Texas Releases the List: Fewer Clinics, a Lot Less Money

On January 19, the Texas Department of State Health Services announced the sharply curtailed list of agencies receiving Family Planning funding for the next year.  The number of organizations funded fell from 78 in 2010 to 41 currently.  The total amount to cover more than 14 months (January 15, 2012 through March 31, 2013) is $12.4 million.  This represents a cut of 79% compared to the $48.9 million for fiscal year 2010.  Only about one-fifth of the funding remains for this critical program.

The Family Planning program provides checkups, screenings, and birth control (not abortion) for low-income Texans.  Funded through a patchwork of federal funds, this program has saved Texas money by reducing Medicaid costs to care for unplanned pregnancies.  Family planning also improves maternal and child health and prevents abortions.

Even at its previous "full" level of funding, the Family Planning program was able to serve fewer than 20% of women in need.  The 2011 Texas Legislature slashed funding for this program from $111.5 million to $37.9 for the 2012-2013 biennium.  Many clinics no longer receive funds from this program, including Planned Parenthood and many small community clinics.

Bexar County providers saw deep cuts in their family planning funding.  Planned Parenthood (Family Planning Associates of San Antonio), which received $717,000 in 2010, will receive no funding.  University Health System (UHS) will receive $610,500 (down from $1.77 million in 2010).  CentroMed will receive $391,000 (down from $476,000). 

These cuts are already being felt in our community, making it more difficult for low-income women to get birth control.   UHS is closing 3 clinics but is attempting to serve as many women as possible with other funding, such as CareLink or the Women's Health Program (WHP). 

The situation will get even worse if WHP, the state's other program for birth control and preventive care, cannot continue.  WHP is due to end in March, unless the state of Texas and the federal government can find a way for the program to continue.  The state's WHP renewal application requires excluding Planned Parenthood (or any affiliate of an abortion provider).  However, the federal Medicaid statute does not allow exclusion of qualified providers.  It is not clear how -- or if -- this impasse can be overcome.  

"It Won't Happen to Me!"

A Centers for Disease Control and Prevention (CDC)  report this month finds that many teen mothers in the U.S. did not use birth control - and many did not think they could get pregnant. 

Most of the 400,000 U.S. teen births each year result from unplanned pregnancies.  To learn why teens who want to avoid pregnancy become pregnant, the CDC analyzed data from the 2004-2008 Pregnancy Risk Assessment Monitoring System (PRAMS), which surveys new mothers about their attitudes and experiences before, during, and after pregnancy.   

In this study, 3 of 4 teen mothers (73%) described their pregnancies as unplanned.  Among these, half (50.1%) were not using any method of birth control when they got pregnant.

The most common reason given for not using contraception was that teens did not believe they could get pregnant at the time.  This was true for nearly 1 in 3 (31.4%) of these teen mothers.  Among Hispanic teen mothers who used no method, even more -- 42% -- thought they could not get pregnant.

Other reasons given for not using birth control included partners not wanting to use it (24%); having trouble getting birth control (13%); and fear of side effects (9%).

Many reactions to this study have focused on the "cluelessness" of teen girls.  Many commentators have called for better sex education to help girls better understand reproduction. 

Of course, accurate and age-appropriate sex education is extremely important.  However, teen pregnancy prevention research tells us that we need to offer teens (boys as well as girls!) more than just information.  Teens need effective programs to help overcome their false sense of invincibility, that feeling that "It won't happen to me".  In order to be able to make healthy choices, teens need to be able to personalize the risks. 

Bill Albert of the National Campaign to Prevent Teen and Unplanned Pregnancy said it well: "This report underscores how much misperception, ambivalence and magical thinking put teens at risk for unintended pregnancy."

It is also extremely important for sexually active teens to be able to obtain and use effective methods of birth control. Without contraception, 9 out of 10 sexually active teens will become pregnant within a year.