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What you need to know about the new Title X restrictions

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When Dr. Tiffany Hailstorks first decided to become an OB/GYN, she didn’t know she was getting into politics. She knew she wanted to help women and that she had an interest in family planning. Since moving to Georgia to work with the Emory Department of Gynecology and Obstetrics Family Planning Division, however, she’s realized that her life’s work also involves navigating a lot of restrictions from conservative lawmakers. For instance, Georgia law states that a woman whose health insurance is covered under the  Affordable Care Act (ACA) cannot receive an abortion unless her life or health is in danger.

“How can you sit here and say, ‘Oh, she’s sick but not that sick to be able to terminate this pregnancy'?" Hailstorks, who’s also a fellow at Physicians for Reproductive Health, told the Women’s Media Center.

Now, thanks to the Title X gag rule that the Trump administration updated on February 22, Hailstorks and her colleagues expect to see a whole new layer of restrictions on the kind of care and advice they can provide to their patients. So, what exactly is the Title X family planning program, and why are health care providers alarmed at what this means for them?

Established under the Nixon administration in 1970, Federal Title X funding allows health care providers to assist low-income patients with reproductive care. In the past, this has meant enabling these professionals to recommend and prescribe birth control to patients and review all of their family planning options, including abortion, with them.

The new restrictions the Trump administration recently made to this funding severely limit the kind of help that physicians can give their patients who need Title X funding to receive care. This means, Hailstorks explained, that she can’t refer those patients for safe and legal abortion. She also can’t discuss her patients’ full options, and receiving birth control or preventative health care at clinics like Planned Parenthood becomes pretty impossible.

“Our biggest concern as providers is just being able to provide our patients with accurate information. I think that this further restricts the patient/provider relationship and it violates our core ethics in health care because we’re not able to provide our patients with evidence-based care due to some of the restrictions around abortion care,” she said.

So how can women get the reproductive health care they need? The answer to this question is the same as the answer to many questions asked since President Trump entered the White House in 2017: Americans have to call their state representatives and tell them that clinics deserve protection and there must be laws that ensure that patient-centered programs can still give their patients the care they need. Healthcare providers need to be on the case, too, Hailstorks added.

“As providers, we need to see what the different organizations are doing, like the American Medical Association, the American College of Obstetricians and Gynecologists, those types of organizations and lobby around what we need to do next. Every phone call, every letter, email, all of those things help,” she said.

Hailstorks knows very well now that her work is entwined with politics and that encouraging people to call their state representatives is as much a part of the job as what she does in the examination room. She knows, too, that what lawmakers say affects the kind of doctor she can be—which is not what you want to hear from the person in charge of your medical care.

“Through medical school and residency, we’re taught to be able to provide the highest quality of care and the most evidence-based methods to be able to have kind of a shared decision-making process with our patients,” she said, while adding that now she “can’t tell them everything” they need to know. “I think that’s hurtful for the patients and harmful ultimately because they’re not aware of what they’re able to even do, mainly because of where they live and what their income is and what they’re insurance is, and that’s just not fair.”



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