Texan primary care providers face challenges filling the family planning gap

Proponents of cutting public funding to Planned Parenthood and other reproductive health providers often argue that other clinics can step in. But research from ANSIRH, University of Texas at Austin and University of Alabama at Birmingham shows that providing family planning care to patients without the participation of established women’s health organizations presents serious challenges.

Researchers interviewed participating organizations in a Texas program designed to integrate primary care and family planning. Four major themes emerged:

• Limited capacity to expand family planning services. The director of a public health organization in an area where Planned Parenthood had closed told researchers, “There was a big learning curve there, and honestly, we got very, very little guidance.” Another primary care contractor said they weren’t ready to serve family planning patients until several months after funding began. Primary care providers often lacked training to provide intrauterine devices (IUDs) or contraceptive implants.

• Inability to reach family planning patients. Many primary care providers reported that they served fewer family planning patients than expected in the first year of funding. Some did not have funding for advertising or other outreach and focused on enrolling existing patients in family planning services. This is in line with previous research that shows that many women stopped receiving care after Planned Parenthood closures.
• Commitment needed to integrate primary care and family planning. Primary care providers cited having to make a “philosophical shift,” and often needed additional staff training in areas like contraceptive needs and intimate partner violence. Some providers felt that their patients’ primary care needs were so extensive that there wasn’t time to address family planning.
• Inconsistent approach to providing contraception. Women’s health organizations more often used evidence-based protocols for contraception. One-third of primary care contractors reported that they did not prescribe IUDs to teens or women who hadn’t had children – an out-of-date approach. Some required medically unnecessary tests for sexually transmitted infections, requiring women to make 2 or 3 visits to get an IUD.

This experience in Texas foreshadows challenges that would arise should federal family planning funding for Planned Parenthood end. In order to ensure low-income women get the care they need, publicly funded programs should continue to support a diverse network of providers, including organizations that specialize in family planning.