As an obstetrician-gynecologist who has been practicing for 26 years I know the essential role contraception and preventive services play in the lives of patients. Thanks in large part to the services funded through the Title X family planning program, New Hampshire has become known for its positive public health trends. The Granite State has one of the lowest rates of unintended pregnancy in the country, one of the lowest rates of teen pregnancy, and some of the most positive maternal health outcomes.
These positive trends are largely due to an advanced network of public health centers in the New Hampshire Family Planning Program that provide high-quality, affordable care for New Hampshire’s low-income or uninsured women, men and young people. The network includes five Planned Parenthood of Northern New England health centers, which provide essential reproductive health care services — including birth control, STD testing and treatment, and cancer screenings — to people across our state, including our most marginalized communities and rural populations.
New Hampshire’s Family Planning Program is funded in part by the federal Title X program, which was established in 1970 under the Nixon administration to provide low-income people with basic reproductive health services.
Of the 4 million people Title X serves, two-thirds live under the federal poverty level and nearly half lack insurance.
I know from professional experience the positive health impact the Title X program has on patients and their families. My patients who have access to all their contraceptive options are able to plan their pregnancies with appropriate spacing in order to optimize their health. Contraception can be literally lifesaving for some women who need to stabilize chronic conditions before becoming pregnant.
For example, one of my patients had severe asthma. During her first pregnancy she became so sick she needed to be on a ventilator in an ICU. Thankfully she survived and went on to have her baby. After that life-threatening illness, she knew that pregnancy, with her health condition, could put her at high risk. Accessing contraception at a Title X health center empowered her to control her asthma and optimize her health before attempting pregnancy again. Indeed, it was a better, safer pregnancy for her.
Despite the public health advancements of the program and the indisputable positive impact on patients’ lives, the Trump-Pence administration recently released a regulation that attempts to unravel the progress we’ve made.
This regulation would dismantle the Title X program and risk health care access for the more than 16,000 Granite Staters who rely on the program to receive their care. It is designed to exclude organizations like Planned Parenthood from the program by prohibiting Title X recipients from referring patients for safe, legal abortion, even though no Title X dollars are used for abortion services.
Planned Parenthood of Northern New England serves more than 11,000 Title X patients in New Hampshire — nearly 70 percent of all Title X patients in the state. While those patients could seek care at the state’s federally qualified health centers or community health centers, those centers simply do not have the staff or expertise to provide a full range of services to an additional 11,000 patients.
In addition to reducing access to care, this regulation runs counter to our commitment as physicians to provide information to patients that is complete, accurate and honest. Leading women’s health care provider groups, medical organizations and physician leaders, including my own professional organization, the American College of Obstetricians and Gynecologists, have come out in strong opposition to this regulation. Others include the American Medical Association, the American Nurses Association, the American College of Physicians and many others.
Put simply, the Trump-Pence administration’s Title X regulation is political interference that would be disastrous for public health. We cannot afford to let this regulation roll back the progress we’ve made to improve public health outcomes in the Granite State.
Dr. Ellen M. Joyce is chair of the New Hampshire section of the American College of Obstetricians and Gynecologists, fellow of Physicians for Reproductive Health and a hospitalist at Dartmouth-Hitchcock Medical Center.