Services and Clinics

Facts about Title X (Ten):

The National Family Planning Program

Introduced and established in 1970 with broad bi-partisan support, Title X of the Public Health Service Act provides federal funds for project grants to public and private nonprofit organizations for the provision of family planning information and services. The objective of these services is to:

• Improve maternal and infant health
• Lower the incidence of unintended pregnancy
• Reduce the incidence of of teen birth
• Lower rates of sexually transmitted diseases (STDs)

Questions about Title X 

• What services does Title X provide?
• Where do people receive services?
• Who receives services through Title X?
• How much does Title X cost?
• The need for Title X is clear

What services does Title X provide?

• Contraceptive information and services
• Gynecological examinations, basic lab tests, and other screening services for STDs and HIV
• High blood pressure, anemia, and breast and cervical cancer screening
• Pregnancy testing, sterilization services, and natural family planning
• Community education and Outreach

Title X prohibits the use of federal funds to pay for abortions.

Where do people receive services?

Community-based providers including state/local health departments, hospitals, university health centers, Planned Parenthood affiliates, independent clinics, and public and non-profit agencies in every state, three-quarters of U.S. counties, and every congressional district in the nation.

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Who receives services through Title X?

• 83% of Title X clients had incomes below 150 percent of the federal poverty level in 1997
• The vast majority of Title X clients are uninsured and do not qualify for Medicaid
• Title X clinics provide services free of charge to clients whose incomes do not exceed 100 percent of the federal poverty level and services are offered on a sliding fee scale for clients with incomes up to 250 percent of the federal poverty level.

Title X clinics primarily serve low-income Americans.

How much does Title X cost?

• The program's FY 1999 appropriation of $215 million will enable approximately 4.5 million Americans to receive services at the over 4,400 Title X - funded clinics nationwide.
• Each public dollar spent to provide family planning services saves an average of $3 in Medicaid cost for pregnancy-related and newborn care alone. (Title X and U.S. Family Planning Effort, AGI, 1997)
• Each year, out of 100 typical women who engage in sex without using contraception, 85 will get pregnant. (American Journal of Public Health, April 1995)
• The cost of an uncomplicated vaginal delivery is $6,378 and the cost of delivery through caesarian section is $10,638. (Source Book of Health Insurance Data, Health Insurance Association of America, 1996)

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Family Planning is Cost-effective!

The Need for Title X is Clear

Unintended Pregnancy

• In the United States, almost half of all pregnancies are unintended. Half of unintended pregnancies end in abortion. (AGI, 1998)
• The 10% of American women at risk of unintended pregnancy (those who do not want to be pregnant but are sexually active and fertile) who do not practive contraception account for 53% of all unintended pregnancies. (Institute of Medicine, 1995)
• By the age of 45, American women, on average, will have had 1.42 unintended pregnancies. ("Unintended Pregnancy in the United State," Family Planning Perspectives, AGI, 1998)
• Women spend more than 75% of their reproductive lives trying to avoid pregnancy. (Hope and Realities: Closing the Gap Between Women's Aspirations and Their Reproductive Experiences, AGI, 1995)

Title X service work to lower the incidence of unintended pregnancy.

Teen Pregnancy

• Each year, 1 in 8 women aged 15 to 19 in the United States becomes pregnant, resulting in over half a million births. Two-thirds of these births are unintended. (Contraceptive Technology, Robert Hatcher et al., 1998, pg. 701-702)
• The teenage pregnancy rate in the United States is much higher than in many other developed countries - twice as high as in England and Wales, France and Canada; and nine times as high as in the Netherlands or Japan. (Teenage Reproductive Health in the United States, AGI, 1994)
• Without publicly funded family planning services, an additional 386,000 teens would become pregnant each year, resulting in 155,000 more teen births and 183,000 more teen abortions. (Title X and the U.S. Family Planning Effort, AGI, 1997)
• Over three-quarters of teen pregnancies are unintended. (AGI, 1998)

Title X works to lower the incidence of teen pregnancy.

Sexually Transmitted Diseases

• Family Planning clinics can play a critical role in addressing out national STD epidemic.
• Women bear a disproportionate burden of STD-associated complications, including infertility, ectopic pregnancy, and chronic pelvic pain. Women are particularly vulnerable to STDs because they are biologically more susceptible to certain STD infections than men and are more likely to have asymptomatic infections that commonly result in delayed diagnosis and treatment.
• A conservative estimate of the public and private costs of STD treatment each year in the United States is at least $8.4 billion. (STDs in America: How Many and At What Cost?, Kaiser Family Foundation and ASHA, 1998)
• Half of the ten most frequently reported infections to the Centers for Disease Control and Prevention (CDC) are STDs, including the most common, chlamydia. (CDC, 1998) The prevalence of chlamydia among teenagers often exceed 10% among girls and 5% among boys. (Mertz, CDC, 1998)
• STD infections increase susceptibility to HIV by three to five times. (ASHA, 1998) However, a third of Americans (36%) are not aware that having an STD increases a person's risk of HIV infection. (Kaiser Family Foundation/Glamour magazine survey, 1998)
• At least one in three sexually active people are estimated to have contracted an STD by the age of 24. (STDs in America: How Many Cases and At What Cost?, Kaiser Family Foundation and ASHA, 1998)
• Over one in five Americans over the age of 12 has a herpes infection. The number of people living with herpes, one of the most common incurable STDs, has risen 30 percent since the late 1970s. (New England Journal of Medicine, October 16, 1997)

Family Planning clinics can play a critical role in addressing our national STD epidemic.

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