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Fragmentation and reproductive freedom: federally subsidized family planning services, 1960-80.

N Aries

Department of Health Care Administration, Baruch College, Mt. Sinai School of Medicine, City University of New York, NY 10010.

This paper analyzes the evolution of the federal family planning program from 1960 to 1980. Political pressure to offer family planning raised the question how best to organize services. Long-standing providers preferred a categorical approach in order to maintain a diverse political coalition for an historically invisible service. In addition, categorical funding meant financial support for non-traditional providers. A compelling argument was also made for service integration. Given an expanded definition of health and the medicalization of contraceptive technology, the health delivery system presented itself as the appropriate service provider. Neither group prevailed. By 1980, federally supported family planning services were provided in autonomous clinics but also were integrated into existing maternal and child health programs. The debate continues but, under the Reagan Administration, terms and motivations differ from those of the past.