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Family Planning is process of determining the preferred number and spacing of children and choosing the appropriate means to accomplish it. Family planning puts greater choice and control in the hands of the individual or couple. Often the focus of family planning efforts is to give people with uteri (or couples) the ability to avoid unintended pregnancy. An unintended pregnancy is one that is either mistimed or unwanted. About half of all pregnancies are unintended.
Contraception is the broad term for birth control technologies -- ways to prevent pregnancy. The terms family planning and contraception are often used interchangeably.
Title X (pronounced Title Ten)
One important support for family planning services is Title X. Title X is a portion of the Public Health Service Act of 1970 that provides funds for family planning services for low-income people. More than 5 million women receive health care services at family planning clinics funded by Title X.
Increased access to family planning has also been an important outcome of the Affordable Care Act (Obamacare). Both the appointment with a doctor or nurse practitioner to select a means of contraception and the prescription for whatever means of contraception the patient selects have been included in the list of essential services in any insurance plan sold on one of the exchanges (like Covered California), under the ACA. This has meant no co-pay on office visits for contraception and no fee for the contraception method itself. Highly effective forms of birth control that previously may have been out of reach of lower-income and younger women have become accessible, due to the ACA. Without insurance, an IUD, for example, can cost $500-1000, including the medical visit.
Gag Rule in International Health
"Gag rule" is the term used to describe regulations that bar physicians and nurses in international clinics receiving U.S. federal funds from counseling clients about abortions. This rule has gone back and forth with which party holds the presidency. Since it was enacted in 1984 under Ronald Reagan, the "gag rule" has been in force under Republican presidents and has been lifted (or removed) under Democratic presidents.
This has major implications for international health, in particular, as family planning clinics around the world will lose funding.
Optional reading on the international "gag rule" (also called the "Mexico City Policy") and international health from Kaiser Family Foundation. Unintended consequences: evaluations of the effect of the gag rule have shown that it increases the rate of abortion, by denying women contraception.
Domestic Gag Rule and Title X Funding in the US
In March 2019, the Trump Administration imposed a "gag rule" on healthcare providers in the United States working in clinics funded under Title X, the first time such a rule was imposed in the US since Title X was enacted. For a clinic to continue to offer contraceptive care with Title X funding,its healthcare providers could not provide referrals to abortion providers, nor accurate health information about abortions. For providers like Planned Parenthood who provide both contraceptive services (some of which is funded by Title X) and abortion services, the new "gag rule" required certain physical and financial separations of those services that go beyond normal accounting procedures. As a result of this policy change, Planned Parenthood and some other healthcare organizations (including several state health agencies, like those in Massachusetts and Oregon) left the Title X program. The impact of this change on access to contraception was significant.
The domestic gag rule on clinics receiving Title X funding was lifted by the Biden Administration.
After President Trump returned to the White House in 2025, he continued to attack Title X. In the 2026 budget, he proposed total elimination of Title X (Commonwealth Fund, 2025). To date, the program has NOT been eliminated, but it has been affected by funding freezes, new regulations and requirements, and delays (KFF, 2026). Planned Parenthood clinics have been especially affected by changes in federal policy, as they were specifically denied eligibility for Medicaid funding in 2025 (KFF, 2026). Medicaid does not cover abortion services of any kind, so the Planned Parenthood services that were denied funding were regular doctor visits for reproductive or general healthcare.
References
Commonwealth Fund. (2025). Reducing or eliminating Title X family plannign program would restrict contraceptive access nationwide. https://www.commonwealthfund.org/blo...-contraceptive
KFF. (2026). Navigating uncertainty. https://www.kff.org/quick-take/navig...ng-safety-net/
Seabert, D., McKenzie, J. F., Pinger, R. R. (2025). McKenzie's An Introduction to Community & Public Health. United Kingdom: Jones & Bartlett Learning.
This page titled 10.6: Family Planning / Contraception was last modified on Tue, 31 Mar 2026 22:57:31 GMT and is shared under a CC BY-NC-SA 4.0 license and was authored, remixed, and/or curated by Janey Skinner.
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