NEJoM on cutting family planning in TX

While I find it highly unfortunate that Texas has cut funding for family planning, it is a good opportunity to learn what the effects will be in the future.  This article was pretty interesting, by the New England Journal of Medicine.

http://www.nejm.org/doi/full/10.1056/NEJMp1207920?query=featured_home&&&

"In addition, as more women are steered toward contraceptive pills, they are being provided with fewer pill packs per visit, a practice that has been shown to result in lower rates of continuation with the method and that may increase the likelihood of unintended pregnancy — and therefore that of abortion."

I can't stress the above point enough.

Also: 

Ostensibly, the purpose of the law was to defund Planned Parenthood in an attempt to limit access to abortion, even though federal and state funding cannot be used for abortion care anyway. Instead, these policies are limiting women's access to a range of preventive reproductive health services and screenings. Disadvantaged women must choose between obtaining contraception and meeting other immediate economic needs. And, as one of our interviewees pointed out, providers are put in the position of “trying to decide, out of the most vulnerable, who is the most, most vulnerable.” Moreover, the impact of these policies is not limited to Planned Parenthood; other organizations have had to close clinics, reduce hours, and lay off dedicated, experienced staff members. We are witnessing the dismantling of a safety net that took decades to build and could not easily be recreated even if funding were restored soon.

Time will reveal the full effects of these budget cuts on the rates of unintended pregnancies and induced abortions and on state and federal health care costs. Already, the legislation has created circumstances that force clinics and women in Texas to make sacrifices that jeopardize reproductive health and well-being. This unfortunate situation does offer an opportunity to compare outcomes such as contraceptive use, unintended pregnancy, and abortion in Texas and other states, such as California, that have less restrictive family planning policies. Such comparisons could provide important information about the impact of these policies. Debates about funding in Congress and in other states should consider the results of such research and take a hard look at the implications for women, families, and communities of restricting access to contraception.