Planned Parenthood’s Adoption “Gag Rule”

by Casey Mattox:

Concerned about the prospect of taxpayer funded counselors steering women toward abortion, the Reagan Administration issued what its critics called a “gag rule,” prohibiting options counselors under Title X from referring women for abortions. Planned Parenthood and others challenged the rule, claiming that it prevented women from receiving full and unbiased information about all of their options. Although the Supreme Court upheld it in Rust v. Sullivan, the “gag rule” was one of the first to be repealed when President Clinton took office. However, it appears that a “gag rule” has reemerged –  as Planned Parenthood works to steer women toward the one option that is financially beneficial to Planned Parenthood, abortion.

Silence Pro-LifeIn 2010, according to its own numbers, for every 391 women who came to Planned Parenthood looking for unbiased information her unplanned pregnancy, 1 chose adoption and 391 chose abortion. And even those numbers may be inflated because former Planned Parenthood clinic directors tell me that there is no reporting system for adoption referrals and they never saw one. In the nation as a whole, there are roughly 1.1 million abortions and 160,000 adoptions every year. If Planned Parenthood’s numbers are subtracted from the equation, there is approximately 1 adoption for every 5.7 abortion decisions. Why is a woman coming to Planned Parenthood 6800% more likely to decide to abort than the general population? And what does it mean for Title X options counseling that its largest single grantee for supposedly nondirective counseling has such a track record?

Although the “gag rule” was repealed in 1993, new Title X regulations to replace it were not issued until the last days of the Clinton Administration in 2000. Almost everyone believes that under these rules a counselor must give pregnant women unbiased and nondirective counseling about all of her options, including adoption. That is a myth. Planned Parenthood brings in over 25%, the largest single share of the $300 million in taxpayer funds under Title X options counseling. Here are its instructions:

5.  A project must:

i.  Offer pregnant women the opportunity to provided information and counseling regarding each of the following options:

A.  Prenatal care and delivery;

B.   Infant care, foster care, or adoption; and

C.   Pregnancy termination.

42 C.F.R. 59.5(a)(1). That’s right. Look at the conjunctions again. If a woman walks into a Planned Parenthood clinic to talk to a taxpayer funded counselor about the full range of her options, that counselor is required by law to tell her about abortion. But information about the possibility of adoption is optional. Would it surprise you to know that Planned Parenthood supported that rule?

And if Planned Parenthood’s taxpayer funded counselors do give a woman information about adoption, what might they tell her? Probably something like this, posted on Planned Parenthood’s website:

The psychological responses to abortion are far less serious than those experienced by women bringing their unwanted pregnancy to term and relinquishing the child for adoption.

Women who relinquish their child for adoption are at risk for long-term grief that can have physical, psychological, and relational repercussions. While this response is comparable to that of losing a child through death, the grieving response post-adoption is often more symptomatic and can be chronic in nature.

The same website instructs that “[r]esearch studies indicate that emotional responses to legally induced abortion are largely positive.” Between silence and telling women that adoption will be emotionally devastating while abortion is quick and easy, is it any surprise that women coming into Planned Parenthood clinics almost never choose adoption?

So far I have shown that women coming to Planned Parenthood for supposedly neutral advice have a disturbingly high likelihood of choosing abortion – almost never choosing adoption. And we have a regulatory structure that permits Planned Parenthood to take taxpayer funds and use them to steer woman toward abortion and away from adoption through silence and abortion-skewed information. The motive is probably obvious.

Planned Parenthood has total annual revenues of just over $1 billion. But its health center income, the amount its individual affiliates bring in from services, was roughly $400 million in 2009. According to the Guttmacher Institute, an average abortion costs $468. Given Planned Parenthood’s approximately 330k abortions, it brought in approximately $155 million from abortion revenues, about 38% of its total health center revenues, in 2009. Depending on how one counts Planned Parenthood’s numbers that percentage of health center revenues attributable to abortion may have been higher in 2010 and 2011.

Planned Parenthood made $0 from its relative handful of supposed adoption referrals. As former Planned Parenthood director Abby Johnson explains, unlike abortion, adoption is not “revenue generating.”

At this point one might object to all of this and point out that it should not be surprising that women going to Planned Parenthood for advice about their pregnancy end up having abortions at such an alarming rate. Despite the organization’s name, its denials of the prominent place of abortion in its revenue stream, and its promises of neutral and unbiased counseling, maybe women do know what they’re getting and come to Planned Parenthood already planning to have an abortion. Maybe the word has gotten out and women understand that Planned Parenthood is not really an all-options women’s health organization but is instead the world’s leading abortionist. Maybe.

But if that is true, why should Title X taxpayer funds intended to help undecided women know about all of their options be spent on counseling where the outcome is such a fait accompli? That is an excellent question for Congress.


NOTE: Casey Mattox will be presenting at a briefing on Capitol Hill tomorrow, September 10 at noon on Promoting the Adoption Option: Myths, Obstacles and Solutions in Rayburn, Room 2325. The briefing is open to the public.

Casey Mattox is senior counsel with Alliance Defending Freedom.


