Publicly Funded Clinics Providing Contraceptive Services in Four US States: The Disruptions of The “Domestic Gag Rule” and COVID-19

Background The federal Title X program has been the addition, the rule required separation of to the impacts of the COVID-19 pandemic cornerstone of publicly funded family finances and physical space for any abor- on the Title X network and on the users it planning care in the United States since tion-related services from Title X–funded serves.5 While the changes to the Title X its establishment. [...] 0 ■ In contrast, among clinics that left the 2018 2021 2018 2021 Title X program, the share that offered Clinics that left Title X Clinics that stayed in Title X basic infertility testing rose between 2018 and 2021 (57% to 78%) and did not Counseling on a full range of contraceptive options change significantly for clinics that stayed Counseling on pregnancy intentions and preferences in Title X (. [...] In 2021, the same share of clinics that changes that had occurred between 2018 Changes over time or according to Title X left the Title X program continued to and 2021 in contraceptive patient volume status in the provision of related services offer such counseling (97%); however, the and clinic staffing. [...] of patients served per week 100 95 Clinics that stayed in Title X 80 Clinics that left Title X 66 60 57 10054 All clinics 40 36 Clinics that stayed in Title X 28 80 20 0 % of women aged 15–44 receiving each service 60 Clinics that left Title X 2018 2021 2018 2021 1002018 2021 80 All clinics Clinics that left Clinics that stayed 2015–2019 Title X in Title X 2006–2010 2011–2015 2015–2019 7075 71 73. [...] This may indicate a lack of of contraceptive methods and services, in the Title X program as well as those that resources for sites that remained in Title X while those that stayed in Title X were left the program.