of family planning care in the US: results from a qualitative study

In recent years, there have been several state and federal policies that have disrupted access to publicly supported family planning care in the United States, including the 2019 rule that altered the federal Title X family planning program. In late 2020, we conducted in-depth interviews with health care providers from 55 facilities providing family planning care in Arizona, Iowa, and Wisconsin with the aim of learning how sites were affected by policy changes. We identified perceived effects on clinic finances, patient confidentiality, contraceptive counselling and service provision, and options counselling resulting from state and federal policy changes. Some clinics lost funding and had to pass some of the cost of services on to patients, raising new confidentiality concerns and creating new burdens on staff to carry out financial counselling with patients. Other sites had to grapple with restrictions on the pregnancy options counselling that they could provide, concentrate counselling on fertility awareness-based methods, and increase efforts to include parents/guardians in the care of adolescent patients. State and federal policies impact how publicly supported family planning care is provided, and compromise efforts to provide patient-centred care.

Advancing Reproductive Justice to Close the Health Gap: A Call to Action for Social Work

Reproductive justice is an intersectional social movement, theory, and praxis well aligned with social work's mission and values. Yet, advancing reproductive justice-the right to have children, to not have children, to parent with safety and dignity, and to sexual and bodily autonomy-has not been a signature area of scholarship and practice for the field. This article argues that it is critical for social work to advance reproductive justice to truly achieve the grand challenge of closing the health gap. The article starts by discussing the history and tenets of reproductive justice and how it overlaps with social work ethics. The authors then highlight some of the ways by which social workers have been disruptors of and complicit in the oppression of individuals, families, and communities with regard to their reproductive rights and outcomes. The article concludes with a call to action and recommendations for social work to foreground reproductive justice in research, practice, and education efforts by centering marginalized voices while reimagining the field's pursuit of health equity.

Title X Regulatory Changes and Their Impact on Adolescent Health

Title X of the Public Health Act has provided access to confidential reproductive care for low-income adolescents and adults since 1970, helping to bring adolescent pregnancy rates to historic lows. Recent regulatory changes in program funding eligibility and provider counseling options may reverse this trend. This policy brief will address the history and impact of Title X funding on adolescent access to reproductive health care, explain the implications of these recent regulatory changes in Title X implementation, and encourage advocacy to protect health care provider practice and adolescent access to confidential care.