Graduation Year

2009

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Community and Family Health

Major Professor

Ellen Daley, Ph.D.

Committee Member

Eric Buhi, Ph.D.

Committee Member

Charles Mahan, M.D.

Committee Member

Marilyn Myerson, Ph.D.

Committee Member

Kay Perrin, Ph.D.

Keywords

Reproductive Health, Policy, Public Health, Contraception, Unintended Pregnancy

Abstract

The Title X Family Planning Program (Public Law 91-572), enacted by President Richard Nixon in 1970, provides federal funds for voluntary, confidential family planning services to all women, regardless of their age or economic status. This federal legislation aspired to prevent unintended pregnancies and poor birth outcomes to those in most need. However, over the past three decades, Title X has faced political, financial and social challenges. Despite its enormous success in improving the health and well-being of women and children by decreasing unintended pregnancies, the need for abortions and providing key comprehensive preventive services, without a newfound political will similar to that during which it was conceived, the future of Title X may be in jeopardy.

This study grounded theoretically and methodologically in a feminist policy analysis approach, critically examined the maturation of Title X by employing a mixed methodology design that consisted of a thematic analysis on Title X's legislative history and the conduction and analysis of oral histories. In Phase I, themes were extracted from the federal bills included in Title X's legislative history, which assisted in the identification of the issues that this policy has endured. In Phase II, a semi-structured interview guide was developed based upon the themes and findings from the thematic analysis as well as from pre-determined constructs from McPhail's Feminist Policy Analysis Framework, to explore key informants' perceptions, recollections and experiences regarding the Title X program. By examining Title X through a feminist lens, various issues were exposed and critically examined, including issues that are typically ignored by traditional policy analyses. Moreover, understanding the historical underpinnings and evolutions of a policy and recognizing past failures and achievements are necessary in order to make informed future decisions. Implications for research, practice and policy are discussed.

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