According to the World Health Organization (WHO), family planning is defined as “the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility” (working definition used by the WHO Department of Reproductive Health and Research [WHO, 2008]). The importance of family planning is clear from its benefits to individuals, as well as to families, communities, and societies (AGI, 2003). Family planning serves three critical needs: (1) it helps couples avoid unintended pregnancies; (2) it reduces the spread of sexually transmitted diseases (STDs); and (3) by addressing the problem of STDs, it helps reduce rates of infertility.

These benefits are reflected in the federal government’s continued recognition of the contribution of family planning and reproductive health to the well-being of Americans. Responsible sexual behavior is one of the 10 leading health indicators of Healthy People 2010, a set of national health objectives whose goal is to increase the quality of life and years of healthy life. The Healthy People indicators reflect major public health concerns. The United States has set a national goal of decreasing the percentage of pregnancies that are unintended from 50 percent in 2001 to 30 percent by 2010 (HHS, 2000). The objectives for increasing responsible sexual behavior are to increase the proportion of adolescents who abstain from sexual intercourse or use condoms if currently sexually active, and to increase the proportion of all sexually active persons who use condoms.

The 2007–2012 Department of Health and Human Services (HHS) Strategic Plan is intended to provide direction for the Department’s efforts to improve the health and well-being of Americans. The provision of family planning services promotes several HHS goals, including increasing the availability and accessibility of health care services, preventing the spread of infectious diseases (through testing for STDs/HIV), promoting and encouraging preventive health care, and fostering the economic independence and social well-being of individuals and families. The contribution of Title X to these goals is discussed in Chapter 3.1


It should be noted that, despite the clear contributions of family planning to important public health goals, the public varies widely in its attitudes toward family planning and contraception. A large majority (86 percent) of the American public supports family planning services as part of health care for low-income women (where family planning is defined to exclude abortion) (Adamson et al., 2000). However, not everyone wants or believes in birth control. Some believe it should be available for married couples but not for unmarried people or teenagers for fear of encouraging sexual activity. Some religions, notably the Roman Catholic Church, oppose certain methods of contraception, although these strictures often are not followed by their congregants. Recent years have also seen vigorous political debates about emergency contraception (Plan B®), the rights of providers to refuse to offer care that

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