Between 2000 and 2012, the number of U.S. women in need of publicly funded family planning services increased by 22%, or 3.5 million women; in 2012, 20 million women were in need of publicly funded services. Women were considered to be "in need" if they were adults with a family income below 250% of the federal poverty level, or teens regardless of family income, and were sexually experienced and did not want to become pregnant. The increased need for publicly funded family planning services was driven primarily by a rise in the number of poor and low-income adult women (<250% of poverty) in need of contraceptive services and supplies.
Publicly funded family planning centers served 6.1 million women in 2012, according to "Contraceptive Needs and Services, 2012 Update," by Jennifer Frost et al. Centers that received some funding through the federal Title X program served 4.3 million of those women. The remaining 1.8 million women received services at non-Title X–funded centers.
In the last two years, the number of women who received contraceptive services from publicly funded centers has declined, with 9% fewer clients served in 2012 than in 2010. This decline could be due to an increase in LARC use, changing standards for cervical cancer screening and cuts to some funding sources, most notably Title X—although more research is needed to determine the exact cause of this trend.
"Family planning services play a critical role in helping millions of women access highly effective contraceptive methods and avoid pregnancies they are not prepared for," says Jennifer Frost, the report’s lead author and a senior researcher at the Guttmacher Institute. "Investing in these programs is good public health policy."
In 2012, publicly funded family planning services provided by safety-net health centers helped avert 1.5 million unintended pregnancies that would have resulted in more than 741,000 unplanned births and 510,000 abortions. Without these publicly funded family planning services, the overall U.S. unintended pregnancy, unplanned birth and abortion rates would all have been 44% higher. Health centers that received some Title X funding provided more than 70% of these publicly funded services, underscoring the critical importance of the Title X program. Title X–funded centers alone helped women avert 1.1 million unintended pregnancies, thereby preventing 527,000 unplanned births and 363,000 abortions. Without the services provided by Title X centers, the U.S. unintended pregnancy rate would have been 32% higher.
"The number of women needing publicly funded contraceptive services has skyrocketed over the last decade," says Rachel Gold, Guttmacher’s acting vice president for public policy. "Publicly funded family planning centers are safety-net providers—they are essential in enabling women to plan the pregnancies they want and avoid the ones that they don’t. But public funding sources—such as the federal Title X program and state revenues—are failing to keep pace with women’s growing needs."