Following Title X guidelines for unintended pregnancies in South Carolina

Background/significance: Approximately 51% of 6.6 million US pregnancies are unintended (mistimed/unwanted). For South Carolina, the rate is 56%.  Low income women have higher rates; these women often use Title X family planning services. Title X programs have required guidelines regarding unintended pregnancies, giving unbiased information on three options: adoption, parenting, or termination, and referrals upon request. In practice, there appears to be confusion about what providers can and cannot say in Title X programs.     

Objective/purpose: To develop a training program on the Title X guidelines, providing clear explanations and tools to help health providers offer full options counseling within the bounds of Title X. 

Methods: The training program was client-focused, promoted active listening, teaching ways to do options counseling, and a simple acronym--women must ACT when faced with an unintended pregnancy—Adoption, Carry and Parent or Terminate. They were given a one-page protocol with Title X rules, plus a resource list for referrals. 102 participants were trained and did post-test surveys across 8 sites; a subset (33) completed follow-up surveys.   

Results:  Over 90% of post-test surveys were positive about the training. In follow-up, over 80% reported continued enthusiasm for training content. Participants improved their ability to provide non-biased options counseling and referrals. The state office reworked their directives to comply with Title X guidelines.     

Discussion/conclusions: Trainings were warranted as several participants thought it was illegal to mention termination as an option. Trainings helped the state with Title X compliance and fulfilled their grant objective of a more competent workforce.