Women's Experiences Seeking Publicly Funded Family Planning Services in Texas

Abstract

CONTEXT Little is known about low-income women’s and teenagers’ experiences accessing publicly funded family planning services, particularly after policy changes are made that affect the cost of and access to such services. METHODS Eleven focus groups were conducted with 92 adult women and 15 teenagers in nine Texas metropolitan areas in July–October 2012, a year after legislation that reduced access to subsidized family planning was enacted. Participants were recruited through organizations that serve low-income populations. At least two researchers independently coded the transcripts of the discussions and identified main themes. RESULTS Although most women were not aware of the legislative changes, they reported that in the past year, they had had to pay more for previously free or low-cost services, use less effective contraceptive methods or forgo care. They also indicated that accessing affordable family planning services had long been difficult, that applying and qualifying for programs was a challenge and that obtaining family planning care was harder than obtaining pregnancy-related care. As a result of an inadequate reproductive health safety net, women experienced unplanned pregnancies and were unable to access screening services and follow-up care. Teenagers experienced an additional barrier, the need to obtain parental consent. Some women preferred to receive family planning services from specialized providers, while others preferred more comprehensive care. CONCLUSION Women in Texas have long faced challenges in obtaining subsidized family planning services. Legislation that reduced access to family planning services for low-income women and teenagers appears to have added to those challenges.

Unmet demand for short-acting hormonal and long-acting reversible contraception among community college students in Texas

“…These categories and the contraceptive preference question were developed from previous work with postpartum 24–26 and low-income women in Texas. 27…”

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

“…We used a qualitative approach to explore in depth the strategies that organizations used to implement or expand their family planning program. The interview guide was based on known gaps in family planning services that followed the 2011 funding cuts, as well as potential challenges to offering contraception at primary care organizations that have been noted in other studies (Akers et al 2010;Beeson et al 2014;Hopkins et al 2015;White et al 2015). Specifically, the interviews explored how organizations began offering services through the EPHC program, the range of reproductive health services offered on-site or by referral, protocols for providing contraception that were informed by the U.S. Medical Eligibility Criteria for contraception (Centers for Disease Control and Prevention 2010), other sources of funding for women's health care (e.g., Title X, the state's Family Planning program, and the state-funded fee-for-service Texas Women's Health Program [TWHP]), and approaches to address family planning clients' primary health care needs; we also asked new primary care contractors about any family planning services offered prior to receiving EPHC funds.…”

Short Interpregnancy Intervals: Results from the First Baby Study

“…Access to LARC services likely played a substantial role because these data were collected before the contraceptive provisions in the Affordable Care Act, and because, at the time of data collection, Pennsylvania Medicaid did not provide reimbursement for immediate postpartum LARC insertion (American College of Obstetricians and Gynecologist, n.d.). Other studies have also documented the relationship between access barriers and LARC use (Hopkins et al, 2015;Potter et al, 2014;Potter et al, 2016).…”