Emily Nestler, attorney for Maine Family Planning, and George Hill, president and CEO of Maine Family Planning, talk to reporters outside the federal building in Bangor in this April 24, 2019, file photo after a hearing on a motion requesting a preliminary injunction to stop a Trump administration rule that would limit what heath care providers can tell pregnant patients about abortion services. Credit: Gabor Degre

It all starts with family planning.

That conviction guided family planning pioneers to help establish and secure state funding for Maine’s family planning network nearly 50 years ago, at a time when access to birth control and other sexual health services was extremely limited, in Maine and nationwide.

It’s a statement that rings true today.

Family planning care — contraception, testing and treatment for sexually transmitted infections, cancer screenings and more — empowers people to pursue their educational and career goals, to follow their dreams and to build families when and if they are ready to do so. People with convenient, affordable access to these specialized services experience more economic security and better health outcomes. Do we want healthy communities, robust economic development and personal autonomy?

If so, we must start by investing in Maine’s family planning network, which now serves 23,000 patients a year at health centers from Fort Kent to Sanford, from Rumford to Calais.

This network, which has achieved great gains, grew out of a bipartisan commitment to family planning — a proud legacy that’s now at risk.

The Title X National Family Planning Program was enacted in 1970, with broad bipartisan support under President Richard Nixon. In his signing statement, Nixon himself said it was “noteworthy” that actors from both political parties came together to ensure all people had access to high-quality family planning services, even if they couldn’t afford them.

Soon after, a small group of visionary Mainers established a way to deliver those services widely and efficiently throughout our large and rural state. They understood that facilitating access to family planning services was one of the best ways to increase economic security for all Maine people.

The result was the organization now known as Maine Family Planning, which served until last August as the Title X grantee for the state of Maine, administering federal family planning funds throughout a network of providers that today reaches patients across Maine.

In the early days, in bad weather, providers sometimes delivered birth control pills by snowmobile. In warmer months, outreach workers would be sure to knock on the doors of houses where cloth diapers hung from clotheslines.

More recently, I heard that staff at Presque Isle Family Planning made calls after a snowstorm to let patients know the parking lot was slippery. Family planning providers don’t just serve local communities; they are a part of them.

Over 49 years, this network has helped Mainers take control of their reproductive freedom and futures. Where Maine once had one of the highest teen pregnancy rates in the country, we now have the sixth lowest in the nation. Maine boasts the highest rate of effective contraceptive use among people at risk of unintended pregnancy in the United States.

From teens able to access confidential, trustworthy contraceptives to women able to control the number and spacing of children (and, therefore, their lives) to people who rely on their local provider for gender-affirming, high-quality, non-judgmental care, the family planning program has benefited so many of us. As a mom and a feminist, I am proud to know that Maine has always valued this patient-centered, forward-looking care.

Last year, Maine Family Planning’s board of directors voted unanimously to reject Title X funding due to enforcement of the Trump-Pence administration’s domestic gag rule, which threatened birth control and abortion access and unlawfully interfered in the patient-provider relationship. We did so on behalf of Maine patients, because they need and deserve access to full, timely and medically accurate information, from providers they trust.

As a result, the network faced a funding shortfall of roughly $2 million. Maine Family Planning and its partners in reproductive health have relied on limited reserves and private fundraising to continue meeting immediate patient needs, but now the state must step in to avoid dramatic reductions in access. To prevent clinic closures or cuts to services — and the ensuing negative health outcomes — Maine’s elected officials should pass state House Speaker Sara Gideon’s bill, LD 1613, An Act Regarding Women’s Health and Economic Security.

Bold state leaders knew family planning providers would play a key role in keeping Mainers healthy and secure. Let’s honor their legacy and continue supporting health care that works.

Marcia DeGeer of Damariscotta is president of Maine Family Planning’s board of directors.