Updated on April 4, 2025:
As the original 90-day review deadline of April 24 approaches, it is clear that the Trump administration’s “freeze” on US foreign assistance is not temporary. The administration has fully dismantled the US Agency for International Development (USAID) and terminated all family planning grants the agency administered—although Congress has not approved USAID’s closure and has continued to appropriate funds for international assistance, including for family planning.
Please see Just the Numbers for an analysis of the impact of US investment in family planning—impact that has been lost with the termination of funding. Guttmacher will continue to pressure Congress to act to save this vital investment in people’s lives.
Updated on March 7, 2025:
On March 5, the US Supreme Court upheld a lower court order that required the Trump administration to unfreeze payments for foreign assistance work that has already been completed. The payments have not yet been made, and the lower court continues to deliberate on the case. Also in recent days, the State Department terminated more than 90% of USAID contracts and grants, including nearly all for family planning. Family planning programs funded by USAID have not resumed providing services.
Guttmacher joined a letter to Congress urging policymakers to preserve foreign assistance for global health, including family planning.
Updated on February 14, 2025:
In response to a court challenge from several organizations that deliver foreign aid, a US district court judge has issued a temporary restraining order on the Trump administration’s freeze on all US foreign assistance funding and work. The order bars the administration from canceling contracts related to USAID, freezing funds or implementing stop-work orders that have been in place since last month; it will remain in place while the full case makes its way through the courts. We will update this page as more information becomes available on how this will affect family planning programs that had to close in recent weeks, including whether or when they will be able to resume providing services.
For the last nine years, Congress has consistently appropriated $607.5 million annually in foreign aid for family planning, including $32.5 million for UNFPA. This funding is estimated to provide 47.6 million women and girls with modern contraceptive care in 2025.
This critical service—which saves lives and gives people control over whether and when to build their families—is currently blocked by the Trump administration’s stop-work order on all foreign assistance. On average, 130,390 women get contraceptive care each day under US-funded programs, so the total number of women denied care will increase by that number every day of this callous withholding of funding that has been lawfully appropriated by Congress.
After one week of the freeze, 912,720 women and girls will have been denied care, and after one month, the figure will reach about four million. Over the course of the full 90-day review period, 11.7 million women and girls will be denied this essential care.
When people are not able to access contraceptive care, they are put at risk of unintended pregnancy.
If 11.7 million women and girls are denied access to contraceptive care in 2025, 4.2 million will experience unintended pregnancies, and 8,340 will die from complications during pregnancy and childbirth.
We call on the Trump administration to end its harmful and unlawful withholding of funds appropriated by Congress. These funds are essential to protecting the rights, dignity and lives of women and girls around the world.
Estimation methodology
The estimates of the impacts of the Trump administration’s foreign assistance freeze were calculated using estimates from the Guttmacher Institute’s annual Just the Numbers analysis showing the impact of US foreign assistance for family planning.1
Measuring family planning foreign assistance
For FY 2024, US Congress appropriated $575 million for family planning, plus an additional $32.5 million for the United Nations Population Fund (UNFPA). To estimate the impact of this funding or any funding changes on users, we first determined what portion of that total $607.5 million Congressional appropriation is used to support family planning services. We estimated the share of the $575 million going to support services in countries, using country-specific allocations from FY2023 and data on the proportion of regional funds going to serve country programs.2 We applied the distribution of funding across countries in FY 2030 to the total FY 2024 appropriation amount. We then adjusted funding to UNFPA to reflect that an estimated 18% of core funding to UNFPA goes to family planning–specific activities.3
Measuring users impacted
We estimated the total number of users served by US family planning foreign assistance by dividing the total funding supporting family planning service provision at the country-level by the estimated country-specific cost per modern contraceptive user.4 The annual number of users served averaged over 365 days then produced the estimated number of women and couples impacted by the foreign aid freeze per day (because we assume that the number of women and girls served by US foreign assistance is distributed equally throughout the year). This approach was employed for calculating the number of women and couples impacted in one month and over the full 90-day review period.
Measuring health outcomes impacted
The impacts stemming from the reduction in the number of women and couples receiving modern contraceptive care was based on estimated 2024 country-level per-user impacts, which come from the most recent comprehensive analysis of the costs and impacts of family planning in low- and middle-income countries.4
Impacts per user were estimated as the difference between the annual number of events that would occur if all women wanting to avoid pregnancy but not using a modern method of contraception used a modern method and the number that would occur if they relied on traditional methods or no method.5
To estimate the impacts of this freeze on unintended pregnancies and maternal deaths, we multiplied the estimated total number of users impacted over the 90-day period by country-level per-user annual impacts. Women and girls who are denied access to contraceptive care during the US foreign assistance freeze may not immediately have access to services again once it is lifted: For instance, they may not know when frozen services start back up and may not have an alternative source for receiving care. Therefore, our approach assumes that people denied care over the 90-day period are then without contraceptive care for 2025.
References
- Damavandi S et al., Just the Numbers: The Impact of US International Family Planning Assistance, 2024, New York: Guttmacher Institute, 2025, forthcoming.
- ForeignAssistance.gov, Budget dataset, Nov.15, 2024, https://foreignassistance.gov.
- Wexler A et al., Donor Government Funding for Family Planning in 2023, 2024, https://www.kff.org/report-section/donor-government-funding-for-family-planning-in-2023-report/.
- Sully EA et al., Adding It Up: Investing in Sexual and Reproductive Health 2024, New York: Guttmacher Institute, 2025, forthcoming.
- Guttmacher Institute, Adding It Up: Investing in Sexual and Reproductive Health 2024—Methodology Report, New York: Guttmacher Institute, 2025, forthcoming.
