West Virginia women can’t afford another barrier to basic healthcare

by Ellen Allen. Originally published July 22, 2026 in West Virginia Watch.

 

For decades, women in West Virginia have learned to make do with less.

Less access to healthcare. Less access to specialists. Longer drives to appointments. Higher rates of chronic illness. Fewer maternity providers. More hospital closures. More counties where getting routine reproductive care requires taking time off work, arranging childcare, and traveling hours across the state.

Now, another vital piece of that fragile healthcare system is under threat.

The Trump administration’s proposed overhaul of the federal Title X family planning program would fundamentally change a program that has quietly helped millions of Americans — including thousands of West Virginians — access basic preventive healthcare for more than 50 years.

Despite what many people assume, Title X is not an abortion program. Federal law has prohibited Title X funds from being used for abortion services since the program was created in 1970.

Instead, Title X provides affordable birth control, cancer screenings, sexually transmitted infection (STI) testing and treatment, infertility counseling, and preventive reproductive health care for people who are uninsured or underinsured. For many women, especially in rural communities, a Title X clinic is the only place they receive routine healthcare.

That matters enormously in West Virginia. Our state consistently ranks among the poorest in the nation. We have one of the oldest populations, some of the highest rates of chronic disease, and significant shortages of primary care physicians and OB-GYNs. Many counties have little or no maternity care at all. For thousands of women, preventive care isn’t simply inconvenient — it’s increasingly inaccessible.

Rather than strengthening that safety net, the administration wants to redefine Title X’s mission.

Instead of focusing primarily on helping people prevent unintended pregnancies and make informed family planning decisions, the program would prioritize increasing births through fertility awareness education, natural family planning methods, marriage counseling, and broader efforts to encourage family formation.

There’s nothing wrong with helping people who want to become parents. In fact, West Virginia desperately needs stronger supports for families who choose to have children. But encouraging childbirth is not the same thing as helping women stay healthy.

Women need cancer screenings whether they’re planning a pregnancy or not. They need STI testing whether they’re married or single. They need reliable contraception if they’re trying to finish school, recover from a difficult pregnancy, manage a chronic illness or simply decide that now is not the right time to have another child.

Those needs don’t disappear because federal priorities change. The irony is difficult to ignore. If policymakers truly want more families to choose parenthood, they should ask why so many young people hesitate.

In West Virginia, the answers are obvious.

Childcare is expensive and difficult to find. Rural hospitals continue to struggle financially. Maternal health outcomes remain among the nation’s worst. Mental health services are scarce. Too many communities lack obstetric providers. Families worry about housing, wages, transportation and whether they’ll be able to access prenatal care close to home.

Those are the barriers keeping many people from expanding their families — not access to contraception. Research consistently shows that people are more likely to have children when they feel economically secure, have access to affordable healthcare, and know they’ll receive quality care before, during, and after pregnancy.

Taking away preventive reproductive health services doesn’t solve those problems. It creates new ones. We’ve seen this before.

During the first Trump administration, restrictions placed on Title X caused many clinics nationwide to leave the program, reducing access to contraceptive care and preventive services for hundreds of thousands of patients. If similar disruptions occur again, states like West Virginia — with fewer providers and fewer alternatives — will likely feel the effects more acutely than wealthier, more urban states.=

Women who lose access to affordable contraception won’t suddenly gain access to childcare, paid leave, stable housing, or high-quality prenatal care. They’ll simply have fewer options. And those with the fewest resources will pay the highest price.

West Virginia has spent years trying to improve maternal health, expand rural health services, and reduce infant mortality. Community organizations, health systems, and policymakers across the political spectrum have recognized that healthier mothers lead to healthier babies and stronger families.

Weakening one of the nation’s most successful preventive health programs moves us in the opposite direction.

This isn’t about politics. It’s about whether women can receive affordable cancer screenings before disease becomes deadly. Whether a young woman in McDowell County can obtain birth control without driving across multiple counties. Whether a mother recovering from a difficult pregnancy can safely space her next pregnancy. Whether a woman struggling with infertility can receive counseling alongside comprehensive reproductive health care. Those are deeply personal decisions that should remain between patients and their health care providers.

West Virginia women deserve more healthcare choices, not fewer.

If we truly value healthy families, we must start by ensuring women have access to the full range of preventive reproductive health services they need — not just the ones that fit a changing political agenda.

Healthy families begin with healthy women. And healthy women deserve better than another barrier to basic care.