Abstract
Objectives
To compare pregnancy options counseling and referral practices at state- and Title
X-funded family planning organizations in Texas after enforcement of a policy restricting
abortion referrals for providers participating in state-funded programs, which differed
from Title X guidelines to provide referrals for services upon request.
Study design
Between November 2014 and February 2015, we conducted in-depth interviews with administrators
at publicly funded family planning organizations in Texas about how they integrated
primary care and family planning services, including pregnancy options counseling
and referrals for unplanned pregnancies. We conducted a thematic analysis of transcripts
related to organizations' pregnancy options counseling and referral practices, and
compared themes across organizations that did and did not receive Title X funding.
Results
Of the 37 organizations with transcript segments on options counseling and referrals,
15 received Title X and 22 relied on state funding only. All Title X-funded organizations
but only nine state-funded organizations reported offering pregnancy options counseling.
Respondents at state-only-funded organizations often described directing pregnant
women exclusively to prenatal care. Regardless of funding source, most organizations
provided women a list of agencies offering abortion, adoption and prenatal care. However,
some respondents expressed concern that providing other information about abortion
would threaten their state funding. In contrast, respondents indicated staff would
make appointments for prenatal care, assist with Medicaid applications and, in some
instances, directly connect women with adoption-related services.
Conclusions
Pregnancy options counseling varied by organizations' funding guidelines. Additionally,
abortion referrals were less common than referrals for other pregnancy-related care.
Implications
Programmatic guidelines restricting information on abortion counseling and referrals
may adversely affect care for pregnant women at publicly funded family planning organizations.
Keywords
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Article info
Publication history
Published online: October 01, 2018
Accepted:
September 24,
2018
Received in revised form:
August 15,
2018
Received:
July 5,
2018
Footnotes
☆Conflicts of Interest: None.
☆☆Role of the funding source: This project was supported by a grant from the Susan Thompson Buffett Foundation, and a center grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2C HD042849) awarded to the Population Research Center at the University of Texas at Austin. These funders played no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
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