Imagine a young woman sitting in a family planning clinic and facing an unintended pregnancy. Perhaps she has a limited support system or is struggling financially. Maybe she already has children. She may be nervous or confused.  Did she have a hard time getting time off from work or arranging childcare for today’s appointment? Did she struggle to find a ride to the clinic?

This patient has decided continuing this pregnancy is not best for her and asks her health care provider – someone she trusts to give clear, unbiased information – for an abortion referral. Under the Domestic Gag Rule, the provider can’t give this young woman a straight answer.

That’s not how we do things at Maine Family Planning.

And that is why, on July 16, we announced our withdrawal from the Title X National Family Planning Program after almost 50 years overseeing the program in Maine.

MFP was established in 1971, soon after the bipartisan creation of Title X, to administer the newly created family planning system in Maine. Title X dollars support the provision of affordable birth control and other sexual and reproductive health services through a network of 50 health care sites statewide. Title X has contributed to many public health successes in Maine, including low teen pregnancy rates and the highest rate of contraceptive use among those at risk of unintended pregnancy in the nation.

At MFP’s 18 clinics and with partners like Planned Parenthood of Northern New England and community health centers, we serve more than 23,000 low-income Mainers each year. Many of them are uninsured or underinsured. The majority qualify for free or reduced-fee services. Title X helps keep Mainers healthy and more economically secure.

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But the U.S. Department of Health and Human Services wants to fundamentally undermine Title X by imposing medically unjustified rules that get between patients and providers, all because of political ideology. Collectively, these changes are known as the Domestic Gag Rule because they restrict the way medical professionals can speak to their patients about abortion care. And, under a separate provision of the rule, health care providers like MFP would lose critical Title X funding because we also separately provide abortion care at our 18 clinics statewide.

The rule is yet another salvo by the Trump-Pence administration against poor people, those who live in rural communities, and Mainers who already struggle to access compassionate health services.

Under the Gag Rule, our patient who asked for an abortion referral would be handed a list of providers — some that provide abortion, some that do not. The clinician is barred from specifying which is which. Meanwhile, a referral for prenatal care would be required. This scenario violates medical ethics and standards of care, making it an unacceptable option for our expert providers, who are barred from coercing or withholding information from patients.

We refuse to comply with the Gag Rule, but we are committed to preserving Maine’s robust and successful family planning network. Our top priority is our patients – those who need and deserve evidence-based, unbiased care in their communities.

To them, we say: Our doors are open and we are here for you.

For now, MFP is supporting the system with funding from our limited reserves. This is only a short-term solution. Just as we pursued every avenue to block the Gag Rule, we are doing everything we can to maintain health care access for women and families in our state without any interruption in service or clinic closures.

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That means working to secure alternative sources of public funding as well as urging state and federal lawmakers to protect reproductive health in Maine and nationwide. This is a public health imperative.

Earlier this year, MFP sued the Trump-Pence administration to block the Gag Rule. That case is ongoing. We maintain the beliefs put forth in our motions, namely that the rule is unconstitutional and would inflict harm on Mainers by wreaking havoc on the statewide reproductive health network.

We may have withdrawn from Title X, but our commitment to our patients is unwavering.

 

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