Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence

White, Mark; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E.

doi:10.1111/1475-6773.12783

Cited by 18 publications

(15 citation statements)

References 18 publications

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“…Long‐acting methods are particularly difficult for smaller private clinics to provide because of high up‐front costs, poor reimbursement rates and costs of training staff in insertion . Among clinics that do provide the full range of methods, many do not offer same‐day insertion of IUDs and implants . Requiring women to attend a follow‐up visit to obtain their desired method is a known barrier to postpartum contraceptive use .…”

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confidence: 99%

“…Requiring women to attend a follow‐up visit to obtain their desired method is a known barrier to postpartum contraceptive use . Challenges with patient scheduling and clinic visit flow, as well as medically unnecessary delays (such as when providers require a visit to test for STDs prior to an IUD placement visit), are reasons clinic staff give for not providing same‐day insertion …”

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confidence: 99%

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Low‐Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit

Coleman‐Minahan

Dillaway

Canfield

et al. 2018

Perspect Sexual Reproductive

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CONTEXT: Early access to contraception may increase postpartum contraceptive use. However, little is known about women’s experiences receiving their desired method at the first postpartum visit or how access is associated with use. METHODS: In a 2014–2016 prospective cohort study of low-income Texas women, data were collected from 685 individuals who desired a reversible contraceptive and discussed contraception with a provider at their first postpartum visit, usually within six weeks of birth. Women’s experiences were captured using open- and close-ended survey questions. Thematic and multivariate logistic regression analyses were employed to examine contraceptive access and barriers, and method use at three months postpartum. RESULTS: Twenty-three percent of women received their desired method at the first postpartum visit; 11% a prescription for their desired pill, patch or ring; 8% a method (or prescription) other than that desired; and 58% no method. Among women who did not receive their desired method, 44% reported clinic-level barriers (e.g., method unavailability or no same-day provision), 26% provider-level barriers (e.g., inaccurate contraceptive counseling) and 23% cost barriers. Women who used private practices were more likely than those who used public clinics to report availability and cost barriers (odds ratios, 6.4 and 2.7, respectively). Forty-one percent of women who did not receive their desired method, compared with 86% of those who did, were using that method at three months postpartum. CONCLUSION: Ameliorating the various barriers that postpartum women face may improve their access to contraceptives. Further research is needed to improve the understanding of clinic- and provider-level barriers.

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confidence: 99%

mentioning

confidence: 99%

Low‐Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit

Coleman‐Minahan

Dillaway

Canfield

et al. 2018

Perspect Sexual Reproductive

Self Cite

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“…Additionally, we did not interview staff from all organizations that received Title X or state family planning funds, and there may have been more variation in practices than we identified. However, our sample included diverse providers from across the state that received the majority of family planning funds [10], and these practices likely reflect the service environment for many Texas women. Finally, many Title X-funded organizations in Texas that received state family planning funds operated in a hybrid policy environment in which options counseling was expected and contact information for abortion-specific providers could be provided, but active referrals were not permitted.…”

Section: Discussionmentioning

confidence: 99%

“…In a qualitative study of publicly funded family planning providers in Texas, we explored how organizations implemented or expanded family planning services after the state reorganized its family planning programs and recruited primary care organizations into the provider network following the exclusion of Planned Parenthood [10]. Fully state-funded and administered family planning programs included the Expanded Primary Health Care program that aimed to integrate family planning and primary care services, the fee-for-service Texas Women’s Health Program and the state’s Family Planning program.…”

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confidence: 99%

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Counseling and referrals for women with unplanned pregnancies at publicly funded family planning organizations in Texas

2019

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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.

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The Valley as the Border, the Border as a Dangerous, Faraway Place

Fleuriet

2021

Rhetoric and Reality on the U.S.—Mexico Border

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Providing Family Planning Services at Primary Care Organizations after the Exclusion of Planned Parenthood from Publicly Funded Programs in Texas: Early Qualitative Evidence

Abstract: Many primary care organizations in Texas initially lacked the capacity to provide evidence-based family planning services that women's health organizations already provided.

Cited by 18 publications

References 18 publications

Low‐Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit

Low‐Income Texas Women's Experiences Accessing Their Desired Contraceptive Method at the First Postpartum Visit

Counseling and referrals for women with unplanned pregnancies at publicly funded family planning organizations in Texas

The Valley as the Border, the Border as a Dangerous, Faraway Place

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