A Matter of Facts — October 2024

From Our Leadership

Seven years ago, Guttmacher embarked on an ambitious multiyear project to document the impact of US state and federal policy changes on publicly funded family planning services. Led by researchers Megan Kavanaugh, Jennifer Frost and Alicia VandeVusse, in collaboration with state partners, the Reproductive Health Impact Study (RHIS) aimed to better understand how policy changes—such as shifts in Title X requirements and clinic decisions to leave the Medicaid family planning program—affected patients, providers and systems of care.

Guttmacher staff and local partner Affirm shared RHIS findings this past August in Arizona.

We anticipated some illuminating findings because drastic changes to family planning support seemed inevitable (it was 2017, after all). But as our research adapted to document the effects of key developments, like the 2019 “domestic gag rule” and the COVID-19 pandemic, the RHIS yielded an even richer and more wide-ranging body of evidence than expected.

Notably, the findings showed the inextricable links among all types of reproductive health care services, underscoring how policy restrictions on one aspect of care have ripple effects on others. They demonstrated how cost is a significant barrier to many patients’ ability to access care and achieve reproductive autonomy, and how person-centered contraceptive care is essential. These findings are described in more than two dozen journal articles, multiple policy briefs and profiles of the four states we focused on: Arizona, Iowa, New Jersey and Wisconsin.

Dissemination events in these focus states served as opportunities to connect with providers, advocates and policymakers and to discuss how research can inform advocacy and equitable policy. Together with our partners and community stakeholders, we hope to pave the way for a future where accessible reproductive health care is a reality for all.

Destiny Lopez and Jonathan Wittenberg

Acting Co-CEOs

Behind the Scenes

High-level happenings at the United Nations

Rising seas. Conflict in Ukraine, Sudan and Gaza. Progress toward the Sustainable Development Goals. The issues on the agenda at the 79th session of the UN General Assembly, which opened in September, were weighty. The Guttmacher Institute was on deck to ensure that government officials and advocates paid heed to sexual and reproductive health and rights (SRHR) in the discussions for global progress.

The New York City headquarters of the United Nations.

Advocating for SRHR at the General Assembly, also known as UNGA, is no small feat. The Guttmacher Institute’s Global Policy and Global Communications teams worked in tandem, planning partnership activities, attending meetings and spearheading initiatives to promote our research and resources at this important convening.

“At a time when anti-rights actors are increasingly mobilizing to roll back gains made at the UN, it’s essential that Guttmacher and its allies continue holding space for sexual and reproductive health and rights at UNGA,” says Irum Taqi, director of Global Policy. “Through our presence in these high-level discussions and collaboration with groups working on SRHR, adolescent health, LGBTQIA+ issues and gender equality, we were promoting a holistic view of SRHR that recognizes its connection to human rights, development and equality.”

One of the most powerful tools Guttmacher brought to these discussions was our interactive Family Planning Investment Impact Calculator, which we recently updated to ensure that attending stakeholders had access to the latest data. The calculator can help advocates, donors and governments make the case for investing in family planning services in low- and middle-income countries.

Guttmacher cosponsored two high-level events: One, on adolescent SRHR, was hosted by the governments of Chile, Ireland and Colombia and organized by the Partnership for Maternal, Newborn & Child Health and WHO; the other focused on safeguarding the SRHR agenda during assessments of global progress on key initiatives, such as the 1995 Beijing Declaration and the 1994 International Conference on Population and Development. In addition, we attended strategy sessions with partners and the Youth Power Summit. We were present for a review of financing models for SRHR in Sub-Saharan Africa, a discussion on maternal health equity for women and girls of African descent, and other focused side events.

Several events that Guttmacher participated in—including one on SRHR and climate justice and a high-level meeting to cultivate commitments to SRHR in development funding, particularly for youth—took place around the pivotal Summit of the Future. During this summit, UN Member States adopted three intergovernmental guiding documents. One, the Pact for the Future, reflects the efforts of Guttmacher and our partners to ensure clear commitments to respect, protect and uphold SRHR in the coming years.

