HHS Emails Demonstrate Trump Admin Promotes Little-Used Fertility Awareness Method Over Effective Birth Control

Top Healthcare Official Worked With Anti-Birth Control Ideologues


Contact: Michael Clauw, mclauw@campaignforaccountability.org, 202.780.5750

WASHINGTON, D.C. – Today, Campaign for Accountability (CfA), a nonprofit watchdog group focused on public accountability, released communications from the U.S. Department of Health and Human Services (HHS) revealing a top healthcare official, Deputy Assistant Secretary for Population Affairs Dr. Diane Foley, repeatedly communicated with abortion opponents to promote so-called natural family planning methods over hormonal or contraceptive birth control. Ironically, Dr. Foley oversees the Title X family planning program, which is congressionally mandated to provide comprehensive family planning and affordable access to birth control. Further, 99% of sexually active women use non-fertility based methods and seven out of ten Americans believe the federal government should be providing birth control for low-income women.

Click here to view the documents.

CfA Counsel Alice Huling said, “The Trump administration is determined to promote little-used, cumbersome, and less effective birth control methods at the expense of proven contraceptives preferred by the vast majority of Americans. Using the guise of semi-scientific language and studies, HHS is putting ideology ahead of public health. Congress should investigate whether HHS is improperly redirecting resources intended to help Americans plan when and how to have a family.”

Through FOIA litigation, CfA obtained Dr. Foley’s communications with several anti-choice groups including Focus on the Family, Live Action, Family Research Council, and the Heritage Foundation. The emails reveal clear coordination in molding the agency’s policies including the promotion of Fertility Awareness-Based Methods (FAMBs). In one series of emails, Dr. Foley collaborated with HHS colleagues and administration officials Katelyn Walls and Shannon Royce to promote the use of fertility awareness smartphone apps as a method of birth control after the three met to discuss partnering to engage faith-based partners. The apps help users track menstruation and ovulation using body fluids and temperatures, algorithms, and menstrual cycle history, to alert sexually active users whether they are fertile and should avoid sexual activity. Communications between Dr. Foley and others referred to the use of these apps as “science-based” and “evidence-based” methods of family planning, yet there is still no clear scientific consensus on the efficacy of FABMs. A 2018 study concluded that pregnancy rates and probabilities varied across different FABMs and even in the same FABM method, finding them considerably less reliable than hormonal and other contraceptive methods.

Dr. Foley also worked with anti-choice groups on a variety of other issues. In one email, HHS official Laura Trueman arranged a private conference call for representatives from The Susan B. Anthony List, the United States Conference of Catholic Bishops, March for Life, National Right to Life, and the Family Research Council. The email explicitly warned recipients not to “alert other groups or Hill staff to our call.” In a separate email, a representative from the anti-choice group Focus on the Family thanked Dr. Foley for her help in “fill[ing] the room with the right people” for one of Focus on the Family’s upcoming events.

Emails show numerous communications between Dr. Foley and Brian Gottstein, Chief Communications Officer and Head of Government Relations at Live Action. Mr. Gottstein asked Dr. Foley several questions about Title X subgrantees’ requirements under the new Title X rule, including whether individual subgrantees would be required to promote FABMs and whether subgrantees could be co-located on a church property. Dr. Foley clarified that HHS’s new rule only prohibited subgrantees’ co-location with facilities providing abortions, not with churches. Live Action has a history of dangerous anti-abortion extremism and is known for creating deceptively edited videos taken at Planned Parenthood clinics over the last decade.

CfA has previously questioned Dr. Foley’s management at HHS. In March 2019, HHS awarded $1.7 million in Title X funding to the Obria Group, which operates a network of crisis pregnancy centers that fail to provide contraceptive choices to its patients, including oral contraceptives, or even condoms. In December 2019, CfA submitted a letter to Dr. Foley and HHS Secretary Alex Azar detailing how Obria lied on its Title X application and mismanaged its grant award. HHS has yet to hold Obria accountable.

Click here to read more about Obria.

Ms. Huling continued, “The documents reveal a concerted and ongoing effort by Dr. Foley and other Trump administration officials to push an ideology out of step with most Americans, and contrary to the goals of the congressionally-approved Title X program. Despite rhetoric to the contrary, these emails prove the administration isn’t just anti-abortion, it’s anti-contraception.”

Campaign for Accountability is a nonpartisan, nonprofit watchdog organization that uses research, litigation, and aggressive communications to expose misconduct and malfeasance in public life and hold those who act at the expense of the public good accountable for their actions.