  1. Patrice Woodworth says:

    #1 congress would not be able to answer that question……they cannot answer yes and no questions.

    #2 For all purposes please stop referring to P.P. as ‘clinic’ and/or “health center”

  2. Many important points made in this article. Unfortunately, its credibility will be marred by what appears to be bad math. “1 chose adoption” + “391 chose abortion” = 392, not “391 women who came to Planned Parenthood looking for unbiased information”. Or maybe it should read 1 + 390 = 391. Either way, the numbers are incorrect as presented.
    Also 5.7 abortions for every 1 adoption equals 912,000 abortions for every 160,000 adoptions. The figure that includes PP referrals is 1,100,000 for every 160,000, which represents a figure of women approximately 120.6% “more likely to decide to abort than the general population”, not 6,800% – how did you arrive at this percentage?
    My second observation is that no matter how appealing it is to consolidate political power through forming alliances under the guise of a good cause, God does not require it to do His works, and actually call us to separate from heresy. Alliance Defending Freedom supports ecumenism and yoking together with heretical individuals and institutions including the Catholic church, whose many heresies include idol, Mary and Pope worship.

    • Please see my comment below.

    • See… the problem you have is that you are trying to examine actual facts about abortion. Everyone knows that abortion is ACTUALLY a debate over who can call the other side more evil the loudest.

      In reality, the “X% of pregnant women at PP get abortions but only Y% get adoption referrals” followed by “this is true by PP’s own report” has never used valid statistical methods because the data to do so either doesn’t exist or would be tied up in HIPPA. In fact, PP does not keep track of the number of pregnant women seen because they do not necessarily test every women who comes in the door. Additionally, women who go to PP are subject to a self selection bias (that is, plenty of them have decided to get an abortion and know PP is a place they can get one more safely than other alternatives). As a result, we know nothing about the actual impact that PP has on abortion rates.

    • Angela, interesting that you start your comment complaining about unfactual information and then end with your final accusation which is untrue. I don’t know where you got your “facts” but it was not from the Catholic church. I invite you to investigate at the source. Check the actual church teachings in the ‘Catechism of the Catholic church’. I applaud your high ideals but encourage you to seek the truth with an open heart led by the holy spirit.

  3. Angela, could you manage to stay to the topic without spewing catholic bigotry and ignorance? Thanks.

  4. Mr. Mattox, why did you feel the need to reverse engineer the numbers on the “amount of money coming in from medical procedures” statistic when it is clearly on page 9 of the report you cited? From that data, it is fairly clear that Planned Parenthood is NOT actually making a profit from medical procedures and, in fact, makes very little profit at all (a scant $9.7m on a $960m operating budget). For the “PP profits from abortion” angle to make any sense you would have to assume that the abortion profits subsidize other procedures they provide and they do a lot of those other procedures and/or the margin on abortions is incredibly small. This, of course, begs the question: Why would PP do all of these other procedures which are not profitable when they are motivated by money and abortion is where the real money lies? Certainly as someone who believes in the free market, you would have to conclude this is a bad business model regardless of the ethics involved. Why wouldn’t all of these people jump ship to make more money elsewhere and save themselves the hassle of dealing with all of the controversy around abortion?

    Perhaps, and I’m just throwing this out there, your analysis of the Planned Parenthood business practice is deeply flawed and is based more on your need to cast them as evil profit seeking baby killers (wait… is this an anti-corporate screed? Is socialism okay when it serves your needs?). It would, of course, be troublesome if the people who ran PP were rational people acting according to their own ethical beliefs. If that were the case then we might actually have to work together to find ways to reduce abortions instead of just claiming to have a moral high ground… but that’s hard work. We can’t have that.

  5. Chairman Mao's Adoption Emporium says:

    “The motive is probably obvious. Planned Parenthood has total annual revenues of just over $1 billion. But its health center income, the amount its individual affiliates bring in from services, was roughly $400 million in 2009.”

    Curious argument to make in a capitalist society that it’s wrong to make a profit off of something.

  6. @ Sean and Maija – I was born and raised a Catholic and even performed as an altar server so my knowledge of Catholicism is first-hand. Having been a Catholic, my comment was not based on bigotry, nor ignorance. I stand by the validity and veracity of my statements. I respectfully ask you to prayerfully consider it, and look into the matter for yourselves.
    Concerning my questions for Casey regarding the calculations presented in the article, I asked them for clarification purposes, and NOT in defense of Planned Parenthood.
    @ Chairman Mao’s Adoption Emporium – should economics override ethics? Should capitalism allow for profiting off of manipulation, bloodshed and the destruction of life?

    • Chairman Mao's Adoption Emporium says:

      Uh, in a capitalist society, what other ethic is there? Your question is as nonsensical as asking “Should gravity push things down?”

  7. Thirty seven years ago I went to Planned Parenthood just for a pregnancy test. When they came in to tell me the test was positive the next question was did I want information for an abortion. I replied with an insulted attitude and voice that I didn’t come there to learn how to kill my baby. He will soon be 37 yrs. old. Boy am I glad he’s mine.

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