Availability of Services Related to Achieving Pregnancy in U.S. Publicly Funded Family Planning Clinics

Abstract

Background: Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods: A nationally representative sample of publicly funded clinics was surveyed in 2013-2014 (n ¼ 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results: Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42-1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01-1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01-1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40-0.74) and primary care services (aPR, 0.74; 95% CI, 0.68-0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions: The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.