The fanfare surrounding the General Assembly’s High-Level Week has concluded, but we’ll continue to work behind the scenes, at many levels and around the world, to advocate for sexual and reproductive rights for everyone.

Make an Impact on DAF Day!  

October 10 is the inaugural Donor-Advised Fund (DAF) Day—a day dedicated to making impactful contributions through DAF giving. Contributions via cash, stocks, bonds or mutual funds provide immediate tax benefits while streamlining your giving and maximizing your impact on causes important to you.

If you have a DAF, please consider a grant today to support Guttmacher's mission.

Your support will ensure that our experts have the resources they need to produce timely, actionable research, policy analysis and evidence-based advocacy during this critical year for reproductive rights. For more information on how to support Guttmacher through a DAF, visit Ways to Give.

Coming later in October: Guttmacher’s Impact Report

Keep an eye out for this powerful summary of our work during this consequential year. The Impact Report shares stories of Guttmacher and our data in action as we strive to protect reproductive freedom and bodily autonomy—core pillars of democracy and human rights. You’ll learn about our partners, from fieldworkers interviewing Rohingya women in the Cox’s Bazar camps in Bangladesh to advocates powering the Green Wave across Latin America. You’ll also hear from Guttmacher staff responsible for research design, data science, policy innovation and more. And you’ll see what our data is truly about: transforming people’s lives for the better.

Evidence in Action

Attendees raved about our September policy webinar The Road to Progress, presented in partnership with SIECUS: Sex Ed for Social Change, the National Black Justice Coalition and PEN America. Panelists talked about the intersection of state policies on gender, race and reproductive rights, and they discussed threats to all of the above in state and federal legislatures, in courts and on school boards.

Fast Facts

Fallout from the domestic gag rule

Since the 1970s, the Title X program has helped millions of people with low incomes in the United States access contraception and other reproductive health care. Despite its success, the publicly funded family planning program has been repeatedly threatened with funding cuts and regulations that undermine its mission. Such was the case in 2019, when the Trump–Pence administration imposed its so-called domestic gag rule.

What’s with the name? While it is formally known as the 2019 Title X Final Rule, that name doesn't quite convey its true nature. The rule prohibited clinics that received Title X funds from providing information and counseling about abortion, stifling their ability to even talk with patients about this option.

How much havoc did the gag rule wreak? According to our recent policy analysis, a lot. The policy caused many clinics to leave the Title X program and had devastating consequences for patients and providers.

• Between 2019 and 2020, the number of patients served by the program dropped from 3.1 million to 1.5 million; 63% of that decrease is attributed to the domestic gag rule.
• Nearly eight in 10 clinics that left the program reported decreased funding.
• Six states (Hawaii, Maine, Oregon, Utah, Vermont and Washington) had no Title X clinics for nearly two years.

Though the Biden–Harris administration rescinded the domestic gag rule in 2021, the Title X program is still recovering. Clinic staffing, funding and payment structures all took a hit, and have taken time to rebuild and renew. It doesn’t help that the US Congress hasn’t increased program funding since 2015.

The bigger picture: Restrictions on one type of reproductive health care can have repercussions on all aspects of reproductive health care, including contraception and pregnancy care. 

We Recommend...

• Johanna Goodman’s funky feminist collages caught the eye of our director of production Kathleen Randall. 
• Development associate Rhea Goveas says that Mikki Kendall’s book Hood Feminism, with its call to unite the racial justice and feminist movements, is “essential reading.”
• Rebecca Wind, director of administrative operations for the Communications & Publications Division, highly recommends The Defenders, a podcast series portraying post-Dobbs abortion access through the lens of resistance and activism.
• Senior global communications manager Ana Dilaverakis Fernandez found some cool video from pro-choice protests in Brazil that happened earlier this year circulating on social media.

Notions

We recognize that the US Supreme Court’s decision to strike down Roe v. Wade has had a global impact. So does Mallah Tabot, of the International Planned Parenthood Federation’s Africa Regional Office and member of the CATALYSTS abortion alliance, who has written about this issue as well as the need for collaborative action to protect and advance SRHR in Africa.

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