'Domestic gag rule' will negatively impact women's health care

October 11, 2018, University of Texas at Austin

A new Texas Policy Evaluation Project (TxPEP) study on Texas organizations receiving family planning funds finds that proposed federal guidelines restricting abortion counseling and referrals for Title X providers may adversely impact the health care of pregnant women.

The study, published in Contraception, compares pregnancy options counseling and referral practices at state-funded and federal Title X-funded family planning organizations in Texas after the state enforced a policy in 2013 restricting referrals for participating in state-funded programs. Pregnancy options counseling consists of providing information on parenting, adoption and abortion. Referrals can include handing out a list of providers, connecting patients to programs for financial assistance and making an appointment for the patient.

Proposed changes to the Title X guidelines prohibit organizations from receiving funds if they provide comprehensive abortion referrals. This new 'gag rule,' similar to a policy implemented in Texas in 2013, states that organizations and providers receiving family planning funds must not "provide or promote elective abortions." The changes would severely limit providers' abilities to provide medically appropriate information about abortion to the nearly 4 million clients who rely on Title X-funded services nationwide.

The study found a major discrepancy between abortion referrals and referrals for other pregnancy-related care. At both Title X and state-only funded organizations, if providers did offer patients information about abortion services at all, they typically only gave patients a list of facilities that provided abortion, which was not always up to date. In contrast, providers were more willing to offer additional information and referrals for prenatal appointments.

At the time of the study, Title X providers were required to provide abortion referrals upon request, but the new guidelines do not require organizations to provide abortion referrals at all. Even in the case that organizations choose to offer a list of women's health providers to someone explicitly seeking information about abortion, organizations may not distinguish between those that offer abortion services and those that offer only prenatal care.

"None of the organizations in our study provided abortions, but the people we interviewed were worried that they could lose their family planning funding just by sharing information about abortion. They feared this might be seen as 'promoting' abortion, which would violate state policy," said Kari White, Ph.D., lead author of the study and investigator at TxPEP, part of the Population Research Center at The University of Texas at Austin. "What we saw in Texas is likely to happen on a national level under the proposed Title X guidelines that include similar restrictions."

The study also found that all Title X-funded organizations offered pregnancy options counseling while less than half of the state-funded organizations did. "Our study shows that if the policy does not require providers to counsel patients about all their pregnancy options, including abortion, providers often don't," said Kristine Hopkins, Ph.D., TxPEP investigator and an author on the study. "This policy is inconsistent with best practices for patient-centered care for pregnant women. When providers cannot even discuss abortion as an option with women experiencing unplanned pregnancies, it may not be seen as a valid choice—this intensifies abortion stigma."

The study took place between November 2014 and February 2015. The conclusions are based on interviews with administrators, medical directors, clinical services directors, and clinicians from 15 Title X-funded organizations and 22 state-funded organizations.

Major medical associations, such as the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, recommend that women receive options counseling and referrals to appropriate sources of care. Restricting options counseling and referrals can pose ethical dilemmas for medical practitioners who seek to follow medical best practices for pregnant patients.

Explore further: Regulations restrict providers' ability to offer info on abortions

More information: White K, Adams K, Hopkins K, Counseling and referrals for women with unplanned pregnancies at publicly funded family planning organizations in Texas, Contraception. Online First 2018.

Related Stories

Regulations restrict providers' ability to offer info on abortions

July 26, 2018
(HealthDay)—Proposed regulations restrict providers' ability to deliver unbiased patient care for individuals wanting to know about or undergo abortion, according to a perspective piece published online July 18 in the New ...

ACOG, others come out against proposed rule on Title-X

July 27, 2018
(HealthDay)—Health care organizations have come out against the U.S. Department of Health and Human Services' proposed rule that amends regulations governing the Title X of the Public Health Service Act, which provides ...

UK legislators reject curb on abortion advice

September 7, 2011
(AP) -- Britain's House of Commons has rejected a proposal to bar abortion providers from counseling women about their decisions on whether to terminate their pregnancies.

Distance that U.S. patients travel for care illustrates growing inaccessibility of abortion

June 9, 2017
Abortion fund recipients who have to travel out of state for an abortion travel roughly 10 times farther for their procedures than patients able to get care in their homes states.

Women's basic rights under threat from Trump gag rule, warn experts

June 13, 2018
The Trump administration is mounting a ferocious attack on abortion rights with plans for a domestic gag rule on abortion counselling and provision, warn experts in The BMJ today.

US top court to hear abortion rights info case

November 13, 2017
The US Supreme Court agreed on Monday to examine a California law that obliges private anti-abortion agencies to tell pregnant clients they can get a publicly-financed abortion and contraception.

Recommended for you

Juul e-cigarettes pose addiction risk for young users, study finds

October 19, 2018
Teens and young adults who use Juul brand e-cigarettes are failing to recognize the product's addictive potential, despite using it more often than their peers who smoke conventional cigarettes, according to a new study by ...

Self-lubricating latex could boost condom use: study

October 17, 2018
A perpetually unctuous, self-lubricating latex developed by a team of scientists in Boston could boost the use of condoms, they reported Wednesday in the journal Royal Society Open Science.

Engineered enzyme eliminates nicotine addiction in preclinical tests

October 17, 2018
Scientists at Scripps Research have successfully tested a potential new smoking-cessation treatment in rodents.

Nutrition has a greater impact on bone strength than exercise

October 17, 2018
One question that scientists and fitness experts alike would love to answer is whether exercise or nutrition has a bigger positive impact on bone strength.

How healthy will we be in 2040?

October 17, 2018
A new scientific study of forecasts and alternative scenarios for life expectancy and major causes of death in 2040 shows all countries are likely to experience at least a slight increase in lifespans. In contrast, one scenario ...

Study finds evidence of intergenerational transmission of trauma among ex-POWs from the Civil War

October 16, 2018
A trio of researchers affiliated with the National Bureau of Economic Research has found evidence that suggests men who were traumatized while POWs during the U.S. Civil War transmitted that trauma to their offspring—many ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.